![]() What is Gap Cover? Gap Cover is the invaluable safety net that covers the shortfall between what medical schemes pay and what specialist doctors charge. Without a gap cover policy, a member would be required to pay this unexpected cost from their own pocket. In addition, a comprehensive gap cover policy also covers co-payments, penalty fees and cancer benefits. At Daberistic, our preferred provider is Sirago. Why Choose Sirago? • Personalised customer service • Gap Cover Solutions • Cover for in and out of hospital • Shortfall cover for day-to-day specialists, GP consultations, dentists and Alternative Therapy • Standard waiting period • Emergency Room Cover for accident, trauma and Illness • No maximum entry age. Benefits do not cease at the age of 65. • Cover for you and your family either on single medical scheme membership or on multiple memberships. • Sirago provides effective turnaround time so as not to compromise policyholders. • A stated benefit is paid straight into the policyholder's bank account or arrangements can be made to settle directly with providers • Claims run weekly • You can claim online, an industry first and for our clients: https://www.daberistic.com/gap-claim-ch.html
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Please contact Namhla or Tammy in our Health and Wellness Department, email [email protected] , if you have any queries about Gap cover
![]() 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. Gap Cover policies are proving to be an invaluable safety net, as the shortfall between what medical schemes pay and what specialist doctors charge has widened, leaving policy holders with a medical bill big enough to put them back in hospital. To ensure you don’t find yourself with unpaid medical bills contact Namhla in our Health, email [email protected] , tel (011)658-1333 and apply for gap cover Source: Covergap |
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January 2025
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