Last updated on Jun 23rd, 2021 at 12:24 pm

If you’ve ever had to pay a massive co-payment for a medical procedure, you might want to think about getting some gap cover for the next time

Even if you belong to a medical scheme in South Africa you are probably worried about incurring massive co-payments if you land up in hospital.

There is a way to pump up your medical aid membership in an affordable way.

No, you don’t have to step up to a more expensive medical aid option. In fact, by using this technique you may be able to downgrade your medical scheme plan while increasing your overall cover.

First let’s describe what medical gap cover is exactly

Specialist short-term insurance companies offer products called gap cover. These companies have nothing to do with medical schemes: these are two separate entities entirely.

Gap products are also called top-up insurance, shortfall insurance or co-payment cover.

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There are some variations to gap cover. Fortunately, gap cover policies are much easier to understand that medical aid terminology and terms.

The idea behind gap insurance is to insure the portion of your medical bills that medical aids refuse to pay

For an extended stay in hospital with specialists in attendance you could easily be a couple of hundred thousand rands out of pocket. Gap cover will pay the shortfall amount.

You can belong to any registered medical aid in South Africa to qualify to take out gap insurance

So whether it’s Discovery Health, Momentum, GEMS, Selfmed or any of the many other schemes, it’s fine. Find the full list of official medical schemes here.

A single gap cover policy covers everyone on your medical aid plan

You can expect to pay the equivalent of about 10% of your medical aid monthly premium on your gap cover premium. So if your monthly medical aid premium is about R4500, then your monthly gap premium will probably be around R450.

Generally there are no waiting periods relating to gap cover, but do check with your gap cover company.

Watch this video to find out more about gap cover

While All4Women endeavours to ensure health articles are based on scientific research, health articles should not be considered as a replacement for professional medical advice. Should you have concerns related to this content, it is advised that you discuss them with your personal healthcare provider.