SERVICES WE OFFER
MEDICAL AID
& GAP COVER
Provides financial cover for medical expenses for members who pay a monthly contribution for healthcare costs such as hospitalisation, treatments and medicine. These costs are covered according to the rules of the medical scheme and the member's medical aid plan. These rules ensure that members are fairly cared for.
MEDICAL COVER FOR YOU AND YOUR FAMILY
Everyone needs some form of medical aid cover. Few of us could afford the costs of long hospital stays or care for serious injuries, surgery, or chronic illnesses. Medical schemes help us finance life’s curve balls when we can’t do it alone.
It’s advisable to evaluate your medical aid coverage each year to make sure you have adequate cover for your needs or for any changes in your health, for example, deciding to have a child or being diagnosed with a chronic condition.
More importantly, traumatic events like a car accident, crime-related incidents or sport-related incidents can happen to anyone at any age or life stage. The costs associated with one of these random, high-risk events can run into many thousands or even hundreds of thousands of rands, which few people can afford at any life stage – especially when you’re young.
Without the assistance of a medical aid, very few South Africans would be able to pay for a variety of extremely expensive treatments, procedures, surgeries, and general hospital fees.
Overburdened state facilities simply cannot cope with the number of patients who seek their assistance.
Medical Aid provides cover for your day-to-day medical expenses such as doctors' visits and medication; certain plans may come with a medical savings account for these claims.
Benefits of having medical aid:
Contact Capitalise Wealth Management today to get your plan on track…
MEDICAL GAP COVER
Helps you cover unexpected medical costs, including when healthcare professionals charge more than what your medical scheme pays, or when you have a life-changing event.
Benefits of gap cover:
Covers shortfalls on approved in-hospital specialist claims, specific out-of-hospital costs related to an approved hospital admission, and co-payments on approved claims.
Provides cover for specified co-payments on procedures and scans performed in- and out-of hospital.
Cover for the difference in the amount charged by a Registered Medical Professional and the Medical Scheme Rate for services rendered while admitted in hospital.
Cover the difference between what your medical scheme will pay and the actual cost of your in-hospital doctor’s bills up to a maximum of 500% of medical scheme rates
Contact Capitalise Wealth Management today to get your plan on track…
QUESTIONS & ANSWERS
WHAT ARE THE TYPES OF MEDICAL AID PLANS TO CONSIDER?
There are 2 main types of medical aid plans to consider:
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Traditional. All hospitalisation and day-to-day costs paid by the plan.
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New Generation. All hospitalisation is paid by the scheme and day-to-day benefits are paid from your personal medical savings account.
WHAT IS A COMPREHENSIVE MEDICAL AID PLAN?
A Comprehensive Medical Aid pays both in and out of hospital costs. They are the most expensive of plans because they offer the widest amount of benefits.
They typically have no overall limit hospitalisation, excellent set benefit amounts or high savings for day-to-day needs and the highest number of chronic illness medications. Comprehensive Plans are designed for those who have (or expect to have) high medical expenses or who want the security of knowing they are fully covered should ill health occur. Members and families who want the security of knowing high medical costs associated with children are covered and the elderly, who have higher needs for medical treatments, are catered for.
WHAT IS A HOSPITAL PLAN?
Hospital plans are designed to meet the need for high cost, elective and emergency hospitalisation and essential chronic illness treatment. Most medical aids offer these plans. They offer the best method of controlling medical aid costs, by "insuring " for the greatest medical financial risk we face - private hospitalisation - whilst you self-pay for your day-to-day costs. They therefore cost less than a comprehensive medical aid plan. They are recommended for those with a strict budget or healthy members who have little need for out of hospital cover.
