WHY YOU NEED MEDICAL GAP COVER
As a medical scheme member, you would probably expect your full costs to be covered if you are ever hospitalised. Unfortunately, this is seldom the case. Medical scheme benefits are limited to the Medical Scheme’s Tariffs (MST) and medical practitioners can charge considerably more than the MST. Certain medical specialists have been known to charge up to five times the MST.
This creates a shortfall — or gap — between the MST and the medical practitioner’s charge. Your medical scheme does not cover this and you are liable for this amount. The actual cost of many procedures performed by surgeons, anaesthetists and other medical practitioners can add up to sizeable payment gaps.
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