The holidays are notorious for high incidents of road traffic accidents, which can result in a variety of injuries from minor to serious, often requiring immediate medical attention. Festive periods also see increased incidents around other accidents, from sports injuries to household mishaps, which can also require a trip to the hospital.
When these accidents occur, and emergency medical care is necessary, medical expense shortfalls are often the result. While medical aid will typically pay a portion of costs, gap cover can save you from having to fund the shortfalls, which can be significant, out of pocket.
Accidental harm
With the increased traffic on the roads, car accidents are common around this time of the year. People travel long distances on holiday and are more frequently on the roads to visit friends and family. Car accidents can cause a range of injuries, from cuts and bruises to broken bones and more serious head and spinal injuries.
Even taking road accidents out of the equation, holidays often result in more frequent injuries around the home as well as injuries resulting from sporting and leisure activities. These injuries could result in a variety of medical expense shortfalls.
A trip to casualty for stitches on a weekend or holiday may not be covered by medical aid schemes if it does not result in hospitalisation and if you are away on holiday and cannot find a hospital in your network, there will also be non-Designated Service Provider (DSP) penalties.
In more serious accidents, if the emergency is life-threatening, you will be stabilised at a network hospital and then have to either move to a different hospital or pay penalties. In addition to initial treatment, which may involve specialists, surgeons and anaesthetists, car, and other accidents can require ongoing treatment, especially when underlying issues like lower back problems and rotator cuff injuries are exacerbated by accidental injury.
Falling short
Treatments that are not an emergency at a non-DSP hospital will typically involve a co-payment of up to R10,000. Even if treatment is sought at a network hospital, there can still be co-payments attached to certain procedures and treatments that can be up to R34,000 or even more.
Then the treatments themselves can result in shortfalls on accounts for doctors and specialists, as they may charge many times the medical aid rate, particularly when it comes to spinal and muscular-skeletal problems. For example, Turnberry Management Risk Solutions has paid a claim for R119,617.50 for cervical disc replacement. The total bill was R164,774.20 and the patient’s medical aid paid just R39,048.10 of this.
These sums are not uncommon, with disc disorders resulting from accidents frequently leading to medical expense shortfalls of more than R100,000. Aside from the initial injury, complications can arise, as in the case of a malunion of a fracture, which is where a broken bone fails to heal correctly. Turnberry have paid claims of more than R80,000 for these treatments.
Are you covered?
Without gap cover, these patients would have been left to try and find massive sums of money, decimate their savings or make long-lasting payment plans with the treating physicians. Gap cover covers you for medical expense shortfalls, co-payments and (on some plans) emergency room visits for both accidents and illness. Having gap cover to augment medical aid provides a safety net that can safeguard your financial well-being and give you peace of mind as you enter the Easter break. Speak to your broker or financial advisor to help you find the best gap cover plan to suit your needs.
https://www.sowetanlive.co.za/opinion/columnists/2023-04-05-brian-harris-are-you-covered-against-medical-expense-shortfalls-from-accidents-this-easter-/
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What is Gap Cover?
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Client Testimonials
Turnberry assisted with claims for various incidents during the last few years – from an elective orthopaedic surgery for my young daughter to emergency surgeries for my wife. When my wife was diagnosed with cancer last year, the once-off payment assisted in a number of the out-of-hospital expenses. In addition, the knowledge that the expenses threshold is so much higher than the standard medical rates provided peace of mind. I have recommended Turnberry Gap Cover to our family, and reiterate that it is an essential or mandatory product. No healthy person believes critical or emergency procedures will happen. But the truth is that it can happen to anyone. The cost vs benefit is not a logical debate, without gap coverage you may end up selling assets to cover the bills. Turnberry’s services were professional, quick and efficient – ‘Peace of mind’. Mynhardt Oosthuizen
I first learnt about Turnberry when my 1st born needed to get his own medical, and because medical schemes are so expensive, I had to take a plan which we could afford. I took out a Turnberry policy for him and when he was in a serious accident, we could not afford the cost of the helicopter which needed to fly him to Pretoria but Turnberry paid the expenses. That was when I decided to take out a Turnberry policy for myself as well. Because of your excellent services I have already promoted your product to all my friends and lot of them have also signed up with Turnberry. Thank you for your excellent service. I do not think that anyone with any medical scheme can be without your product. Lena Ras
If it wasn’t for gap cover I would have had enormous medical expenses. I have had to claim twice in one year. Don’t think about it just do it! It’s the right thing to do. One never knows when you might need the gap cover. I broke my foot just before lockdown due to a brick that was left on a pavement after someone had a motor vehicle accident and they kept the robot upright with the bricks. Whomever did that left some of the bricks on the pavement and at 5h00 in the morning I didn’t see the bricks… Needless to say I ran into the brick and that’s how I broke my foot. Unexpected medical disbursements which I did not budget for and already had to undergo two operations. I have had many expenses and I can truly recommend gap cover. I would recommend Turnberry Gap Cover and have already done so amongst my colleagues at the office. I rate their services as – Excellent! Louna van Tonder
Turnberry Gap Cover insurance has helped me financially after my accident with claims that I could never afford if I never got Turnberry GAP Cover. I have indeed told my family about Turnberry.