Is Gap Cover Worth It?

Our clients often ask us whether gap cover is a necessary expense. Many of them already know that you simply can’t do without medical aid in our country, but the importance of gap cover remains unclear. If you speak to anyone that has ever had any type of medical procedure whether it was in a hospital or in the doctor’s rooms, they will be able to tell you that medical aid is simply not enough. More often than not, gap cover was their saving grace.

What Is Gap Cover?

Gap Cover is a short-term insurance option that covers mostly in-hospital payment shortfalls. You may be wondering what these shortfalls could be, as medical aid covers 100% of their Medical Scheme Tariff (MST), but specialists and doctors can charge up to 700% of the MST amount. That’s a 600% shortfall that you are accountable for without gap cover.

Advantages

1. Flexibility

There are no waiting periods if wanting to change Gap providers for like for like benefits. And only a 12 month waiting period can be placed on specific procedures. Your benefits will even be transferred to the new medical aid option straight away.

2. No Age Restriction

Gap cover is no longer restricted to individuals who are 60 years and under. However, you may be charged more depending on your age.

3. Clear Waiting Periods

There are clearly defined waiting periods when you first subscribe to gap cover. This gives you an exact indication of whether your condition will be covered or not.

Disadvantages

1. Exclusions

Your day-to-day medication is not covered by gap cover, nor is GP or specialist visits.

2. Not Tax Deductible

Gap cover contributions are not tax deductible. This means that even if you don’t claim, you don’t get your premium back.

Given the significant shortfalls faced in medical care, we highly recommend to our clients that they take gap cover. At CC&A we offer gap cover through Turnberry, should you be interested in finding out more please do not hesitate to contact us.