Picture: 123RF/RONSTIK
Picture: 123RF/RONSTIK

In this edition of the Business Day Spotlight, we talk about the medical cover shortfalls that are hurting consumers.

Our host Mudiwa Gavaza is joined by Travys Wilkins, chief executive guru of insurance comparison platform Compareguru.

The discussion focuses on gap cover, which Compareguru recently starting offering on its platform. Put simply, Gap cover is short-term insurance which provides funding for the shortfall where doctors and specialists charge above medical aid rates of cover.

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Wilkins says many South Africans with medical cover are often shocked to discover that they need to pay substantial shortfalls in medical expenses — even those on the most comprehensive and expensive plans.

Business Day Spotlight host Mudiwa Gavaza. Picture: DOROTHY KGOSI.
Business Day Spotlight host Mudiwa Gavaza. Picture: DOROTHY KGOSI.

“When you’re considering medical aid or hospital plans, hearing that you’ll be covered at 100% of the medical scheme tariff sounds comprehensive. But specialists typically charge up to 600% of this tariff, which means that you could be in real financial trouble if you’re under the impression that all medical costs will be covered by your medical aid or hospital plan.”

Wilkins relates his own experience in this regard, having recently had a childbirth in their family which resulted in a R26,000 shortfall that they ordinarily would have had to cover themselves.

Gap cover, ensures that any cost surprises are paid if a person lands up in hospital, says Wilkins.

The discussion focuses on the importance of gap cover, the disparity between the amounts paid by medical aids versus what is charged by doctors and hospitals, the need for greater consumer education around medical cover and Compareguru’s business model.

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 Business Day Spotlight is a MultimediaLIVE production.

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