The Gap Cover benefit covers the difference between the medical scheme rate and the rate that service providers charge.
Ultimate Gap | Plus Gap | Gap Assist | Gap Liberal | Gap Core | Exact with Gap and Co-Pay
Benefit description:
This benefit provides cover for the difference between what a service provider charges for BMI (procedure codes 0018 and 0019) for In-Hospital treatment and what your medical scheme pays towards BMI.
Important points to consider:
- If your Medical scheme does not contribute their scheme rate to the BMI charged amount, the tariff line will not be assessed.
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