You’ve heard about medical aid gap cover and that it’s a pretty darn important insurance policy to own nowadays. Before you look to become a policy holder and shell out a few extra bucks each month, you might have a few questions. One of them is, “Will the policy automatically cover my entire family?”
Let’s start with the second part of the question first. Nope, your entire family isn’t necessarily covered under a medical aid gap cover policy, only those family members who are on your medical aid scheme plan will be covered.
Let’s take a look at a quick example to clarify the issue.
You belong to the Discovery Health medical aid scheme. On your plan, the following members are currently covered:
- You (as the principle member)
- Your wife (as an adult dependent)
- Your kids (as child dependents) x 2
If you take out a medical aid gap cover policy only the above mentioned parties will enjoy cover. Why? Because those are the people insured on your medical aid plan. Your mother, father, cousins and actually anyone else in your family won’t simply enjoy cover.
“But what happens if I need to add a family member to my medical aid plan? Will it cost me anymore in premiums to add them to my gap cover policy and do I need to let the gap cover company know?”
At Zestlife (our gap cover partner) you pay a flat premium of R140 per month regardless of how many people you’ve got on your medical aid. That’s pretty neat! No additional charges to add additional family members.
You don’t need to let them know when you’ve added a new family member to your medical aid. Provided at claim stage, the person you intended claiming for was a member (spouse, adult or child dependent) of your medical aid, they are covered. Zestlife will confirm this before entertaining the claim.
Again let’s look at an example and using the above information.
On your Discovery Health medical aid plan you’ve got yourself, your wife and your kids (2) covered. You’ve taken out a medical aid gap cover policy with Zestlife which covers everyone on your medical aid plan for a flat R140 per month.
Lets assume your mother isn’t on a medical aid scheme at all. You get her added to your Discovery Health plan as an adult dependent. Under your medical aid gap cover policy with Zestlife your mother now enjoys cover immediately. No waiting period.
Did you need to notify Zestlife? Nope.
Have you decided that now is the time to look into medical aid gap cover?
Kind regards,
The InsuranceFundi Team