This type of insurance goes hand in hand with your medical scheme.
Most of the medical schemes only pay up to 100% of the medical scheme
rate, but the specialists that treats you when admitted to hospital will
in most cases charge you more than the medical scheme rate (300% is
very common). This means that you will be liable for the GAP between
100% of the applicable rate and the rate the doctor charges you.
GAP cover can pay that shortfall up to 500%.
The shortfall can be as high as R40 000 or more and then GAP cover will come to the rescue if this happens.
There are a few different options with GAP Cover products.
It can
vary according to your specific needs. You can extend your GAP cover to
pay the co-payments on MRI and CT scans or even the Hospital co-payments
if your medical scheme imposes it.