FA News – 3rd April 2024


Tony Singleton, CEO at Turnberry Management Risk Solutions

World Health Day 2024, with the theme “My Health, My Right,” is a call to action for everyone to have access to essential health services, education, and information. This theme is particularly relevant in South Africa, where access to healthcare is far from equitable, and accessing private healthcare in particular can be limited due to financial constraints. Even with medical aid, individuals often face significant co-payments or medical expense shortfalls, which can prevent them from fully enjoying their right to health. Gap cover has become essential in assisting more South Africans in managing medical expenses within their existing medical schemes. .

The challenge of healthcare access

South Africa has well-acknowledged challenges when it comes to healthcare access. In the public sector, there are simply not enough facilities nor staff to ensure consistent access to quality healthcare. While the National Health Insurance (NHI) Bill is aimed at addressing this, the reality is that this in itself is fraught with even more challenges. Even in countries where free healthcare is available to all, such as the National Health Service (NHS) in the United Kingdom, there are issues with long waiting times for treatment, which again impacts people’s right to access quality healthcare.

The financial barriers are one of the major reasons why access to healthcare remains unequal and why public healthcare services cannot keep up with demand. This is a common global problem. In fact, the World Health Organisation (WHO) Council on the Economics of Health for All has identified that, while at least 140 countries recognise health as a human right in their constitutions, only four countries have mentioned how to finance it.

The right to health in South Africa

Until such time as South Africa can effectively address the universal healthcare challenge, private healthcare will continue to play an essential role. Accessing this means medical aid is vital, However, escalating medical costs have compelled medical schemes to introduce a multitude of different options, offering different levels of coverage. Within this, leaves potentially significant gaps between the level of coverage and what private specialists and hospitals charge. This means that individuals will continue to face medical expense shortfalls, especially when specialists charge many times more than the rate that medical schemes will pay.

Shortfalls can accumulate to substantial amounts, as evidenced by some our clients’ lifetime claims. For instance, we have covered R502,983 for cancer treatment that exceeded the medical scheme’s coverage, and R414,331 for multiple instances of spinal stenosis treatment. These examples illustrate the significant financial gaps individuals may face, even when they are on premium medical aids.

These shortfalls, which often can exceed R100,000 for a single event, present a significant financial burden. Covering these expenses out of pocket can deter individuals from seeking the ultimate level of treatment. Gap cover has become invaluable in ensuring that South Africans can access quality healthcare without facing overwhelming financial strain. By investing in gap cover, individuals can safeguard themselves from such financial pressures and ensure that they have access to the healthcare they require at a more manageable cost.

While gap cover is not the sole answer to South Africa’s healthcare access challenges, it supports the WHO’s goal of Universal Health Coverage (UHC) by ensuring that more people can access a wider range of services without financial hardship. In settings where public healthcare systems are under-resourced or overburdened, such as in South Africa, gap cover can provide a critical safety net.


Why Access to Comprehensive Health Coverage is Vital on World Health Day (fanews.co.za)



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Client Testimonials

Kudos to Turnberry! The best gap cover there ever is. I am super highly impressed with how fast the turnaround response was. How fast the payout to my bank account was. Absolutely no delays no miss communication no hassles no emailing back and forth, wow wow wow. You guys are superb! I will highly recommend this gap cover to so many of my family and friends. The process for the claim was straight forward and simple. And literally within the same day you guys paid to my bank account so I can cover the shortfall with my medical aid. I just want to say thank you so much to the claims department. For the start of a new year – you guys are on the ball. So efficient. Highly impressed. Thanks Turnberry gap cover – you guys rock.   Raeesa Govende

Excellent, easy and quick replies with quick payments, really no hassles. Must have Gap cover, without it we would have been in financial trouble, Turnberry makes it easy.  Health and medical insurance are not easy and claiming has always caused us anxiety but we can honestly say we are impressed, from sending the claims, the communication, professional and friendly staff not to mentioned the quick payments has made a difficult situation so much easier. We have been so impressed by how quickly the claims have been processed which allows us to settle the service providers quickly and we are very grateful for this excellent service.  We will be promoting Turnberry to family and friends as it has been a pleasure working with you and we look forward to dealing with your company.     Wayne Muller