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Compendium FAQs: Gap Cover

As the experts in insurance and assurance products, we’re more than happy to sit down with our clients and answer any questions that they might have. Whether it’s medical aid or gap cover, it’s okay to feel a little bit confused with what they do and don’t cover. It’s why we decided to compile a few of the commonly asked questions that are usually posed to us by members of the public.

When you’re properly informed, you’re able to make great choices that suit your needs, budget and lifestyle. This is something we aim for with every product we offer. Thanks to customisable options, our customers are always able to do just that. When it comes to gap cover in particular, we like to make sure that they know all the facts before signing on that dotted line. Here are a few commonly asked questions and their answers. 

How does it work?

Imagine you need surgery and your doctor is above medical aid rates. This means there’s sure to be a shortfall between what your medical aid will cover and what the specialist actually costs. If you have the right gap insurance cover, you won’t have to pitch in to pay for the rest. Should you be caught without it, things could get pretty costly. 

How is it different to medical aid? 

“I don’t need gap insurance, I already have medical aid.” This is a statement we hear all too often. It’s why we’re stating, for the record, that the two are not one and the same. Medical aid serves as your primary health cover whereas Gap insurance will cover the shortfalls incurred. 

Does Gap insurance offer cover when medical aid rejects a claim? 

Unfortunately not. Should your medical aid not pay towards a procedure or a hospital stay, your gap policy will be unable to offer compensation. This is why it’s important to know exactly what your medical aid will and won’t cover. 

What else does Gap insurance offer?

Depending on the type of cover and the policy selected, your gap insurance could also help you with medical aid co-payments, sub-limits and even oncology shortfalls. 

What does the monthly premium cost? 

Whilst this is dependent on the provider and the level of cover, a gap policy should only cost you a few hundred rands a month. When you consider how severe the shortfall could be if you need an operation, it’s well worth it for the financial peace of mind it gives you. 

How do I claim from my Gap insurance? 

If you’re ready to claim, submit your claim form, hospital bill and your medical aid statement with all the relevant codes to your gap provider and this should be paid out. 

Will there be any exclusion periods? 

Again, this depends on the policy and provider but in most cases there are definite exclusions. These might apply to chronic or pre-existing conditions. It’s why sitting down with a knowledgeable broker is key to prevent any nasty surprises later on.

Do I really need it? 

To put it plainly, yes. Unfortunately, life is not without the unpredictable. Whilst these might be unavoidable, what we can do is prepare for the financial impact of them. Policies like gap insurance lighten the burden should something go wrong. This will help you cover necessary expenses and get you or your loved ones back on the road to recovery in no time. Even if you have to make a few small sacrifices each month to afford the premium, it’s only a few takeaway coffees if you really think about it. 

Get a Gap policy you can count on 

If you’re currently looking for Gap insurance that suits your needs and budget, we would love to sit down with you and chat about your options. Thanks to a wide range of products on offer, there’s bound to be one that’s ideal for you and your situation. With passionate and knowledgeable brokers at your service, you’ll have access to a wealth of knowledge across the insurance and assurance spectrum. This means we’re always in your corner when you need us and looking out for you no matter what. For more on our services and how we can help you, why not call us today on 031 242 6800 or email or send an sms/whatsapp or ‘call me back’ to 064 753 8910.