NM
Nokulunga M
1 reviews | Active since Jan 2015
27 Mar 2025, 11:37
I took the cover in 2022 and never claimed until February 2025
I took the cover in 2022 and never claimed until February 2025. Before my claim I saw it as a need but after my claim I see it as a want, I know they say there are things they do not cover but then who will cover those if the very thing that is meant to cover my medical aid shortfalls picks and choose what it covers.
Helpful (0)
Replies (1)0
Replies (1)
Zestlife's replyOfficial
27 Mar 2025, 12:56Dear Nokulunga,
Gap Cover is mainly to cover specialist shortfalls for hospital procedures, as most people are on medical aid options that cover 1 times tariff and specialist can charge up to 4 or 5 times medical aid tariff. Gap Cover does offer other benefits such as procedure co-payments imposed by the medical aid and cover for specialist shortfalls for certain out-of-hospital listed procedures, etc. It is however not designed to cover all your medical aid shortfalls as this would make the policy premium very expensive.
I will arrange for one of our agents to contact you to explain the policy terms and conditions to clarify what are covered and not covered by Gap.
Kind regards
Noleen
Gap Cover is mainly to cover specialist shortfalls for hospital procedures, as most people are on medical aid options that cover 1 times tariff and specialist can charge up to 4 or 5 times medical aid tariff. Gap Cover does offer other benefits such as procedure co-payments imposed by the medical aid and cover for specialist shortfalls for certain out-of-hospital listed procedures, etc. It is however not designed to cover all your medical aid shortfalls as this would make the policy premium very expensive.
I will arrange for one of our agents to contact you to explain the policy terms and conditions to clarify what are covered and not covered by Gap.
Kind regards
Noleen
Zestlife's reply27 Mar 2025, 12:56
Official
Dear Nokulunga,
Gap Cover is mainly to cover specialist shortfalls for hospital procedures, as most people are on medical aid options that cover 1 times tariff and specialist can charge up to 4 or 5 times medical aid tariff. Gap Cover does offer other benefits such as procedure co-payments imposed by the medical aid and cover for specialist shortfalls for certain out-of-hospital listed procedures, etc. It is however not designed to cover all your medical aid shortfalls as this would make the policy premium very expensive.
I will arrange for one of our agents to contact you to explain the policy terms and conditions to clarify what are covered and not covered by Gap.
Kind regards
Noleen
Gap Cover is mainly to cover specialist shortfalls for hospital procedures, as most people are on medical aid options that cover 1 times tariff and specialist can charge up to 4 or 5 times medical aid tariff. Gap Cover does offer other benefits such as procedure co-payments imposed by the medical aid and cover for specialist shortfalls for certain out-of-hospital listed procedures, etc. It is however not designed to cover all your medical aid shortfalls as this would make the policy premium very expensive.
I will arrange for one of our agents to contact you to explain the policy terms and conditions to clarify what are covered and not covered by Gap.
Kind regards
Noleen