You can belong to the simplest medical aid or the most comprehensive medical aid there is. The truth is, that for the huge premium you pay each month for your plan, medical aids are going to leave you still having to pay a large sum of money towards certain procedures. That’s why you need Simeka gap cover from Sanlam.
Medical bills relief
Medical aids will only partially pay for treatments where the medical specialist charges you way over the standard medical aid tariff. If your specialist charges you R20 000 for a procedure and medical aid only pays R12 000 towards it, then you have to pay the outstanding sum of R8 000.
That is unless you have gap cover. Add to this dismal scenario the fact that for certain procedures the medical scheme will also apply co-payments. If you don’t pay this co-pay upfront, you can’t proceed with the procedure.
Gap cover has therefore been made an affordable ancillary benefit that supplements your medical scheme cover.
You can’t look at gap cover as a useful enhancement to have – it has become a critically important insurance product to have. In fact, not having gap cover will have you opting to rather not go ahead with a procedure.
The reason for this is that you could get a bill of 30, 40 or R50 000 to pay and unless you’ve won the lotto, there are very few people who have this kind of money in a savings account. It’s why you have to have gap cover. The right medical scheme and gap cover option can protect your health and your pocket.
Accredited gap cover assistance
Simeka Health Pty (Ltd) is a financial service provider and also an independent healthcare consultancy. They are accredited by the Council for Medical Schemes and they represent different medical schemes, primary health insurance providers and gap cover providers.
- Simeka Health is a member of the Sanlam group. You can trust the Sanlam group. They were founded in 1918, starting off as a traditional insurer to the diversified financial service provider they are today.
- Simeka Health has a specialised, skilled healthcare team who analyse your needs before providing you with a free quote of a plan that appeals to you. It’s a case of describing your healthcare needs to Simeka on their online form and within 5 minutes the form can be submitted.
- Simeka has plans for individuals and employers. Some of the medical expenses covered by this gap cover include among others, tariff shortfalls for in- and out-of-hospital procedures, co-payments, deductibles and sub-limits.
- Gap cover from Simeka gap cover providers is designed to protect South Africans against those unexpected medical expenses.
- You can choose gap cover from some of South Africa’;s top gap cover providers – Ambledown, Total Risk Administrators, Stratum, Kaelo, Sanlam, Discovery and Sirago. When you choose gap cover from one of these providers, age restrictions apply and with research, you will see it varies from service provider to service provider.
- The gap cover providers from Simeka aren’t medical schemes. To find the gap cover that will supplement your specific medical aid, you can ask your financial advisor for more information.
- Between these gap cover providers, you’ll find gap cover plans with different names starting anything from R100 a month to R600 a month.
Choose Simeka gap cover to give you peaceful assurance
Simeka has set out to help you select the best gap cover there is for your unique needs and they encourage you to do research and make the gap cover plan you choose the one that brings you peace of mind.
Get a quote now by completing and submitting the form on this page