Gap Cover is a short-term insurance stated benefit product that covers the difference between the medical aid rate and private rate’s charged by doctors or specialists for in-hospital treatment.
Most medical aid's in South Africa cover specialists in hospital (i.e. surgeons & anaethetists etc) at the "medical aid rate" or "100%" whereas most specialists in South Africa tend to charge "private rates" or "300%" illustration: Colin Daniel
The difference where a specialist charges 300% and the medical aid only covers 100% is two thirds of the specialists bill.
So if your specialist charges private rates (300%) and their bill is R30,000 for an operation and your medical aid covers you at medical aid rates (100%) they will only pay the specialist R10,000 and you will be liable for the R20,000 difference.
By taking our Gap Cover you will have peace of mind that no matter what your specialist charges in the event of you being hospitalised, you will have cover for the portion that your medical aid does not cover.