The Day-to-day Specialist Consultation Fee benefit covers the difference between the medical scheme rate and the rate which the specialist charges for the cost of the consultation only, up to the available sub-limits. Payment is dependent upon the medical scheme paying a portion towards the consultation fee.

Options

Ultimate Gap | Plus Gap | Gap Liberal

Benefit description:

This benefit provides cover for the difference between what a specialist doctor charges for a consultation and what your scheme pays.

Important points to consider:

• This benefit only covers costs related to the consultation only and not any scans or tests done during the consultation.
• This includes consultations charged for ICD-10 (Diagnosis) Code F83. Refer to the policy wording definition clause for the description.