The Appliance benefit will cover the shortfall of claims for a range of appliances if there is a defined rand limit for benefits on the medical scheme:



Options

Ultimate Gap | Plus Gap | Gap Assist | Corporate Comprehensive

 Gap Lite | Gap Only | Exact Cover | Exact with Gap and Copay | Corporate Base


Benefit description:


The appliance benefit provides cover for the shortfall between what the medical scheme pays and what the service provider charges for specific appliances outlined.


Appliances covered include:

oHearing aids.oWheelchairs.oCPAP machine.oHumidifiers.oInsulin pump.oGlucometer.oNebulisers.oMirena device. oHearing aids.oWheelchairs.oCPAP machine.oHumidifiers.oInsulin pump.oGlucometer.oNebulisers.oMirena device.

  • Hearing aids.
  • Wheelchairs.
  • CPAP machine.
  • Humidifiers.
  • Insulin pump.
  • Glucometer.
  • Nebulisers.
  • Mirena device.



Please consult your policy wording for complete list of appliances applicable to your benefit option. 


Important points to consider:


  • If your medical aid does not provide cover for the applicable appliance and there is not shortfall to assess, your claim will be rejected.