Medical Aid Gap Cover: Pretty Useful After All My Life 08 APR 2014

stratum benefits logoA couple of years ago, just after Chantelle and I had gotten married and were in the process of amalgamating all of our accounts, etc, Chantelle on the advice from her family had us sign up with Stratum Benefits through a broker.

Now essentially, Stratum provides medical aid gap cover, but because it sounds nicer and more important when they say it:

Dear medical aid member, it is important to understand that should you be admitted to hospital for any reason, there might be a difference between what the medical provider charges and what is actually paid by your medical aid. You will personally be liable for these shortfalls that could amount to THOUSANDS OF RANDS, as illustrated below.

Our products are designed to protect medical scheme members from the shortfalls which they may encounter when incurring medical expenses. The reality is that the portion of medical bills not covered by medical schemes have increased significantly in recent years. Inadequate cover could spell financial ruin for a family in the event of a long period of hospitalisation or other medical crisis. […]

Yes, it is a little sensationalized, what with all those unnecessary CAPSLOCK instances, but it turns out that they really do provide a useful service, if you are at all inclined to end up in the hospital on more than just a few occasions.

Obviously our big hospital encounter was the recent(ish) birth of Emily at the Vergelegen MediClinic, and although everything went super smooth and we were thrilled with the level of service received from both Dr. La Grange and Dr. Blaine, the reality is that when the invoices arrived, both far exceeded the Discovery Health’s Medical Rate, pretty much by double.

Of course these were grudgingly paid, and of course, that left a rather large hole in our finances, which therefore makes it super pleasingly that, after a brief review period, Stratum has just gotten back to us with the following news:

Patient: Chantelle Louise Lotter         
Procedure: C-Section
Admission date:  2014-01-13
Doctor La Grange: R 6 788.00
Doctor Blaine: R 2 567.40
ClaimStatus: Assessed
Claim amount:   R‎ 9 355,40
Claim payment date: 2014-04-15

…which is of course a welcome sigh of relief for my rather stressed bank account.

So yay for medical aid gap cover then in other words.

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About Craig Lotter

South African software architect and developer at Touchwork. Husband to a cupcake baker and father to two little girls. I don't have time for myself any more.