How does it work?
Co-payment Cover
A co-payment or deductible is an upfront amount that needs to be paid to the: Hospital, Radiologist or Day Clinic before undergoing certain procedures, as specified by your Medical Scheme. When you experience a co-payment for a procedure or scan (as specified by your Medical Scheme) you would need to pay for the co-payment up-front and then claim the amount back from your Turnberry Policy (provided that the plan you selected offers co-payment cover).
Non-DSP Hospital Cover
Should you choose to go to a hospital or day clinic outside of your Medical Scheme’s Hospital Network/ Designated Service Providers, you would be liable for a portion of the account, as specified by your Medical Scheme. Example: Henry’s Medical Scheme stipulates that he needs to go to hospital X, if he chooses to go to another hospital he would need to pay the first R8 700 of the hospital account. Henry chooses to go to hospital Y and pays the R8 700 and then claims it back from his Turnberry Premier Policy.
Claims paid by Turnberry over the past 12 months
Other idiopathic scoliosis thoracic region
Provider: Orthopedic surgeon
Amount charged: R115 121.53
Amount paid by Medical Aid: R38 754.90
Amount paid by Turnberry:
R76 366.63
Provider: Anaesthetist
Amount charged: R22 895.93
Amount paid by Medical Aid: R7 762.00
Amount paid by Turnberry:
R15 133.67
Provider: Clinical technology -cardiology
Amount charged: R6 684.00
Amount paid by Medical Aid: R3 342.00
Amount paid by Turnberry:
R3 342.00
Total amount paid by Turnberry:
R94 842.30
Malignant neoplasm of prostate
Provider: Urologist
Amount charged: R80 583.00
Amount paid by Medical Aid: R26 811.00
Amount paid by Turnberry:
R53 772.00
Provider: Anaesthetist
Amount charged: R7 466.34
Amount paid by Medical Aid: R3 416.80
Amount paid by Turnberry:
R4 049.54
Total amount paid by Turnberry:
R57 821.54
Chronic sinusitis unspecified
Provider: ENT
Amount charged: R93 259.73
Amount paid by Medical Aid: R42 239.43
Amount paid by Turnberry:
R51 020.30
Other specified disorders of nose
and nasal sinuses
Provider: ENT
Amount charged: R9 696.60
Amount paid by Medical Aid: R5 775.70
Amount paid by Turnberry:
R3 920.90
Provider: Anaesthetist
Amount charged: R29 721.88
Amount paid by Medical Aid: R20 402.10
Amount paid by Turnberry:
R9 319.78
Provider: Plastic and reconstructive surgeon
Amount charged: R69 145.00
Amount paid by Medical Aid: R16 721.20
Amount paid by Turnberry:
R52 096.80
Total amount paid by Turnberry:
R65 337.48
Atrial septal defect
Provider: Cardiothoracic Surgeon
Amount charged: R89 284.11
Amount paid by Medical Aid: R29 738.33
Amount paid by Turnberry:
R59 545.78
Delivery by elective caesarean section
Provider: Gynaecologist
Amount charged: R48 907.80
Amount paid by Medical Aid: R8 956.30
Amount paid by Turnberry:
R35 825.20
Provider: Anaesthetist
Amount charged: R22 255.57
Amount paid by Medical Aid: R5 563.90
Amount paid by Turnberry:
R16 691.67
Total amount paid by Turnberry:
R52 516.87
Client Testimonials post claim submissions
Turnberry’s Gap Product settled my out of medical aid expenses. It is so important to have Gap Cover insurance, as you never know when you or your child will need this, and what really will be covered under your Medical Aid. I had a second co-payment implemented by my medical aid without any explanation and Wendy was brilliant in enquiring about this with the Medical Aid, and thereafter settling this. Dina Lala – August 2021
Doctors charged above medical aid rates which required upfront co-payments. These co-payments were submitted to Turnberry for processing. My claim form was completed and submitted to my Broker on 29 June 2021. Payment of my 1st diagnosis of cancer was paid on 16 July 2021. On 9 July 2021, I received an email to advise that my claim was submitted to an assessor to conclude the assessment. Your timeous and prompt responses and feedback has assured me that Turnberry provides the best value for money which has benefitted me during my claim experience. I believe Turnberry provide a prompt, fast and efficient customer service and satisfaction. I would recommend Gap Cover which helps with the additional medical expenses. It covers the shortfall where Doctors and Hospitals charge above medical aid rate. The up-front co-payments for certain procedures and admission can be claimed from Gap Cover if you have the right benefit product in place. Excellent service. Highly recommended. Vijay Pillay – August 2021
I was very impressed with the efficient and excellent service I received from Turnberry Gap cover especially Verna Nel. I was kept updated on the process of my claims and all queries were dealt with speedily. I have already recommended Turnberry Gap cover to friends and family as you will definitely have peace of mind when you are hospitalized and you are covered with Turnberry Gap cover. Thank you for your excellent service. Shanaaz – June 2021
Turnberry paid the full difference between what medical aid covered and the cost of the procedure. It is a must have product with medical aid. Has much higher value compared to monthly amount paid. Thank you once again for quick and effective service. Some of rare exceptions of what really works well. Paulius – Aug 2021
I was able to claim the added expenses after my knee surgery. I have had no problems with Turnberry and their service was helpful and efficient. Gap Cover Insurance is something that unfortunately in today’s times needs to be considered. A small expense to give one peace of mind. Turnberry claims division were quick and helpful in answering my questions. Dave – August 2021
I wanted to write to you to thank you for your commitment to your customers. It was incredibly refreshing to receive the payment in good faith, as I can assure you, I would have NEVER received this kind of commitment from any other medical aid or GAP cover provider.
I will endeavour to give your company and your brand as much positive recommendation on social platforms that I can and felt it was crucial that I write to you to let you know that I will be a customer of Turnberry for life and I truly thank you for honouring your commitment to us. We appreciate your service and your service excellence. I am very proud to be a client of Turnberry. Thank you once again for your phenomenal service. Collette Roetz – May 2021