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BVSA offers a range of options in medical aid

Medical aid and Gap cover:

Medical aid cover is a priority – even during these challenging financial times.

During the period of September to December, you have the opportunity to change your medical aid plan or gap cover.

Now is the time to consider your specific medical needs and compare plans that are tailored to suit your pocket.

 

What you should know:

  • Hospital costs aren’t always fully covered – the specialist who treat you in hospital might charge a higher tariff than the medical aid payment rate.
    It will be the members responsibility to pay the shortfall if there is no gap cover in place.
  • Certain procedures – such as MRI/CT scans, endoscopic procedures as gastroscopies, in-hospital admissions and wisdom teeth removal might require a co-payment.

 

Who can benefit from a hospital plan?

  • Young and healthy members who don’t have large day-to-day medical expenses are usually happy with a hospital plan.
  • Affordable access to private healthcare.
  • Those who can afford to pay for day-to-day medical expenses out of their pocket but want to protect themselves against large medical expenses such as hospitalisation.

 

When is comprehensive cover required?

  • It works well for people with specific medical conditions or chronic ailments that require expensive treatment. (Specialised Medicine).
  • Need for biological drug medication, higher cancer benefit limit.
  • If your out-of-hospital spend is higher than the cost of paying for a full medical aid over a 12 month period, you’re better off on a full medical aid.

 

Reasons why members are sometimes liable for co-payments:

  • Specialists fees for in-hospital treatment and procedures might be higher than medical aids are willing to pay. Members often take out gap cover insurance to cover the shortfall.
  • Medical aid schemes require co-payments for certain procedures such as endoscopic procedures or wisdom- tooth removal. Gap cover usually covers this.
  • Doctors and specialists out- of-hospital consultation fees might be more than your medical aid’s tariff structure: in which case you must pay the difference from your own pocket.
  • If dentistry or optometry costs are more than the medical aid benefit, you are liable to pay the difference.
  • If you don’t get your chronic medication from your medical aid’s preferred supplier, or you use medication that’s not on your scheme’s list of approved medications, you pay the difference in price. A generic version of the medication usually cost less.
  • If you’ve reached your fund limit and/or your savings account has been exhausted, you must pay all other medical costs yourself.

 

How to save?

  • Consider getting a hospital plan that has a network option. Medical aids negotiate tariffs with private hospitals to limit costs. The hospitals are then part of that medical aid’s network of hospitals. By changing to a network hospital plan you can save money without sacrificing benefits.
  • Get Gap cover insurance for unexpected medical expense shortfalls.

BVSA offers a complete range of options in benefits and medical aid cover options.

We’ll help you find the cover that suits your needs and budget.

 

MEDICAL AID SCHEMES:

Medical scheme membership financially protects you if you suddenly must pay large, unexpected medical costs.

Bonitas | Bestmed | Discovery | Fedhealth | Genesis / Momentum | Medihelp | Medshield | Profmed

 

GAP COVER: (Insurance)

(Insurance is not purchased for the Expected, but rather for the Unexpected)

If you’re in hospital, you want financial concerns to be the least of your worries. Medical aid schemes often don’t pay out in full for certain specialists or procedures. Gap cover is a short-term insurance product designed to provide extra protection for those who already have medical aid. GAP cover is designed to help cover in-hospital account shortfalls that your medical aid doesn’t cover in full.

Choose between a 200% or 500% benefit option.

Discovery | Momentum | Sirago | Stratum | TRA Gap | Liberty Gap

Feel free to contact us for a comprehensive explanation of all the valuable benefits.

Karin Theron
karin@bvsa.co.za
028 514 1102

Anel Heyns
anel@bvsa.co.za
028 514 1102

Zelna Visser
zelna@bvsa.co.za
028 754 2009

Luanne Nel
luanne@bvsa.co.za
028 754 2009

Michelle Marais
michellem@bvsa.co.za
022 482 3838

 

Article by:

Karin Theron
Medical Aid Consultant
Boshoff Visser Financial Services

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