Poll: is medical gap cover worthwhile?

What do you feel about medical gap cover?

  • I have it and it has saved me a lot of money

  • I don’t have it but I want it

  • I have it but want to cancel

  • I don’t have it and think it’s unnecessary

  • What’s medical gap cover?

  • I don’t have medical insurance

  • Other

  • I have it and have never used it but think I'll need it one day

Results are only viewable after voting.
I only have a hospital plan, my wife and son have a fairly comprehensive medical aid plan with gap cover, which is good because it is like they both suffer from Munchausen syndrome the amount of time they force me to be at doctors and/or hospitals.
 
Superjakes said:
OK, so my situation is as follows. My company subsidises medical aid and Gap Cover is part of the package. I will note that Gap cover is not from Discovery (where the medical aid is from). Our Gap cover premium is R162 per month and yes, there is an annual limit. The annual limit is something like R185k per person per annum, and according to the presenter, this is regulated.

Practical use - co-payments in any hospital procedure. You will easily pay 3 - 4k per event when a "scope" is used. That is not the old timey girlie mag, but includes endoscopes, gastroscopies, colonoscopies, et cetera. Our little one had a kidney procedure earlier this year. Enter "scope" and co-payment. R160 x 12 = R1920 < R6150 (upfront co-payment amount).

Just one more thing - medical expenses are a tax deduction. Gap cover is insurance. So, strictly speaking, R6150 from my pocket is a tax deduction, not to be added back because I got my money back from insurance. Use it, don't use it - your choice.
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Interestingly, with Discovery you only have a co-payment when it is an in-hospital procedure, not when it's done in doctors rooms. The surgeon who fixed my hernia has all the equipment in his rooms. No co-payment.
The surgeon who did my colonoscopy rents an operating room from the hospital for half a day or a day and then it counts as her rooms. No co-payment. On the colonoscopy thing - if you have colon cancer in the family, you want to start your checkups at an age 10 years earlier than when your family member was first diagnosed...
 
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Had it for both hospital births of my kids and it saved us thousands. Many years of premiums. While we have been lucky since then and not needed hospitalization I am still happy to pay it because its fairly cheap (R200pm for my family) and when a big event happens it can save you a ton of money. Compared to my total medical insurance cost its a small addition but can be very helpful for the worst case scenario where you spend significant time in hospital. Curious to know from people who where hospitalized for covid for long periods how much it helped then.
 
At 109pm, for the 4 years I have been on it, it paid out more to me for claims than I have paid in premiums and still about 2 years before it's even again (assuming no more claims)..

Well worth it..
 
I have a Medical Lyfestyle policy from Liberty which is like gap cover just much, much more. They pay out a fixed amount per medical procedure whether you have a medical aid or not.

In my family we have had to cope with cancer and in the last five years we have actually received much more money in insurance and medical aid payments than what we have spent. Then, at the end, the policy also functions as a life insurance policy.
 
Have it, haven't used it yet but I'm sure when I eventually do then I'll get back what I've paid in and then some
 
Single and unmarried, had gap cover for 5 years and later discovered I have an excellent medical aid (CAMAF) which covered all my items and never had to use gap cover, hence cancelled it and didn't regret it. But I'll get it probably again when I'm married and/or kiddie on the way, just as an additional backup
 
Before GAP was limited, saved us a ton of money. With the limits, raised the same question with a broker but it does help as GAP for us is R300 odd ( whole family ) and we used the additionals with childbirth etc. They have also extended the plan with items like casualty visits etc which normally come out of your MSA's and what not, never mind any co-payments.

Simple maths, the price differance per month is way cheaper than a higher hospital plan or MSA, so yah, will keep it.
 
Goliath said:
Single and unmarried, had gap cover for 5 years and later discovered I have an excellent medical aid (CAMAF) which covered all my items and never had to use gap cover, hence cancelled it and didn't regret it. But I'll get it probably again when I'm married and/or kiddie on the way, just as an additional backup
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Is it possible to be single and married?
 
BBSA said:
Do you think most people get more back than what they have put in?
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Not too concerned with other people but looking at my moms health and medical costs, genetically I'd say that I have a decent chance of needing it. That's besides the random stuff of car accidents etc.
 
BBSA said:
Do you think most people get more back than what they have put in?
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This is what I’m wondering too. The feeling on here seems to be everyone with it saying they got more than they put in, but gap covers aren’t running a charity so are they purely making their money back from re-investing all the premiums on their side?
 
Kosmik said:
Before GAP was limited, saved us a ton of money. With the limits, raised the same question with a broker but it does help as GAP for us is R300 odd ( whole family ) and we used the additionals with childbirth etc. They have also extended the plan with items like casualty visits etc which normally come out of your MSA's and what not, never mind any co-payments.

Simple maths, the price differance per month is way cheaper than a higher hospital plan or MSA, so yah, will keep it.
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Sounds good! Do you mind sharing which gap cover you’re on? So far I’m looking at Stratum (recommended on here) and Turnberry (which my broker recommended to me).
 
Foxhound5366 said:
This is what I’m wondering too. The feeling on here seems to be everyone with it saying they got more than they put in, but gap covers aren’t running a charity so are they purely making their money back from re-investing all the premiums on their side?
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I haven’t got a cent back from gap cover in the four years or so that I've had it.
 
bwana said:
And they might not. What then?
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Assuming we're talking about non-emergency procedures, there is usually more than one doctor around and sometimes they do actually have to compete for work a bit like the rest of us mortals, so you could try another one?
 
Other. I have it to supplement a lower medical aid plan as it makes economic sense for me personally to do so.
 
Tomtomtom said:
Assuming we're talking about non-emergency procedures, there is usually more than one doctor around and sometimes they do actually have to compete for work a bit like the rest of us mortals, so you could try another one?
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Too many assumptions, usually's and sometimes'es to want to risk my family's health on. Remove any one of them and it would seem to justify gap cover.
 
bwana said:
Too many assumptions, usually's and sometimes'es to want to risk my family's health on. Remove any one of them and it would seem to justify gap cover.
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I guess a side-benefit of gap cover is protection from needing to have an awkward conversation about price and/or the need to shop around for health.

My point is just that if you don't have it you need to say so, because doctors' bills can be remarkably flexible.
 
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