You can’t depend on your medical aid plan to ensure you never receive a medical procedure bill.
Medical Schemes are paying less and less but asking for bigger premiums each month. You can’t even say it depends on the medical aid plan you’re on, because whether it’s the simplest plan or the most comprehensive, you’re going to have to pay for the shortfalls that exist when your medical aid won’t pay for your procedure in full.
Co-payments – the bane of your life
You may also be responsible for coughing up a co-payment. Yes, in spite of your huge premium that you pay each month, your medical aid still expects you to put down a certain amount out of your own pocket for certain procedures.
The amount you have to paywill be determined by your particular medical aid scheme as well as on other circumstances. If you don’t have the money for this co-payment, then get used to the idea of simply going without the treatment.
It is these dreadful co-payments that make people take out gap cover.
Medihelp Gap cover for Medihelp members
Medihelp is a leading, open South African, registered medical aid. It has been around for a long time, well over 100 years. But even belonging to a medical scheme such as Medihelp isn’t going to prevent you from having to pay medical bills that the medical scheme only partially pays.
You will need to have gap cover if you want to avoid debilitating co-payments. Gap cover is a short-term insurance product that works out to be very affordable. Most times with premiums ranging from R95 a month to R500 a month, it’s about a tenth of what you pay for your medical aid premium each month.
Medihelp offers many different medical aid plans. But still, these plans come with co-payments – a fee that the member is liable for when having certain procedures. They usually apply to specialist medical procedures. Co-payments can be quite high too.
While medical aids such as Medihelp are a good tool to manage your risk, you can’t get by without gap cover.Gap cover gives you peace of mind that no co-payment will prevent you from getting the treatment you need. When comparing the different gap cover options there are, consider the costs and benefits before you make your choice.
Every Medihelp Scheme member needs to understand co-payments. They need to understand the importance of getting gap cover that covers co-payments as some options don’t.
Use healthcare networks to avoid co-payments
Some medical schemes especially have payment arrangements with some specialists and then it means you won’t be liable for any co-payments. Members of the Medihelp scheme use providers appointed by Medihelp for certain procedures and then they can avoid co-payments.
But if you particularly want to see another specialist, you may be required to pay an amount up-front. You can cut down on co-payments by making use of healthcare networks whenever possible.
As you can see, belonging to a medical scheme doesn’t for one minute mean you aren’t going to have additional medical expenses and you therefore need to choose your Medihelp gap cover with great consideration.
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