Poll: is medical gap cover worthwhile?

[Tomtomtom]

Not that I think I’ll need it one day. My belief is that no matter how unlikely an event is, you insure against it if it could possibly bankrupt you.

I’ll be very happy to live my whole life having never used my gap cover, but I’ll keep it since I don’t want to be bankrupted if I develop Hodgepikinson’s Nymphomania or something.

I stand to be corrected but I don't think there's any gap cover that protects you from bankruptcy in the event you end up with a very rare and expensive condition.

Past a certain point you're going to need a gofundme.

 

[Kosmik]

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).

Turnberry is my current one. It was origionally Ambledown Complimed but they were taken over by Turnberry, same guys AFAIK.

Medical Aid Gap Cover South Africa - CompliMed®

We believe Gap Cover is essential for every Medical Aid member in South Africa. CompliMed® are experts in helping our clients cover the shortfall in their medical aid through simple, affordable and comprehensive Gap Cover solutions.

complimed.co.za

Legacy Series​

2022 MONTHLY PREMIUM:​

R340.00

per family for under 65yrs

R485.00

per family for 65yrs+

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IN-HOSPITAL BENEFITS​

• Medical Expense Shortfall Cover
• Co-Payment Cover
• Non-DSP Hospital Penalty Cover
• Sub-Limit Cover
• Trauma Recovery Cover

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IN-HOSPITAL AND OUT-OF-HOSPITAL BENEFITS​

• Traditional Cancer Cover
• Biological Cancer Drug Cover
• MRI and CT scan cover
• Trauma care cover
• Breast Cancer Prevention Cover
• Breast Cancer Reconstruction Cover

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IN-HOSPITAL DENTAL COVER​

• Medical expense shortfall cover
• Co-payment cover
• Sub-limit and co-payment cover for dental implants
• Sub-limit cover

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OUT-OF-HOSPITAL BENEFITS​

• Co-Payments for MRI, CT and PET Scans
• Co-Payments for scopes
• Sub-Limit Cover for MRI, CT and PET Scans
• Casualty Benefits for accidents
• Casualty Benefits for illness

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ADDED BENEFITS​

• Cancer Diagnosis Benefit
• Medical Scheme Contribution Waiver
• GAP Premium Waiver
• Personal Accident Benefit
• Critical Illness Benefit
• International Travel Cover

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WAITING PERIODS​

New Policy Waiting Period​

• A 3-month general waiting period applies to all benefits (except in the event of an accident, which occurred while on the Policy). In the event the commencement date of the Policy is the same as the commencement date of the Medical Scheme, no 3-month general waiting period will apply to Medical Expense Shortfall Cover (increasing the medical aid rate up to 600%)
• A 10-month waiting period on pregnancy/childbirth
• A 12-month waiting period on / investigations, treatment or surgery for: hysterectomy, hysteroscopies, endometriosis, ovarian cysts and fibroids (myomectomy), muscular-skeletal (except in the event of an accident, which occurred while on the Policy), tonsillectomy, myringotomy, grommets, adenoids, wisdom teeth, hernia, cataracts, gastroscopies, colonoscopies, cancer, nasal and sinus

Existing Policy Transfers​

• No other waiting periods will apply to any benefits on your CompliMed® policy where such benefits are similar by definition to those being replaced (like-for-like), and where the replaced policy has been in force for at least 12 months or longer.
• Standard waiting periods will apply to any new benefits not found on your replaced policy.
• Please be advised that proof of current cover will need to be provided when applying for a CompliMed® policy, to avoid any new waiting periods being applied.

The current rider with ALL GAP policies

Monthly premium:

R340 per family for under 65yrs

R485 per family for 65yrs+

Overall Annual Limit (OAL) - R177 800 per insured per annum

Some of the more expensive plans have a limit per person ( someone on here had that one ). Before the legislation limit, cover was capped at 2M or 3M if I recall.

 

[rodga]

What was the reason for the cap? Seems stupid if they didnt limit or move in line to what the medical industry can charge as well