Five myths that could hurt your finances

MANY South Africans assume that having medical aid means that the full cost of private healthcare will be covered.

- BRIAN HARRIS

This is often not the case. Patients are increasingly faced with co-payments, specialist shortfalls and sub-limits that leave them responsible for part of the bill.

Gap cover plays an important role in addressing these shortfalls, but it is often misunderstood. Misconceptions about how it works, what it covers and who needs it can result in significant out-of-pocket shortfalls when undergoing necessary medical treatment.

Understanding these misconceptions is key to avoiding unexpected out-of-pocket medical costs that can have significant consequences for your financial health and wellbeing.

Misconception 1: I have medical aid, so everything is covered

One of the most common assumptions is that medical aid on its own is enough. However, medical schemes pay according to their own scheme rates, while specialists often charge significantly more.

This creates shortfalls that must be paid out of pocket. Co-payments and sub-limits are also becoming more common, even on higher-tier plans.

This means that members are increasingly responsible for part of the cost of treatment, despite having what appears to be comprehensive medical aid.

Misconception 2: Gap cover is only for certain people or plans

Gap cover is often seen as something only needed on lower-tier medical aid options or only for older individuals.