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Medical Schemes

It refers to the maintenance or improvement of health via the prevention, diagnosis, treatment, recovery, or cure of disease, illness, injury, and other physical/ mental impairments. The financial adviser will assist the client to ensure that these medical expenses are planned for and that the cover fits the client’s specific medical needs.

 

Medical aid – Plans that offer in hospital cover for emergencies and planned procedures. Additional savings for out of hospital cover such as General practitioner appointments, dentist appointments etc is also available on the higher plans. Medical schemes are regulated by the Council of Medical Scheme (CMS) and your adviser will help you ensure that all of the legislation requirements are understood.

 

Gap cover – This product is regulated by the Short-term Insurance Act and claims are processed as within this industry and provides shortfall cover where doctors and specialists charge above medical aid rates of cover. Gap cover works in conjunction with your medical aid. Cover is also provided for co-payment and certain sub limits.

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