hospital cover
Managed care is used by medical schemes to reduce costs, while still keeping the quality of care high, and these can be done through provider networks, provider oversight, drug formularies, chronic condition programmes, and pre-authorisation mechanisms. While managed care programmes
The cover provided by your gap cover benefit will depend on the level of cover you opt for, which can range from 200% to 600% of medical aid tariff.
In its simplest form, gap cover is designed to cover the difference between what your medical specialist charges for in-hospital treatment and your medical aid tariff, up to a certain limit, with top-end gap cover providers offering up to 600%
Determine the extent to which the medical scheme has kept pace with technological innovation which allows for ease of interaction, claims submission, communication, and service provider interface. Technologically advanced medical aids offer user apps through which members can track their
