Supplementary Cover 101

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Medical schemes don’t always pay for everything

Unfortunately, membership of a medical scheme is not enough anymore to provide for the debilitating financial consequences of illnesses, accidents and assaults. The reality is that schemes are not perfect.

Fortunately, affordable supplementary cover is readily available to plug many of these holes and enhance your peace of mind beyond measure.

Here are some examples of situations where supplementary cover finds application. This will give you an idea of what it is all about:

Will your option pay for The Gap?

A specialist, doctor or anaesthetist may charge you a lot more than what your option is prepared to pay. And if you don’t have  cover for the ensuing difference (The Gap) you must foot the bill yourself. Which can run into the thousands!

Who will pay the balance of R500 000?

A general overall annual limit of 1 Million Rand, for example, sounds like a lot of money. But, should the medical costs shoot past your limit and the final accounts add up to 1,5 Million Rand… What then?

Pay first, then only will we admit you

If you are already nervous because of an imminent operation, you are definitely not in the mood for a stiff co-payment before admission to hospital. Especially if you cannot really afford it at the time.

Specialised radiology can be very, very expensive

Cover for specialised radiology, e.g. CT & MRI scans, is often way inadequate. It may cost you an arm or a leg before you know it.

Can you afford the internal prostheses?

Internal prostheses are everything but cheap. For an everyday knee replacement it easily costs somewhere between R30 000 and R45 000. For a hip replacement from R35 000 to R50 000. And just wait till you must replace a worn out prosthesis!

Insufficient cover for cancer may cost you your life

Will your option pay everything? Will your benefits be exhausted halfway through your treatment? Will you be forced to stop your treatment, or be satisfied with the second best, just because you cannot afford better and more expensive treatment?

The scheme pays the accounts, but who pays scheme?

Especially professional persons, business men/women and farmers are at risk. Your scheme pays your medical accounts as long as you pay your contributions. But what if your income dries up during a protracted illness and you don’t have money anymore to pay your medical scheme? If you do not pay your contributions, the scheme will cancel your membership which will surely leave you in dire straits.

Critical illnesses lead to traumatic financial consequences

Illnesses like cancer, stroke, heart attack or blindness more than often start a chain reaction of unforeseen non-medical costs which can easily lead to your insolvency.

Even funeral cover is extremely important

Death is a subject one would rather avoid thinking about. But, an illness, accident or assault, sad to say, often do end in the inevitable funeral…

Adequate funeral cover provides for human dignity in tragic circumstances. It helps to somewhat lessen the grief for those staying behind.

The solution

Eliminate the shortcomings of your health care cover to a large extent by taking out the right supplementary cover. Also  income protection, critical illness and funeral cover. Before it is too late.

It is easy, it is affordable, it is a necessity.

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