It’s easier to take the gap now
The medical gap cover controversy is over
The policies have their place, as some specialists in hospitals charge more than 500% of medical scheme rates
The business of gap cover, which takes care of shortfalls in medical aid payments, was once seen as a rogue industry. It was deemed to encourage medical practitioners and hospitals to charge more, knowing that they would be reimbursed. It was also dressed up as a cheaper alternative to medical aid, even though it can never provide the cover needed in a serious health event. These days nobody is allowed to buy gap cover unless they are already a member of a registered medical aid. It is not surprising that the industry was dominated by church mouse-sized businesses such as Stratum, TRA, Turnberry and Zestlife. The most mainstream business was Admed, part of Guardrisk, now owned by MMI. But it seems as if Admed spent more time fighting the regulator in court than servicing its clients.
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