Many South Africans assume that once they have medical aid, every medical bill is taken care of.
Unfortunately, that’s not always the case.
While medical aid plays an important role in helping you access healthcare, there may still be costs that you’ll need to pay yourself. Depending on your medical aid option and the treatment you receive, you could face co-payments, tariff shortfalls or other qualifying medical expenses.
These unexpected costs often arrive at the worst possible time, when your focus should be on recovering, not worrying about how you’re going to pay the bill.
That’s why it’s important to understand what your medical aid covers and where additional financial protection could make all the difference.
What are unexpected medical expenses?
Unexpected medical expenses are the costs that can arise when your medical aid doesn’t pay the full amount for eligible treatment.
Many people only discover these costs after they’ve been admitted to hospital or undergone a medical procedure.
Whether it’s an emergency, planned surgery or specialist treatment, receiving an unexpected bill can place unnecessary financial pressure on you and your family.
The good news is that you can prepare for these situations before they happen.
How to prevent medical shortfalls.
Four situations where unexpected medical costs can happen
No one plans to end up in hospital, but life has a way of surprising us. Here are four common situations where unexpected medical expenses can arise.
1. Emergency surgery
One day you’re going about your normal routine. The next, you’re in hospital needing urgent surgery.
Whether it’s appendicitis, gallstones, an unexpected injury or another emergency procedure, medical treatment often can’t wait.
While your medical aid may pay a significant portion of the costs, there may still be qualifying medical expenses that you’ll need to cover yourself.
2. An accident
Accidents happen when you least expect them.
A fall at home, a sports injury or a car accident can result in emergency treatment, hospital admission and specialist care.
Recovering from an accident is stressful enough without the added worry of unexpected medical bills.
3. Planned procedures
Not all medical costs come as a surprise.
Even planned procedures can include co-payments or tariff shortfalls, depending on your medical aid option and the treatment required.
Understanding your cover before your procedure can help you avoid unexpected financial surprises afterwards.
4. Serious illness
No one expects to receive a life-changing diagnosis.
Whether it’s a condition that requires hospitalisation, specialist treatment or ongoing care, the costs associated with treatment can add up quickly.
Having additional financial protection can help reduce the impact of qualifying medical expenses while you focus on your recovery.
Why it’s better to prepare before you need it
Medical emergencies don’t usually come with a warning.
Most people don’t think about healthcare costs until they’re already sitting in a doctor’s office or preparing for a hospital admission.
By then, it’s too late to change your cover.
Planning ahead means you’re better prepared for the unexpected and can focus on what matters most: getting the care you need.
How Oneplan Gap Cover can help
Oneplan Gap Cover is designed to provide affordable financial protection by helping to cover eligible in- and out-of-hospital shortfalls, co-payments and other qualifying medical expenses when your medical aid benefits or Medical Scheme Savings have been exhausted.
Depending on your plan, benefits may include cover for eligible:
- In- and out-of-hospital shortfalls
- Co-payments
- Casualty treatment following an accident or illness
- Day-to-day savings benefits
- Mental health benefits
- Cancer-related benefits
- Accidental HIV exposure treatment
Always refer to your policy wording for full benefit details, limits, waiting periods and exclusions.
Peace of mind when you need it most
No one can predict when they’ll need medical treatment.
But you can prepare for the possibility that your medical aid may not cover every cost.
Understanding your cover and having additional financial protection in place can help reduce the impact of unexpected medical expenses, giving you greater peace of mind when you need it most.
Discover how Gap Cover can eliminate medical shortfalls.
Make today better with Oneplan
Medical aid is an important part of your healthcare journey, but it doesn’t always cover every expense.
Oneplan Gap Cover helps bridge the gap by providing affordable financial protection for eligible medical shortfalls, co-payments and other qualifying medical expenses.
Because when it comes to your health, it’s always better to be prepared before you need it.
Your Insurance Family,