GapCo MRI Cover

This option extends Cura’s standard Gap Cover to include co-payments or deductibles claimed by health service providers for treatment received whilst a covered member is an in- or outpatient.

This is not a medical scheme and the cover is not the same as that of a medical scheme. This policy is not a substitute for medical scheme membership.

What does Cura GapCo MRI Cover entail?

cover annual limit Benefit description
Overall annual limit of R165 000.00 per insured
Gap Cover No penalty shortfalls will be covered under this policy.

Pays from 100% to 500% of scheme tariff for shortfalls incurred as a result of service providers billing higher tariffs than scheme tariffs for in-hospital procedures/services and certain specified out-of-hospital treatments.

Pays shortfalls incurred as a result of service providers billing higher tariffs than scheme tariffs for administering chemotherapy or radiotherapy for the treatment of cancer on an out-patient basis, and/or for kidney dialysis on an out-patient basis.

Pays from 100% to 500% of scheme tariff for reconstruction due to a mastectomy, provided that cancer is diagnosed after inception of the Cura policy.

Co-payment waiver (whilst as an in-patient and/or outpatient)

R50 000.00 per family per annum.
No penalty co-payments will be covered under this policy

A benefit equal to the charges in the form of a co-payment or deductible applied for treatment received whilst as an in-patient and/or outpatient (including co-payments on MRI and CT scans in and out of hospital).
Consumables R6 000.00 per insured per annum Covers shortfalls on disposable items such as surgical gloves, bandages and gauze
Casualty Benefit R10 000.00 per family per annum The cost of a medical or a surgical procedure following an emergency incurred in the casualty unit of a hospital where such costs are not covered by the medical scheme
Trauma Counselling R10 000.00 per family per annum This benefit covers counselling sessions with a registered counsellor or clinical psychologist that may be required after a serious or traumatic event due to violence, an accident or on the diagnosis of a dread disease, restricted to the insured lives on the Cura policy. Must receive couselling within (1) one year of trauma incident.
Additional benefits (these benefits do not aggregate to the R165 000 cap)
Medical Scheme - Premium Waiver (Death or Total and Permanent Disability) Maximum of R5 000 per month. Following the death or the total and permanent disability of the principal member of the medical scheme, a benefit equal to the total value of the medical scheme contribution calculated for 12 months on the medical scheme option of the registered medical scheme within the stated limitations. Only members who have not reached the age of 65, qualify for disability cover.

Waiting periods:

  • A 3 months’ general waiting period applies
  • A 12 months’ waiting period applies for pre-existing conditions
  • A 9 months’ waiting period applies to pregnancy
  • An underwriting process will determine the waiting period applicable to each case.

Maximum Entry Age:

There is no maximum entry age on this policy.

Premium:

Entry Age Monthly Premium
64 or younger R363.00 per month
65+ R510.00 per month

Premiums (incl. VAT) are for a family, or a single person.

 

Terms and conditions apply in terms of exclusions and claim procedures.

 

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E-mail: mail@curaadmin.net

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Moreletapark
0044
Pretoria
Gauteng

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About Us

At Cura we are ready to help you enhance your medical cover without leaving your chosen medical scheme. Enjoy the ultimate in medical cover for total peace of mind. Put the fears for excessive hospital cost shortfalls and unforeseen co-payments for medical services behind you.