Types of risk insurance and what they are used for (long-term insurance, short-term insurance and healthcare)
Medical aid scheme:
Pays the provider’s account (doctor / hospital / specialist) for consultations, treatment, an operation, medicine etc. There are various options from hospital cover only to comprehensive plans which cover hospitalisation and day to day expenses.
Gap cover is a benefit designed to provide extra protection for those who already have medical aid. It covers the deficit between your medical scheme’s tariff (MST), and the actual rates charged by private healthcare professionals. Medical aid schemes in South Africa currently reimburse doctors and specialists at 100%, 200%, or 300% of the scheme rate. However, professional medical providers may charge up to five times the base tariff. By subscribing to gap cover, you protect yourself and your family against this financial disparity, potentially avoiding significant out-of-pocket medical expenses.