{"id":1964,"date":"2018-06-04T08:37:49","date_gmt":"2018-06-04T08:37:49","guid":{"rendered":"https:\/\/turnberry.co.za\/2023\/new\/?p=1964"},"modified":"2024-01-10T08:13:06","modified_gmt":"2024-01-10T08:13:06","slug":"understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps","status":"publish","type":"post","link":"https:\/\/turnberry.co.za\/2027\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/","title":{"rendered":"Understanding the key terms: co-payments, sub-limits and non-DSPs"},"content":{"rendered":"

\"Surgeons\"While it\u2019s easy for some of these technical terms to wash over us, understanding the structure of your Medical Aid and Gap Cover is a critical aspect of managing your family\u2019s medical and financial affairs.<\/p>\n

Some of the least-understood, but most important terms, are co-payments, sub-limits and non-DSP<\/a> Hospital Penalty cover.<\/p><\/blockquote>\n

Let\u2019s demystify and explain these terms, and ensure you are empowered to have the right conversations with your financial advisor.<\/p>\n

Co-payments<\/strong><\/h2>\n

Did you know that co-payments can extend up to R15 000 for a single procedure? This upfront amount must be paid by consumers \u2013 when visiting hospitals, day clinics, and radiologists – before undergoing certain procedures.<\/p>\n

All of this will be prescribed in your Medical Aid, so it\u2019s important to read up on just how your co-payment structure will work, for the various types of procedures.<\/p>\n

With the right Gap Cover<\/a> in place, you\u2019ll be able to claim back this co-payment amount from your Gap Cover provider. For instance, Turnberry\u2019s Premier<\/a>, Optimal<\/a>\u00a0and Synergy<\/a> offerings all make provision to cover their customers for their in-hospital co-payments.<\/p>\n

Just note that certain types of co-payments \u2013 such as co-payments required at pharmacies – are unlikely to be supported by your Gap Cover.<\/p>\n

Sub-limits<\/strong><\/h2>\n

Within one\u2019s broader coverage limits, you\u2019ll likely find that your Medical Aid will only pay up to a specific amount for certain procedures, internal prosthesis or scans.<\/p>\n

To use a simple analogy, imagine that you were given R1000 to spend in a shopping mall (this would be the total annual coverage limit). A sub-limit would be a restriction to say that out of that R1000, only R300 of it may be used to buy shoes.<\/p>\n

If your Medical Aid imposes a sub-limit on a particular procedure, then with the right Gap Cover in place, you\u2019re able to assist in covering that sub-limit \u201cgap\u201d by sending the bill to your Gap Cover provider however, you need to keep in mind that the sub-limit cover benefit is restricted per admission.<\/p>\n

Non-DSP Hospital Penalty Cover<\/strong><\/h2>\n

Depending on your choice of Medical Aid, you may be restricted to using only their Designated Service Providers (DSPs) \u2013 these are groups of hospitals within a certain network. If you then go to a hospital which is outside of this DSP hospital network, then you may be liable to pay a portion of the account.<\/p>\n

There are a number of reasons why one might visit a hospital outside of the DSP hospital network – for instance, you may be travelling, and no DSP hospital is nearby.<\/p>\n

Certain Gap Cover options will offer to cover all or some of this amount that is billed to the individual that uses a non-DSP hospital.<\/p>\n

By better understanding these three terms, consumers are able to get the most out of their Gap Cover, ensure they choose the right Medical Aid and Gap Cover solutions<\/a> to suit their needs, and protect them against hefty, unexpected medical expense shortfalls.<\/p>\n","protected":false},"excerpt":{"rendered":"

While it\u2019s easy for some of these technical terms to wash over us, understanding the structure of your Medical Aid and Gap Cover is a critical aspect of managing your family\u2019s medical and financial affairs. Some of the<\/p>\n","protected":false},"author":5,"featured_media":1595,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"image","meta":{"inline_featured_image":false,"footnotes":""},"categories":[7],"tags":[],"class_list":["post-1964","post","type-post","status-publish","format-image","has-post-thumbnail","hentry","category-news","post_format-post-format-image"],"yoast_head":"\nKey Terms To Know When Speaking To A Financial Advisor<\/title>\n<meta name=\"description\" content=\"Understanding the structure of your Medical Aid and Gap Cover is critical in managing your family\u2019s medical and financial affairs.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Key Terms To Know When Speaking To A Financial Advisor\" \/>\n<meta property=\"og:description\" content=\"Understanding the structure of your Medical Aid and Gap Cover is critical in managing your family\u2019s medical and financial affairs.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/\" \/>\n<meta property=\"og:site_name\" content=\"Turnberry\" \/>\n<meta property=\"article:published_time\" content=\"2018-06-04T08:37:49+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-01-10T08:13:06+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/turnberry.co.za\/wp-content\/uploads\/2017\/01\/main.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"640\" \/>\n\t<meta property=\"og:image:height\" content=\"350\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"Wendy\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Wendy\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/\"},\"author\":{\"name\":\"Wendy\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#\\\/schema\\\/person\\\/b7a7e30a6a1e8135d7a075ad106c499a\"},\"headline\":\"Understanding the key terms: co-payments, sub-limits and non-DSPs\",\"datePublished\":\"2018-06-04T08:37:49+00:00\",\"dateModified\":\"2024-01-10T08:13:06+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/\"},\"wordCount\":502,\"publisher\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/wp-content\\\/uploads\\\/2017\\\/01\\\/main.jpg\",\"articleSection\":[\"News\"],\"inLanguage\":\"en-US\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/\",\"url\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/\",\"name\":\"Key Terms To Know When Speaking To A Financial Advisor\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/wp-content\\\/uploads\\\/2017\\\/01\\\/main.jpg\",\"datePublished\":\"2018-06-04T08:37:49+00:00\",\"dateModified\":\"2024-01-10T08:13:06+00:00\",\"description\":\"Understanding the structure of your Medical Aid and Gap Cover is critical in managing your family\u2019s medical and financial affairs.\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#primaryimage\",\"url\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/wp-content\\\/uploads\\\/2017\\\/01\\\/main.jpg\",\"contentUrl\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/wp-content\\\/uploads\\\/2017\\\/01\\\/main.jpg\",\"width\":640,\"height\":350},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Understanding the key terms: co-payments, sub-limits and non-DSPs\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#website\",\"url\":\"https:\\\/\\\/turnberry.co.za\\\/\",\"name\":\"Turnberry\",\"description\":\"Gap cover\",\"publisher\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\\\/\\\/turnberry.co.za\\\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#organization\",\"name\":\"Turnberry\",\"url\":\"https:\\\/\\\/turnberry.co.za\\\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#\\\/schema\\\/logo\\\/image\\\/\",\"url\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/wp-content\\\/uploads\\\/2017\\\/10\\\/logo-turnberry.jpg\",\"contentUrl\":\"https:\\\/\\\/turnberry.co.za\\\/2027\\\/wp-content\\\/uploads\\\/2017\\\/10\\\/logo-turnberry.jpg\",\"width\":224,\"height\":75,\"caption\":\"Turnberry\"},\"image\":{\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#\\\/schema\\\/logo\\\/image\\\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/turnberry.co.za\\\/#\\\/schema\\\/person\\\/b7a7e30a6a1e8135d7a075ad106c499a\",\"name\":\"Wendy\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/de829f096308ea07cf5f417c7392178b48f10da9db8071f692092648c05ef6c0?s=96&d=mm&r=g\",\"url\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/de829f096308ea07cf5f417c7392178b48f10da9db8071f692092648c05ef6c0?s=96&d=mm&r=g\",\"contentUrl\":\"https:\\\/\\\/secure.gravatar.com\\\/avatar\\\/de829f096308ea07cf5f417c7392178b48f10da9db8071f692092648c05ef6c0?s=96&d=mm&r=g\",\"caption\":\"Wendy\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Key Terms To Know When Speaking To A Financial Advisor","description":"Understanding the structure of your Medical Aid and Gap Cover is critical in managing your family\u2019s medical and financial affairs.","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/","og_locale":"en_US","og_type":"article","og_title":"Key Terms To Know When Speaking To A Financial Advisor","og_description":"Understanding the structure of your Medical Aid and Gap Cover is critical in managing your family\u2019s medical and financial affairs.","og_url":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/","og_site_name":"Turnberry","article_published_time":"2018-06-04T08:37:49+00:00","article_modified_time":"2024-01-10T08:13:06+00:00","og_image":[{"width":640,"height":350,"url":"https:\/\/turnberry.co.za\/wp-content\/uploads\/2017\/01\/main.jpg","type":"image\/jpeg"}],"author":"Wendy","twitter_card":"summary_large_image","twitter_misc":{"Written by":"Wendy","Est. reading time":"3 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#article","isPartOf":{"@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/"},"author":{"name":"Wendy","@id":"https:\/\/turnberry.co.za\/#\/schema\/person\/b7a7e30a6a1e8135d7a075ad106c499a"},"headline":"Understanding the key terms: co-payments, sub-limits and non-DSPs","datePublished":"2018-06-04T08:37:49+00:00","dateModified":"2024-01-10T08:13:06+00:00","mainEntityOfPage":{"@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/"},"wordCount":502,"publisher":{"@id":"https:\/\/turnberry.co.za\/#organization"},"image":{"@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#primaryimage"},"thumbnailUrl":"https:\/\/turnberry.co.za\/2027\/wp-content\/uploads\/2017\/01\/main.jpg","articleSection":["News"],"inLanguage":"en-US"},{"@type":"WebPage","@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/","url":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/","name":"Key Terms To Know When Speaking To A Financial Advisor","isPartOf":{"@id":"https:\/\/turnberry.co.za\/#website"},"primaryImageOfPage":{"@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#primaryimage"},"image":{"@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#primaryimage"},"thumbnailUrl":"https:\/\/turnberry.co.za\/2027\/wp-content\/uploads\/2017\/01\/main.jpg","datePublished":"2018-06-04T08:37:49+00:00","dateModified":"2024-01-10T08:13:06+00:00","description":"Understanding the structure of your Medical Aid and Gap Cover is critical in managing your family\u2019s medical and financial affairs.","breadcrumb":{"@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/"]}]},{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#primaryimage","url":"https:\/\/turnberry.co.za\/2027\/wp-content\/uploads\/2017\/01\/main.jpg","contentUrl":"https:\/\/turnberry.co.za\/2027\/wp-content\/uploads\/2017\/01\/main.jpg","width":640,"height":350},{"@type":"BreadcrumbList","@id":"https:\/\/turnberry.co.za\/understanding-the-essential-terms-co-payments-sub-limits-and-non-dsps\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/turnberry.co.za\/2027\/"},{"@type":"ListItem","position":2,"name":"Understanding the key terms: co-payments, sub-limits and non-DSPs"}]},{"@type":"WebSite","@id":"https:\/\/turnberry.co.za\/#website","url":"https:\/\/turnberry.co.za\/","name":"Turnberry","description":"Gap cover","publisher":{"@id":"https:\/\/turnberry.co.za\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/turnberry.co.za\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/turnberry.co.za\/#organization","name":"Turnberry","url":"https:\/\/turnberry.co.za\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/turnberry.co.za\/#\/schema\/logo\/image\/","url":"https:\/\/turnberry.co.za\/2027\/wp-content\/uploads\/2017\/10\/logo-turnberry.jpg","contentUrl":"https:\/\/turnberry.co.za\/2027\/wp-content\/uploads\/2017\/10\/logo-turnberry.jpg","width":224,"height":75,"caption":"Turnberry"},"image":{"@id":"https:\/\/turnberry.co.za\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/turnberry.co.za\/#\/schema\/person\/b7a7e30a6a1e8135d7a075ad106c499a","name":"Wendy","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/secure.gravatar.com\/avatar\/de829f096308ea07cf5f417c7392178b48f10da9db8071f692092648c05ef6c0?s=96&d=mm&r=g","url":"https:\/\/secure.gravatar.com\/avatar\/de829f096308ea07cf5f417c7392178b48f10da9db8071f692092648c05ef6c0?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/de829f096308ea07cf5f417c7392178b48f10da9db8071f692092648c05ef6c0?s=96&d=mm&r=g","caption":"Wendy"}}]}},"_links":{"self":[{"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/posts\/1964","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/comments?post=1964"}],"version-history":[{"count":11,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/posts\/1964\/revisions"}],"predecessor-version":[{"id":4934,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/posts\/1964\/revisions\/4934"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/media\/1595"}],"wp:attachment":[{"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/media?parent=1964"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/categories?post=1964"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/turnberry.co.za\/2027\/wp-json\/wp\/v2\/tags?post=1964"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}