Which Stratum Gap Cover?

[RedViking]

Which Gap Cover do you have or would you recommend that has a good benefit vs price. I don't have the energy to go through all 6 options and preferably don't want to or can't afford to pay for the highest plan. My hospital plan is very basic, Discovery Essential Smart Plan.

Gap Cover Options From Stratum Benefits

Discover Stratum Benefits' gap cover option, bridging the gap between medical aid limits & specialist fees, ensuring financial peace.

www.stratumbenefits.co.za

 

[Ecco]

Keen to hear as well, so will tag along to this thread.

 

[BTTB]

If you're with Discovery, go with their GAP plan.

I'm with Momentum using their GAP Cover. I don't have any paperwork to correspondence. Once Momentum has done with my claim, they then send it to Momentum's GAP Cover who pay about 30 days later, into your account.

 

[RedViking]

I have always been advised NOT to go with Discovery's GAP cover or a gap cover with the same medical aid.

 

[BTTB]

I have always been advised NOT to go with Discovery's GAP cover or a gap cover with the same medical aid.

Can't speak for Discovery, but Momentum was fine for me.

Last year I had R178K in claims, Momentum paid R97K, Momentum GAP paid the rest.
One of the claims was for a certain Doctor whose bill came to R58K, Momentum only paid R18K, GAP paid the difference into my account, and I settled with the Doctor.


Might look like I spend time at the Hospital but that is not the case. I save up and don't process any claims for several years, then one year I'll choose to do all those procedures you put off, like my L4/L5 decompression I had done last year. This year so far, hopefully, zero claims.

 

[RedViking]

Can't speak for Discovery, but Momentum was fine for me.

Last year I had R178K in claims, Momentum paid R97K, Momentum GAP paid the rest.
One of the claims was for a certain Doctor whose bill came to R58K, Momentum only paid R18K, GAP paid the difference into my account, and I settled with the Doctor.


Might look like I spend time at the Hospital but that is not the case. I save up and don't process any claims for several years, then one year I'll choose to do all those procedures you put off, like my L4/L5 decompression I had done last year. This year so far, hopefully, zero claims.

thanks, my mom has momentum, will get her on their gap cover as well as she recently had to go in for an opp and we got shock bill from the hospital but cant figure out for what it is as to my understanding everything was covered under PMB.

The bill just shows "Ins Provider Bill - IFFS"

 

[BTTB]

thanks, my mom has momentum, will get her on their gap cover as well as she recently had to go in for an opp and we got shock bill from the hospital but cant figure out for what it is as to my understanding everything was covered under PMB.

The bill just shows "Ins Provider Bill - IFFS"

Its all a racket imho.
However, with GAP on your side, those shock bills are for their account, not yours.

There is a waiting period for claims with GAP if you didn't know that.

 

[RedViking]

Its all a racket imho.
However, with GAP on your side, those shock bills are for their account, not yours.

There is a waiting period for claims with GAP if you didn't know that.

I'm aware of that, so better if I get her onto it now. My mom is also above 60, so she will pay the under 64 price. Think R550 pm.

 

[BTTB]

I'm aware of that, so better if I get her onto it now. My mom is also above 60, so she will pay the under 64 price. Think R550 pm.

Curious, maybe none of my business, perhaps you do the same.

I've been paying my parents medical aid for a decade or more.
I watched how inflation ate up their savings and as they grew older, they became poorer.
It potentially saved the family money with unforseen medical bills.

While my dad is gone now, I still pay my mother's medical aid.
Dad racked up some big bills in the last 2/3 years of his life which Discovery paid. Mom more recently is having a procedure done to her heart to improve the rhythm, but it's all costs a fortune laying in hospital for a week. She has GAP too btw, with a different company to Discovery, but the other day she said she wanted to move it to Discovery. When I see her, I'll ask how it's going with the claims.

Edit: I'm a provisional taxpayer, you're allowed to take off those extended family medical aid contributions, as deductions.

 

[airborne]

Sirago gap cover is also good.
Best to get the level where they have side benefits not linked to the medical aid first paying a portion.
Many have casualty cover, cancer cover etc.

 

[DStvNothingOn]

I'm on Discovery Gap cover and my folks on Turnberry.

Discovery is more expensive but does cover everything promised by the product.
I've never had a rejection on any legitimate or covered claim.
I haven't really claimed to that much to be fair.

My dad has claimed from Turnberry lots, a few spells in hospital for cardiac issues.
They are slightly cheaper than Discovery, no complaints from him.
They have paid out every legitimate and covered claim no problem, in a reasonable time frame.

This is where the big difference is, for discovery every claim you put in to your medical aid automatically also gets send to gap cover To see if there is any claim to cover, so no additional paper work no getting docs to prove that medical aid paid etc.
They pay some claims direct to provider bloods etc

Turnberry you need to fill claim supply docs etc, not that it's over burdensome or anything.
However not automatic like discovery.

Gap cover is a short term insurance product so there's a lot less grey area than medical aid.


I take a bit of a cynical view on it, brokers will push products that make them the most money.
Short term insurers see an additional revenue stream in gap cover and pushing it to market.
Medical Aids aren't pushing so hard yet so aren't rewarding the brokers the same way.
Leading to the don't have gap cover and medical aid at the same place.

The hard part is balancing medical level vs gap cover level
I'm on the top discovery gap cover and a mid level classic plan which works for me.
it's worked for me so far.

Which Gap Cover do you have or would you recommend that has a good benefit vs price. I don't have the energy to go through all 6 options and preferably don't want to or can't afford to pay for the highest plan. My hospital plan is very basic, Discovery Essential Smart Plan.

Gap Cover Options From Stratum Benefits

Discover Stratum Benefits' gap cover option, bridging the gap between medical aid limits & specialist fees, ensuring financial peace.

www.stratumbenefits.co.za

View attachment 1753435

 

[RedViking]

Curious, maybe none of my business, perhaps you do the same.

I've been paying my parents medical aid for a decade or more.
I watched how inflation ate up their savings and as they grew older, they became poorer.
It potentially saved the family money with unforseen medical bills.

While my dad is gone now, I still pay my mother's medical aid.
Dad racked up some big bills in the last 2/3 years of his life which Discovery paid. Mom more recently is having a procedure done to her heart to improve the rhythm, but it's all costs a fortune laying in hospital for a week. She has GAP too btw, with a different company to Discovery, but the other day she said she wanted to move it to Discovery. When I see her, I'll ask how it's going with the claims.

Edit: I'm a provisional taxpayer, you're allowed to take off those extended family medical aid contributions, as deductions.

I'll look into moving her to Discovery, but I think it cost a bit more than her current plan with Momentum. She doesn't have a pension, so I need to foot all the bills. I'll probably also look at moving her to a higher plan than what we have with discovery next year assuming business is steady.

 

[RedViking]

Oh I also need to get my Dog on a medical plan now at R600 a month as she started developing back problems.

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I guess I can't put my mom on that as well.

 

[Snyper564]

Elite500 about 534 for my wife and I a month.
Cannot comment on the actual cover as I haven't needed to use it yet.

 

[Fcon_Vpro]

Which Gap Cover do you have or would you recommend that has a good benefit vs price. I don't have the energy to go through all 6 options and preferably don't want to or can't afford to pay for the highest plan. My hospital plan is very basic, Discovery Essential Smart Plan.

Gap Cover Options From Stratum Benefits

Discover Stratum Benefits' gap cover option, bridging the gap between medical aid limits & specialist fees, ensuring financial peace.

www.stratumbenefits.co.za

View attachment 1753435

I have the elite cover through Stratum. We recently had a baby and the birth cost about R31000. My wife's medical aid only covered like R4000 and stratum paid out the difference in full.
We have claimed a lot recently because of the pregnancy and they have only rejected what our medical aid didn't have cover for.

I am very impressed with them in terms of payments. I will stick with them for as long as I can afford it.

They could definitely improve some of their processes in terms of submitting claims or managing your policy, but it's really minor in comparison to their payouts.

 

[Ecco]

Anybody able to advise the below means? Some stays at hospital easily go over R200k, so this clause is concerning for me?

 

[SauRoNZA]

There's a one pager with a table that compares all of them, just look at that and then consider it for your needs.

The main differences related to Casualty Cover & Cancer Cover...everything else is more or less the same.

I'm on the 500 as it made the most sense with two kids and illness or accidents happening so the casualty benefit made sense to me.

 

[SauRoNZA]

Oh I also need to get my Dog on a medical plan now at R600 a month as she started developing back problems.

Compare Pet Insurance Plans - South Africa

MediPet offers 4 comprehensive pet insurance plans in South Africa for genuine, transparent cover. View our Accidental, Essential and Ultimate plans now.

medipet.co.za

I guess I can't put my mom on that as well.

This has always seemed silly to me if you have a little discipline rather just put that money away in a savings pocket.

But now that you have a condition already in play I don't know if you'll even get cover.

 

[Ecco]

There's a one pager with a table that compares all of them, just look at that and then consider it for your needs.

The main differences related to Casualty Cover & Cancer Cover...everything else is more or less the same.

I'm on the 500 as it made the most sense with two kids and illness or accidents happening so the casualty benefit made sense to me.

Thanks, but still concerned what this number actually means. I have asked them to contact me, so i will ask. But if anybody knows, do advise

 

[RedViking]

This has always seemed silly to me if you have a little discipline rather just put that money away in a savings pocket.

But now that you have a condition already in play I don't know if you'll even get cover.

We have a savings for the doggy. But the vet fees are EXCESSIVE. You literally need a 100K stacked away.

Get insurance. Sell your wife.

No , they don't cover existing. Medipet will give you a 12 month interest free loan.