Gap Cover is Essential, Here’s Why

Gap Cover is Essential, Here’s Why

Typically we all think just because we have a good hospital plan , we are covered however this is not always the case. It’s a scenario that is far more commonplace than you might think. Despite being a fairly healthy and active person, common sense, and a little bit of nudging from family and friends, meant that you did make the decision to invest in a medical aid plan. However, being pretty confident in your health you opted for a bare bones hospital only plan, as who wants to spend more than they need to on insurance coverage they’ll probably never need?

So, when, somewhat to your surprise you do find yourself on the way to the hospital unexpectedly you can console yourself that at least you’ve covered for all of this unexpected medical drama. But, as too many people discover all too often, that actually isn’t always the case..

When ‘Good’ Hospital Cover Goes Bad

So when and why does the hospital cover you always thought was so good actually go bad and leave you stuck with hospital and medical bills you simply did not expect? This happens when there is a shortfall between what a hospital only medical aid plan will actually cover for inpatient hospital expenses and what is billed by the various parties involved in your care.

‘Gap Cover is Essential, Here’s Why’

You see what many people do not realize – until it’s too late, is that every medical aid plan sets its own rates, based on a  number of different factors, in regards to how much they are will pay out for various services a covered person might receive. The difficulty is that every medical professional and medical facility sets their own fees and charges as well, medicine, after all, is still a business. The end result? Often a patient is left in the middle, stranded with bills for the amount of money that makes up the difference between those two figures. And those bills can be far higher than you might think.

‘Gap Cover is Essential, Here’s Why’

These unexpected bills are usually quite a shock for the patient who receives them, especially if they are also still trying to recover from the illness or injury that put them in the hospital in the first place. In an ideal situation they might have been savvy enough to negotiate a better price, as a growing number of medical professionals are open to such arrangements, but usually only if the negotiations occur before the hospitalization.. However, when you are being rushed off to the hospital on an emergency insurance shortfalls and extra costs for your care are probably the last things on your mind.

A gap cover policy, one that is purchased in addition to your hospital plan, can be a great safeguard in these situations though. These ‘additional plans’ are designed specifically to cover these shortfalls so surprise bills don’t add more worry at a time when the only real concern should be how well a patient recovers.

As it is another bill added to your monthly outgoings you may balk at the idea of taking out a gap cover policy. It comes back to the same reason why you opted for a bare bones hospital plan in the first place; why pay for something that you may well never use?

‘Gap Cover is Essential, Here’s Why’

Whether or not you add a gap cover plan to your portfolio of insurance coverages is a personal decision, but it is one that at very least calls for a bit of research. Get out your current medical aid policy and take another look, especially at the standard payable rates in the small print.

Next, take a few minutes to ring up the billing office at the hospital you’d probably use in an emergency medical situation. Ask them about the rates charged by the various medical professionals – and the hospital itself – for common procedures.

If, by comparing the difference between what your hospital plan is willing to pay and what is probably going to be billed  for even a couple of procedures seems to be significantly different then it makes sense to  start looking into adding gap cover. Yes, you very well may never need the coverage, but if you are a good driver you may never really use your car insurance either. And since you would never leave your vehicle under-insured why would you ever think of doing so to yourself?

Your best option is to speak directly with one of our Medical Aid Consultants to find out Why Gap Cover is essential, call us today.