Medical Aid

KeyHealth

Choosing a medical scheme is almost always a complicated task. Medical jargon, a wide variety schemes, and an even wider range of benefits that make it extremely difficult to find the right one for you. KeyHealth Medical Scheme is one exception- true to its philosophy of being smart and keeping it simple, we believe that you should only require ONE good reason to do something.

Gapcover

• GapCover is a short term insurance product that provides a medical scheme shortfall solution. Some medical schemes offer cover at 100%, 150% or 200% of medical scheme tariffs for hospitalisation only, and most of the time the actual costs exceed medical scheme tariffs.
• GapCover covers the difference between what your medical scheme will pay and the actual cost of doctors’ bills while you are in hospital, up to a maximum of 500% of the medical scheme tariff.
• .GapCover means YOU no longer pay the shortfall between the tariff set by your medical scheme and the private rates charged by doctors for in-hospital consultations.

The National Health Reference Price List (NHRPL) is a pricing system maintained by the Department of Health and the Council for Medical Schemes. The NHRPL specifies the rates to which your medical aid scheme must adhere. It is the amount of money that they are bound by law to pay out for a given situation. Doctors, hospitals and other medical service providers however, are not bound to these rates, and in fact charge up to 300% above these NHRPL prices. So despite thinking you are financially covered for any medical eventuality in its entirety, for the most part you are not, and are often liable for an enormous shortfall.