The Insurance Directory – March 2024

Brian Harris, GM of Operations at Turnberry Management Risk Solutions

As medical expenses continue to inflate while medical aid cover increasingly has limitations, co-payments, and shortfalls, gap cover has become essential. However, while gap cover plays a critical role in minimising medical expense shortfalls, it is vital to ensure, first and foremost, that your medical aid cover is suited to your needs, and that gap cover then slots in to ensure maximum coverage. Working with your broker or financial advisor to make sure you have the best products to fit with your lifestyle, life stage, and budget is important for any South African looking to safeguard their financial and physical wellbeing.

Gap cover works with your medical aid, not in isolation

The medical aid and gap cover landscape can be complex and difficult to navigate, which is why a broker is an invaluable ally. One thing that is important to understand is that getting the medical aid plan right is essential. Medical aid needs to offer the best cover for your needs and your budget, and this depends on many factors, including age, general health, chronic conditions, whether you have children, their ages, whether you are planning to have children, and so on.

Gap cover is then supplementary to cover shortfalls that are associated with medical expenses. For example, most medical schemes will pay 100% or 200% of the medical aid rate for medical treatments, but specialists typically charge between 300% and 600% of this rate. This could result in significant medical expense shortfalls, particularly when it comes to surgeries and specialised treatments like cancer. In addition, many medical aid plan options now include sub-limits and co-payments for various procedures, which can also lead to shortfalls. Gap cover can help to minimise or eliminate these shortfalls.

In addition to looking at the basics of gap cover, which is cover for medical expense shortfalls, cover for co-payments, and cover for sub-limits, it can also be beneficial to look at what other benefits gap cover offers. For example, some gap cover providers will offer a casualty benefit, which will cover expenses associated with treatment for casualties that do not result in hospital admissions. The claims process is also important. If claiming is difficult and requires significant effort, it will simply add more stress to your life unnecessarily. It can be helpful to understand a gap cover provider’s claims process and read reviews from actual clients to understand the experience.

Gap cover is for all ages and stages

It is never too early or too late to look after your financial and physical health, and gap cover (and medical aid) are not only for older people. Accidents and illness can happen to people of all ages, and as your life stage changes, so too will your needs. Medical expense shortfalls have the potential to cause significant financial hardship, so no matter where you are in life and what your needs are, aligning medical aid cover with gap cover is critical. Work with your broker to ensure your medical cover is right and that gap cover slots in effectively to provide the best protection possible, now and in the future.

Is your gap cover aligned with your medical aid and your medical needs? – The Insurance Directory

What is Gap Cover?

Client Testimonials

We had a five star experience throughout our claim submission process. Thank you sincerely for all the support during this process – the entire process was seamless.    I would recommend Turnberry Gap Cover to anyone and everyone without hesitation.    Peter Hunter

I logged my claim via the website and it was so quick and easy.  It’s a must have. I have already been telling people about this brand and the GAP cover.    Kerry Badenhorst