17/06/2021

Shocking Top 5 Gap Claims

Gap Claims, and of course your Gap Cover should be smart, simple and of course value for money. It is the invaluable safety net that covers the shortfall between what medical schemes pay and what specialist doctors charge. Without this, policyholders may find themselves paying for unexpected costs from their own pockets.

The Top 5 Gap Claims that are Processed

  1. Cancer Initial Diagnosis
  2. MRI and CT Scans
  3. Colonoscopy and Gastroscopy
  4. Cataract Surgery
  5. Pregnancy Confinement

1. Cancer Initial Diagnosis

The many cancer awareness days and months throughout the year are a reminder of just how prevalent this insidious disease has become in our modern lifestyles.  There is hardly a family that has been untouched by a cancer diagnosis of a loved one or close friend during their lifetime.  There are over 200 different types of cancers affecting one in four South Africans and there is absolutely no discrimination across age, gender or social class when it comes to who is affected.  Every year, over 100 000 South Africans will hear the words ‘you have cancer’, and six out of ten will survive their diagnosis, according to CANSA.

2. MRI and CT Scans

MRI stands for Magnetic Resonance Imaging. A life-saving piece of equipment able to detect and/or show the stages of a specific disease. You can see soft-tissue changes with MRI, that you can’t see with X-Rays, which is why it’s more expensive – in South Africa, you can expect to pay approximately R9,000 for a MRI.A Computed Tomography (CT) scan uses a series of X-rays to construct detailed images of the inside of your body. It is most commonly used on the brain. It can spot strokes and serious head injuries and can cost around R4,000.

3. Colonoscopy and Gastroscopy

A Gastroscopy is a test that allows the endoscopist to look into your upper gastro-intestinal tract. This is done by passing a long flexible tube (gastroscope) through your mouth down your gullet (oesophagus), into your stomach and first part of your small intestine (duodenum). The gastroscope is connected to a television system where pictures of your oesophagus, stomach and duodenum can be seen.

A Colonoscopy is a test, which allows the Doctor to look directly at the whole of the large bowel (colon). In order to do this a flexible tube the thickness of a finger with a light at the end, is carefully passed through the anus into the rectum and into the large bowel. This can be uncomfortable as bends in the colon are negotiated and air is used to
inflate the colon. The Colonoscope is connected to a television system where pictures can be seen.

4. Cataract Surgery

Also called lens replacement surgery, is the removal of the natural lens of the eye that has developed an opacification, which is referred to as a cataract, and its replacement with an intraocular lens.

5. Pregnancy Confinement

Maternal physical and mental health during pregnancy are key determinants of birth outcomes. The costs involved for check-ups to "The due Day" are quite hefty. Then of course, from the onset of contractions to the birth of a child you need to pre-book your stay - this does not come cheap.

Conclusion for Gap Claims

Sirago focuses on offering unique Gap Cover products for the South African market. As an underwriting manager, Sirago seeks market opportunities in specific niche products. Their product development includes benefit determination based on medical scheme design, the premium rating, development of policy wording, and the distribution and marketing strategy of their product. Underwritten by GENRIC Insurance Company Limited, an authorised Financial Services Provider and registered Short-term Insurer. Sirago's core business revolves around the provision of critical benefits to policyholders who are faced with unforeseen medical expense shortfalls, which are not fully covered by their medical schemes. Get Gap Cover now with Sirago. Gap Claims Covered!

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