Medical Gap Cover
Find the Gap Cover which best suits you with a comparison of all of the major Medical Gap Cover providers including:
Cura, Liberty (ZestLife), Sanlam, Stratum Benefits, TRA and Turnberry
From the people that have been bringing you broker-fee-free gap cover since 1999
Get Medical Gap Cover
Examples of Medical Aid shortfalls
|Procedure||Cost||Medical Aid Payout||Shortfall||Gap Claim|
|Wisdom Teeth Removal||R6,260.00||R1,958.50||R4,301.50||R4,301.50|
What is GAP COVER?
GAP cover pays YOU the difference between what the doctors charge in hospital and NHRPL, what the medical aid actually pays.
The National Health Reference Price List (NHRPL) is a pricing system maintained by the Department of Health and the Council for Medical Schemes. The NHRPL specifies the rates to which your medical aid scheme must adhere. It is the amount of money that they are bound by law to pay out for a given situation. Doctors, hospitals and other medical service providers however, are not bound to these rates, and in fact charge up to 300% above these NHRPL prices. So despite thinking you are financially covered for any medical eventuality in its entirety, for the most part you are not, and are often liable for an enormous shortfall.
To Whom It May Concern
This serves as a testimonial for Tyrone Raman who assisted me with choosing my GAP cover and my claim.
On 7 March I received the outcome for my first claim with Turnberry for costs relating to my reconstruction of left breast after my mastectomy. Their letter stated that due to Clause 26, preexisting condition clause my claim had been declined.
I consulted Tyrone and he advised that we had passed the 3 month waiting period and there should be no other preexisting conditions. He immediately wrote to Turnberry and stayed in touch with constant and timeous followups. I was very impressed with his excellent knowledge with regards to the policy definitions and laws, and interpretation thereof. Tyrone displayed excellent communication skills throughout the process of disputing their outcome. I felt reassured that I was in good, capable hands.
Despite their resistance to review the claim outcome he was determined and persistent while staying respectful and professional and got the results needed.
I am impressed with the service standard which is a rare quality in the times we live in and am grateful.JANICE ZEEMAN
I appreciated the speed and efficiency with which my claim was processed.NOLAN WALLACE