What gap cover will and won’t pay for

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Cape Town - Many people who have a basic hospital plan and gap cover on top of that think they are completely covered. Not so fast.

Gap cover is designed to pay the ‘gap’ or shortfall between what your medical scheme pays, and what a private doctor charges.

If your medical scheme tariff or a specialist visit is R600 (in-hospital) and the bill is R1 100, the gap cover is supposed to foot the total bill for the difference of R500 – or so people think.

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