Do you have a Gap Cover policy?

[NightShift]

they are merely speculating and engaging in conjecture, when asked to provide probabilities to said events they were unable to do so

and you would fail at doing so as well

Medical aid is an insurance. You pay it so that if you need it, its there. My old man also decided in the autumn of his life that he would 'save' the money instead of forking it over to medical aid for little perceived value. Then he was in an accident in the garden and fractured his hip. Didn't have sufficient cash to get admitted to private (R60k up front just to get admitted to general if you dont have medical aid), had to wait hours to get transferred to public, and had a hell of a time with that experience. Tried to convince himself that it was wonderful and good, but it clearly wasn't. And this wasn't the last of it. After he passed I put my mom on a seriously entry level medical aid (R1.8kpm at the time) and when she had a pulmonary embolism, her private care in hospital in the cardiac care unit and all the scopes/scans, was covered in full. She's alive today because of that.

So yes, probabilities. The older you get the less in your favour they are. These things that happened to them came out of the blue, with no warning at all, and the treatment and outcomes were vastly different. I would recommend even an entry-level cover if you can afford it. It's insurance as I say - not some kind of day-to-day benefit/saving.

Edit: Also just to note, if you DO happen to have R300k lying around, you could pretty much put that in a high-interest bank account and get the interest to pay your medical aid for you. This is like a no brainer to me and I cant understand why you wouldn't do this if you can afford to.

 

[Kosmik]

First time in hospital in December 2023 at age 58. Had medical aid all my life and thought little of gap cover. Do have it, but thought that medical aid was the main payment mechanism to cover costs with gap covering that small unpaid amount. WRONG! Gap cover is the main portion of payment in my case. Discovery Coastal core payed less that 40% of the bill costs. I was shocked at this. So, those 48% not having gap ... you better rethink.

Why? Why was only 40% covered in a coastal hospital and specialists they have an agreement with?

 

[SauRoNZA]

Why? Why was only 40% covered in a coastal hospital and specialists they have an agreement with?

He means 40 % of the total bill.

So likely a case of plan only covering 100% but doctors charging 300%.

Which is especially what happens in an emergency where you couldn’t plan ahead and just get the guy with the Lambo who is in standby rotation.

 

[Script]

Yes, and been used a couple of times...