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Many gap cover policyholders are facing steep premium increases, despite new limits on payouts you can receive when your medical scheme benefits fail to match what doctors and other healthcare providers charge.
Increases of between 9% and 100% follow two years of high claims that gap cover providers attribute to increased awareness, particularly among doctors, that medical scheme members have this cover.
Many older policyholders, however, may face harsher increases as insurers implement new terms following the promulgation of demarcation regulations under the long- and short-term insurance acts. These regulations took effect on April 1 and allow for late-joiner penalties for those who take out gap cover late in life.
New gap cover policies had to comply with the demarcation regulations from April, but existing policies must comply when cover is renewed. In most cases, this is from January.
The regulations, aimed at ensuring that gap cover policies do not undermine cross-subsidisatio...
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