This cover pays for the shortfalls that might occur on doctors’ and specialists’ accounts when hospitalised or where certain out-patient procedures are performed.
Gap cover policies have been under review by National Treasury and the first draft regulations have proposed banning gap cover products as they were in effect carrying out the business of a medical scheme. But after consultation, it was clear there is a role for gap cover to provide a low-cost solution to meeting bills not covered by medical aid.
The compromise is that these policies can continue, provided they operate within a framework where there are strict product parameters and monitoring by the Financial Services Board. Gap cover may also only be provided to insured persons who are members of a medical scheme. It is seen as an enhancement and not as a replacement.