Gap Cover - BMI Shortfall

Modified on Wed, 21 May at 8:01 AM

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.

Was this article helpful?

That’s Great!

Thank you for your feedback

Sorry! We couldn't be helpful

Thank you for your feedback

Let us know how can we improve this article!

Select at least one of the reasons
CAPTCHA verification is required.

Feedback sent

We appreciate your effort and will try to fix the article