Mind The GAP…

I have been reminiscing a lot about this time last year – Riya was only 4 months old and Kyla was walking and starting to talk.  What a gorgeous time that was.  As I was watching my screen saver of family photos (as I often get lost in doing) I was reminded that around this time last year Kyla was admitted into hospital.  After 4 full days of raging temperatures (40.2 being the highest it got to) we decided (after talking to the Pead) that she should be admitted into hospital…

Kyla's arm - the only way to keep the drip in, she had to have this on from the time she was admitted until she left.

Besides the fact that we have Medical Aid (thank goodness) we still had some shortfalls in cover during this time.  Annoyingly specialists charge far more than what the Medical Aid’s think they should, so they just don’t pay them more than that.  We were left with quite a few additional bills…  So besides the fact that we were dealing with a very sick baby we had to worry about all the bills piling up.  Thankfully after the hospital admission and treatment she came home as right as rain, though we still don’t know what the real cause of it was – the Pead said it was probably a random virus…  Thanks for that.

I don’t usually do this, but if you have been in this situation, I am sure that you would appreciate a solution.  We purchased GAP cover and since then have had to pay nothing when being admitted into hospital.  What a relief.  Especially since we intend to populate the world with at least one more Alfino bambino this cover is particularly useful when it comes to the birth of babies.  So here’s the solution – GAP Cover:

Most Medical Aid’s will tell you that they cover you 100% (or maybe 200%) once you are admitted into hospital, however this is often misrepresented.  What they mean is that they will cover you for 100% of what they have determined that this procedure SHOULD cost. However the specialists still charge a higher rate, thus leaving you with a potential hole in your cover and massive expenses for your own pocket – should the unthinkable happen.  This is where GAP cover would be beneficial for you.  This cover is a must have.

Essentially this is additional cover from a different company called Stratum and completely separate to your current Medical Aid.  This cover as absolutely necessary; let me explain why through an example.

Should you injure your shoulder in a car accident and have to go into hospital to have it fixed, the surgeon (who specialises in shoulders) is could charge you R50 000.  However according to the Medical Aid – this procedure should only cost R10 000, they would only contribute R10 000 towards the payment.  Therefore there is a shortfall of R40 000 for your own pocket.  This would be covered by the GAP Cover.

We had this for both pregnancies and all the other times that we have been admitted into hospital – which is surprisingly a lot.

So you may hate me for doing this on our blog, but maybe you’ll love me for helping you out.  If you have a broker or someone that deals with your Medical issues you should contact them, but if you don’t know anyone I can actually provide this cover if you would like it, so contact me if you are interested.  I promise you that you will not regret it.  You can reach me directly on my office number 021 422 4337 or you can pop me an email to risk@incompass.co.za and I’ll hook you up with more specific details on the plans and an application form.  Plus I promise to be a bit more formal when addressing you as a client, but for now…  Peace out.

5 thoughts on “Mind The GAP…

  1. Oh man! I must say that’s one nice thing about living in the UK and not having to ever think about paying any medical expences!. Saying that, I’ll definitly tell my mom about it!

    • Eventually we will have our own version of the NHS, but it’s going to take many years to properly implement. Sad but true! I’m just glad they came up with GAP cover, at least there is a small solution for now.

  2. Im gonna tell my mom about this…I had the most expensive medical aid plan discovery had to offer..thought it covered everything…after being sick, I ended up with 50 000 i had to pull out of my own pocket ( without having had any major surgery!) 😦 sadly they dont tell you these things and I was gutted when all the bills started coming in and I phoned them and they came up with every reason in the book why they didnt have to cover these bills. Good Job on the post, it will help a lot of people!

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