We will advise you on how to COVERTHEGAP between the medical aid rate and what the doctors actually charge in hospital. COVERTHEGAP is a subsiduary of Rob Mitchell Brokers cc, which has been in existamce since 1990 and started the GAP cover website to market GAP Cover direct to the public on an individual basis. We use Complimed as brokers because they are one of the oldest companies dealing in the GAP cover market and have a very good payment record. They are backed by the popular Hollard group.
The National Health Reference Price List (NHRPL) is a pricing system maintained by the Department of Health and the Council for Medical Schemes. The NHRPL specifies the rates to which your medical aid scheme must adhere. It is the amount of money that they are bound by law to pay out for a given situation. Doctors, hospitals and other medical service providers however, are not bound to these rates, and in fact charge up to 300% above these NHRPL prices. So despite thinking you are financially covered for any medical eventuality in its entirety, for the most part you are not, and are often liable for an enormous shortfall.