This is not a Medical Scheme and the cover is not the same as that of a Medical Scheme.
This Policy is not a substitute for Medical Scheme membership.
What is Gap Cover?
Gap Cover is a short term insurance product that helps you cover certain cost shortfalls that your medical aid does not cover. These medical shortfalls occur when your selected doctor or medical specialist charges rates that are more than what your medical aid will pay for. These shortfalls vary according to the fees charged by a medical specialist and the nature of the procedure required.
Kaelo Gap Cover provides security regardless of the medical aid plan or option selected. This freedom allows patients to select the very best doctors without having to worry about whether the medical bills will be fully covered by the medical aid.
Why Gap Cover is essential:
Gap Cover is essential due to the high cost of specialist treatments and above-inflation increases, meaning that more people are at risk of being left behind and excluded from the quality medical care they need and deserve.
Many medical disciplines are increasing their charges at a rate much higher than that of inflation, some up to 500% of medical aid rates. Patients and their families are required to meet the cost shortfalls that exist between what their medical aid covers and the actual charge of the specialist.
Kaelo Gap Cover Benefits:
- Tariff Shortfalls
- Co-Payments and Deductibles
- Shortfalls from Sub-Limits
- Oncology Tariff Shortfalls
- Oncology Sub Limits
- Oncology Co-Payments
- Oncology First-Time Diagnosis
- Out-of-Hospital Tariff Shortfalls
- Penalty Co-Payment
- Innovative Oncology Medicines
- Dental Reconstruction Benefit
- Family Booster
- Casualty Child Illness
- Accidental Casualty
- Hospital Booster
- Family Protector
- Medical Scheme Contribution Waiver
- Gap Premium Waiver
- Road Accident Fund Claims
- Legal & Financial Advise
- extra by Dis-Chem
Kaelo Gap is not a Medical Scheme or an Insurer.
The administrator for Kaelo Gap is Kaelo Risk (Pty) Ltd, an authorised Financial Services Provider (FSP 36931).
Kaelo Gap is insured by Centriq Insurance Company Limited (“Centriq”), a licensed non-life insurer and an authorised Financial Services Provider (FSP 3417).
Kaelo Risk (Pty) Ltd holds preference shares in Centriq Insurance Company Limited.
The Lifestyle Benefits are Kaelo offerings. Service Providers are contracted to Kaelo.