Blog | Page 2 of 2

Why the Need for Gap Cover?

July 23, 2018

CompliMed has been involved in the gap cover industry from the very beginning. We understand the way in which this industry operates, from the way medical schemes look to limit their risk, to the way specialists charge for their services, to hospital networks and how they may apply co-payments, to the most important aspect, you the client and how you need to manage your potential financial shortfalls.

Gap Cover: The Cost of Delay

May 31, 2018

You’ve heard the term “the cost of delay” when referring to investment or retirement planning, but there is another financial planning scenario where this term is also most appropriate – Health planning. Gap cover is a short-term insurance policy that serves as protection against potential financial shortfalls created by the difference in what a medical scheme will pay for an in-hospital procedure versus what your specialist will charge.

Planning for Gap Cover in South Africa

April 19, 2018

It’s common knowledge that even the most comprehensive Medical schemes won’t cover you fully for every procedure, leaving many South African’s out-of-pocket at least a few thousand Rands, and sometimes much, much more. Even so, many people see Gap Cover as only necessary for those “what if” situations, like a rare dread disease, a medical emergency or unplanned hospitalisation.

Treatment date of the claims is within:	Benefits for childbirth will be capped at:
First 12 months of the Policy	R8 000 per event
13-24 months of the Policy	R12 000 per event
25+ months of the Policy	Subject to the Overall Annual Limit of the Policy

Medical Service Provider	Amount Charged by Medical Service Provider	Amount Paid by Medical Scheme	Amount Paid by CompliMed®
Surgeon	R17,053	R6,021	R11,032
Anaesthetist	R8,256	R2,402	R5,854
		Total Paid by CompliMed®	R16,886