Category Healthcare
SUB CATEGORIES General  |  HIV |  Medical Schemes | 

Gap cover – an employee benefit that makes a real difference today

18 July 2022 Turnberry Management Risk Solutions
Tony Singleton, CEO at Turnberry Management Risk Solutions

Tony Singleton, CEO at Turnberry Management Risk Solutions

Benefits are an important part of attracting and retaining talent for corporates, and these offerings can often be a point of differentiation.

As such, many businesses have started to offer Employee Assistance Programmes (EAP) to cater to physical, financial and mental health, along with the more common medical aid, pension and provident funds. However, while screening is offered as part of EAP, and medical aid pays for a portion of medical expenses, the reality is that the shortfalls between what medical aid pays and what medical procedures cost is widening all the time. Adding gap cover into the employee benefit basket is cost effective and can make a real difference in employees’ lives – and productivity – today as well as in the future.

The true cost
“With the gap between medical aid payments and the cost of procedures growing, as well as new treatments coming in that are not fully covered by medical schemes, many people cannot afford the co-payment or shortfalls that will result from having necessary treatments and procedures. These shortfalls can run into tens of thousands of Rands, sums that most people simply do not have available to them,” says Tony Singleton, CEO at Turnberry Management Risk Solutions.

Often in these instances, people will try and treat problems that actually require surgical intervention with conservative means, which in turn results in increased sick leave as they take time off when they are in pain or unwell. Their wellbeing also suffers as a result of ongoing pain and suffering from not being able to seek the right treatment.

When they cannot avoid surgery any longer, the payments can put them into significant financial difficulty. They may have to take loans from the bank, or microloans from the business, make payment arrangements with doctors, and in general deal with considerable stress at a time when their health should be the focus.

Peace of mind and financial wellbeing
The addition of gap cover to benefits is an affordable way for corporates to make a real, tangible difference to their employees’ health and financial wellbeing. With gap cover in place, those who need medical treatments or surgical interventions can seek the care they need without fear of massive financial repercussions. Co-payments and shortfalls are covered up to the Overall Annual Limit (OAL), providing peace of mind and allowing people to prioritise their health. In the case of unexpected illness or injury, the added stress of having to pay for these shortfalls is reduced.

Andrew Appelgryn has been a member of Turnberry gap cover since 2016 through his employer, and really saw the value of this benefit when he needed to claim for significant shortfalls related to open heart surgery after he suffered a heart attack at work.

“I ended up having a quintuple bypass and spent almost two weeks in ICU. When I started to receive the bills, I was not sure how I was going to pay for any of it. My employer then reminded me that I had gap cover and helped me to submit my claims. The shortfalls from the cardiothoracic surgeon were almost R100,000 and from the anaesthetist around R62,000, which is a huge sum that most people simply cannot afford. Without gap cover from Turnberry, I would have been in deep trouble – I would have gotten my life back only to be in massive debt,” he says.

The benefits of group gap cover
Corporates have access to group gap cover for their employees, which has a number of benefits over private gap cover, including preferential rates and reduced waiting periods. Value-added benefits include access to trauma counselling, additional cancer cover and a lump sum pay-out on first cancer diagnosis, depending on the plan, all of which can help with both financial and mental wellbeing.

Gap cover will provide cover for medical expense shortfalls, co-payments, sub-limits, and other medical bills. This means that employees who need treatment can get the help they need, when they need it, without the added stress of having to pay for the shortfalls. It is important when selecting a Group Gap Cover product to discuss the best solution for your Company with your financial advisor in order to ensure that it augments your employee’s medical scheme option.
“Healthy employees are happier, more productive and ultimately better for business, so having a benefit like group gap cover just makes sense. It is a cost-effective option that can make a real difference to people’s lives today and in the future,” Singleton concludes.


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