Western Gap provides peace of mind and financial cover for in-hospital medical shortfalls and allows you to be able to choose the best medical care for you and your family.
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.
- Tariff Shortfalls (up to 500% of Medical Scheme Tariff)
- Co-payments, Penalties and Deductibles
- Oncology Co-payments (and First Time Diagnosis Benefit)
- Step Down Facility
- Dental Reconstruction Benefit
- Accidental Casualty
- Child Casualty Illness
- Maternity Booster
- Innovative Oncology Medicines
- In-Hospital Tariff Shortfalls
- Accidental Death and Disability Benefits
- Contribution Waiver (in the event of the Death or total and permanent Disability to the Medical Scheme Main Member)