Medical gap cover surges
National Health Insurance isn’t the only threat to medical aids — or your pocket
01 February 2024 - 05:00
As many medical scheme members age while younger, healthier members buy cheaper options with fewer benefits, gap cover can total more than half of some patients’ medical aid payouts.
Interviews with brokers, underwriters, funders, consultants and GPs reveal a medical aid industry struggling to contain inflation. Insurance underwriters tell of regular individual gap payouts to cover medical aid shortfalls of between R50,000 and R191,000. The latter figure is an annual regulated gap cover limit per beneficiary for hospital treatments...
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