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. Dependent upon the benefit design of your chosen medical scheme option.


Ultimate Gap | Plus Gap

Gap Assist | Gap Only | Exact Cover | Exact with Gap and Copay | Corporate Comprehensive | Corporate Base

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 and not any scans or tests done during the consultation.
  • Tariff codes covered are 0190, 0191 and 0192.