Agility Gap & CoPay is the ideal tool to give those healthcare funding gaps a complete miss. This includes co-payments on procedures, as well as benefit shortfalls where the amount that providers charge is higher than the amount the medical scheme pays.
The Agility Gap product settles the difference between medical scheme rates and rates medical professionals charge for in-hospital care. The medical scheme pays the first 100% (or more) and Agility Gap covers the rest up to a maximum of 600%. The product range includes varying levels of cover to suit every need and pocket.
Why Agility Gap
- No annual limits or sub-limits are applied
- There is no maximum entry age
The Agility CoPay cover product is a must-have for any medical scheme member, as it settles a range of co-payments associated with in-hospital procedures.
Why Agility CoPay
- Co-payments will be covered up to R12 000 per insured per incident
- Each beneficiary can use the benefit up to 3 times per annum
- As a family, you will enjoy cover of up to R120 000 per annum
Agility Gap & CoPay Combined
A unique combination of the Agility Gap & CoPay cover products ensures complete peace of mind that your every healthcare need is more than taken care of. The product range includes varying levels of cover to suit every need and pocket.
Why Agility Gap & CoPay Combined
- You have all the benefits of the Agility Gap option with a few handy extras
- You are covered for those often expensive procedural co-payments with an unlimited number of claims per annum
The Agility Gap & CoPay Combined 500 option even provides:
- R25 000 cover if you want to use a surgeon of your choice instead of your medical scheme’s network provider for Prescribed Minimum Benefit (PMB) conditions
- A useful Emergency Room Benefit of R6 000 per annum
Agility Gap & CoPay Ultra
Our Ultimate Cover Option
Agility Gap & CoPay Ultra offers all the benefits of the Agility Combined 500 product as well as additional sought-after benefits for complete peace of mind when:
- Your medical scheme benefits are depleted
- You need additional in-hospital cover
- You need added cover (R35 000 per annum) to use a surgeon of your choice instead of your medical scheme’s network provider for Prescribed Minimum Benefit (PMB) conditions
- You need to cover any penalty co-payments
- You want to include dental and ophthalmology cover
- You need out of hospital cover for specialist consultations
- You need an unlimited number of claims for procedural co-payments
Agility Value-Add Product
The Agility Value-Add Product offers policyholders dental and ophthalmology cover for only an additional R25 per month. This cover is already included in the Agility Ultra product.