Why is it important?

Consulter

Driving costs of healthcare in South Africa creates a gap in medical scheme cover

Having medical aid doesn’t mean you’re 100% covered.

Gap cover assists to bridge the gap between the actual costs of medical expenses and the medical aid payment

Gap cover has seen a 48% increase in shortfalls from 2017 – 2021

Debt

Some of the highest claims paid out by gap providers in 2021:

  • Spinal stenosis, lumber region – R165 000,00
  • Angina pectoris  - R153 850,00
  • Acute ischemic heart disease – R150 000
  • Cervical disorder – R83 911,00
  • Fracture of neck and femur – R60 000


It is also requirement for healthcare intermediaries to advise about gap cover.