The government recently released the National Health Insurance (NHI) Bill with the aim of offering universal healthcare to all South Africans. But the Bill has sparked a great deal of controversy and appears to leave us with many more questions than answers. The impact on private health care, quality of service and the government’s ability to manage such a complex system have been widely questioned. And that’s without even considering how on earth is will be funded. While free health care for all is indeed a very desirable outcome, it’s difficult to feel upbeat about the prospect of yet another badly run South African SOE. Nevertheless, the Government seems intent on pushing ahead and the plan is that NHI will be implemented in phases over a 14-year period that started in 2012. Apart from the other issues mentioned above, many people have argued that the timeframe of 2026 for full implementation is unrealistic and that it will take at least another decade. So at least for now, it’s business as usual as far as providing for your health care is concerned, with private medical aid and gap cover.
Don’t let the hype around the new NHI stop you from putting traditional medical cover in place
Given the current pressures on our dwindling finances, many of us are under the misguided impression that medical aid is enough cover for all our health care needs. This may have been the case in the past, but with spiralling medical costs, you may find yourself severely out of pocket if you don’t take out Gap cover to complement your medical plan. Gap cover is a short-term insurance product designed to provide extra protection for those who already have medical aid. It covers the deficit between your medical scheme's tariff (MST) and the actual rates charged by private healthcare professionals.
So how does Gap cover work?
Medical aids have their medical scheme’s tariffs for operations and procedures. However, many doctors and specialists charge more for their services than your medical aid will pay for the procedure, depending on your plan. That is where Gap cover comes into effect, to pay the difference between what your medical aid contributes and what your doctor or specialist charges – it covers the shortfall so that you are not affected financially.
Gap cover allows you or your loved ones to recover in peace without worrying about expensive doctors’ bills
Depending on the option you select, Gap cover insures in-hospital procedures and certain out of hospital treatments. Other benefits such as oncology, casualty cover and trauma counselling may also be included in your plan of choice.
You must be a registered member of a South African medical aid to qualifying for Gap cover.
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