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We Fill in the Gaps About Gap Cover

We Fill in the Gaps About Gap Cover

“Mind the gap,” is a phrase you will recall with fondness when reminiscing about your London days. Back then you were wild and carefree, as you travelled the world with your then future wife. Your son was just a twinkle in your eye. Fast-forward a few years and here you are examining the smallest of toes and the finest of fingers. He is a miracle, and your little family of three is now your number one priority. Your wife has gone out to buy yet another bag of disposable nappies. Babies don’t just come with a big set of lungs, they come with a big set of expenses too. So whilst “mind the gap” had its place in London, you’re very grateful you didn’t ‘mind’ the Gap cover when planning a family.  Young families need to ensure they don’t end up in financial dire straits due to inadequate Medical aid cover. It is vital to familiarise oneself with what Medical aid and Gap cover are needed prior to the arrival of a third (very vocal) family member.

Here are 3 fundamental things young families must know about Medical aid and Gap cover:

  1. Ensure you take out adequate and reputable medical aid cover.

    Babies are expensive. It was recently calculated by government that it will cost an average middle-income South African family R1,681,470 to raise a child from birth to 18 years of age. You need to be financially prepared.

    An essential part of this financial planning includes taking out the right Medical aid cover for your family. Speaking to the right insurer is important. You don’t need to feel overwhelmed by hunting all over for the best insurance advice. Instead, visit for quick and easy comparative Medical aid quotes.

    Remember that despite your best efforts, babies and toddlers can and do get injured. Between the ages of birth to 6 months they begin to roll, move about and grasp objects, which can make them vulnerable to injury regardless of how vigilant you are. Then at 6 to 12 months of age the fun really starts. They begin to crawl and are insistent on putting every conceivable object into their mouth. Then, whilst you’re still trying to catch your breath, the 1 to 2 years period arrives. This is where your little tyke is almost certain to end up in the hospital casualty with stitches or a broken arm. It is clear to see why Childsafe South Africa reports that children under 5 years are most vulnerable to injuries – ensure your fearless, sword-wielding superhero is adequately covered.

    Visits to the GP also become more frequent with the onset of the preschool years. A young immune system begins to tackle an onslaught of germs and viruses, with high temperatures and stuffy noses being just some of the common frequent ailments.

    Whilst the price of medical aid is an understandable concern for young families, it is important to note these key areas when selecting your medical aid:

    PMBs (Prescribed Minimum Benefits)

    These are the chronic condition benefits that all medical aids must cover. Look for a medical aid that covers more than the required minimum of 27 PMBs.

    In-Hospital Medical Aid Benefits

    Many medical aids cap these. In short, they impose limits on the amount you can claim for in-patient treatment. This can be limited to days or a monetary amount.

    Day-to-Day Medical Aid Benefits

    Ensure that the medical aid you select adequately covers your family’s day-to-day medical needs. This cover amounts can vary quite substantially between insurers.

    Network Option

    Some medical aids give you the option of choosing a doctor from a network rather than going to the professional closest to you. This can help to reduce the cost of the contributions.

  2. Don’t delay in taking out gap cover.

  3. Once you’ve taken out the right medical aid cover for your family, you need to consider the benefits of Gap cover. Your Medical aid is there to cover hospital stays, medical professional fees, anaesthetist fees, as well as any medication and hospital supplies needed. However, depending on which Medical aid plan you are on, there is usually a short-fall percentage that is not covered. In fact, many doctors and other medical professionals are contracted out of medical aid, which may leave you with a medical bill that’s much higher than expected.Gap cover is designed to cover the shortfall (or ‘gap’) between what your private doctor charges and what your medical aid is required to pay. It is important that you familiarise yourself with what gap cover will and won’t pay for. This varies, even between the top gap cover options. So do your homework and get comparative quotes and sound advice from is also important to be aware of waiting periods for gap cover. Don’t wait until after you receive the good news of your wife’s pregnancy before taking out gap cover. Plan ahead! Gap cover providers may exclude pre-existing pregnancy (amongst other pre-existing conditions) for up to 12 months. You’d much rather spend your money on the latest and safest stroller than on the short-fall of an unanticipated emergency C-section bill.
  4. Gap cover and your elderly parents.

  5. It’s hard to imagine anyone loving your little boy more than you and your wife do, right? But, there’s the grandparent factor, and they may well trump your affection. They get to spoil without consequence. To your child, they represent an abundance of snuggles, trips to the aquarium and sticky-faced candyfloss indulgences.Sadly, old age brings with it illness and an increased risk of falling and serious injury. Have the conversation around adequate Medical aid and Gap cover with your parents. A quick family meeting is all that’s required to help your parents choose the right medical aid – it’s a small ask considering all they have done for you. An increase in short-fall medical expenses can stack up rapidly. Adding Gap cover will minimise their financial stress when things go medically wrong.So, whether you are trying to catch up on that ever-elusive sleep, or even if your young family is still in the planning stages, give full thought to your Medical aid cover and Gap cover needs. Even if you currently have a Medical aid, doing a comparative quote investigation on the latest and best options through could prove beneficial for you. While you’re visiting, you can aso enquire about life insurance options. You are everything to your family, so ensure they are cared for in any eventuality – medical or otherwise.