Agility Gap & CoPay:
Bridging the Gap towards Optimal Healthcare
As a medical aid member, you know that unforeseen costs can arise due to shortfalls between your medical scheme cover and actual medical bills. Agility Gap & CoPay steps in to bridge this gap, ensuring that individuals, families and corporate employees receive comprehensive healthcare without financial burden.
What is Agility Gap & CoPay Cover?
Gap Cover
Have you ever been hospitalised and the account was not covered in full by your medical scheme? That's because doctors and specialists’ professional fees are not always regulated, and they can charge more than what your medical aid option covers.
The difference between what your medical scheme covers and what the healthcare provider charges for in-hospital procedures is referred to as a medical shortfall. Agility offers a range of gap & co-payment cover options to help bridge this financial gap.
Co-payment or Deductible Cover
A co-payment or deductible is an amount that your medical aid scheme requires you to pay from your own pocket for a specific medical treatment or procedure.
An example is knee replacement surgery, colonoscopies, or use of hospitals outside of your network. Co-payment cover makes sure these unexpected expenses are covered.
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Get in touch with our team of experts:
Call 011 796 6464 |  E-mail info@agilitygroup.co.za
Why choose Agility Gap & CoPay Cover?
Being at the forefront of innovation gives us a distinct advantage: intuitive understanding of specific benefit gaps that exist in the healthcare sector.
Combining our clinical expertise, industry insights, and innovative technology, Agility is able to identify and focus on resolving these gaps in order to provide our members with benefits that are relevant, accessible, and highly cost-effective. This insight is applied to the entire Gap & CoPay product line.
Through a variety of cover levels, the Agility Gap & CoPay product range provides access to benefits when they are most needed. This allows for a fundamental shift away from the traditional one-size-fits-all approach and towards one that is more focused on flexibility and choice in order to achieve optimal health and superior healthcare cover for our members.
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What’s in it for you?
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More in-hospital medical cover without needing to upgrade your current medical aid
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Unlimited cover for procedural co-payments across all Combined options
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Extensive medical emergency cover
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Maternity Cover
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PMB Cover
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Gap and medical scheme premium waivers
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NEW Hospital Booster Benefit (which covers private room upgrades, in-hospital sub-limits & robotic-assisted surgery)
The Agility Gap Range
The Agility Gap range offers comprehensive, highly specialised gap cover, suitable for all budgets. Starting from as little as R121 per family per month, these options are guaranteed to cover the difference between your medical scheme rate and what your doctor or hospital charges for an in-hospital procedure.
Most medical schemes cover the first 100%. The Agility Gap range covers the shortfall, up to as much as 500%. All Agility Gap products include cover at any private facility, as well as cover for all Prescribed Minimum Benefit (PMB) conditions.
The Agility Combined Range
The Agility Combined & Corporate product range offers integrated Gap & Co-payment benefits. Therefore, these options cover benefit shortfalls; where your doctor or hospital charges more for an in-hospital procedure than what your medical scheme will cover, as well as any out-of-pocket contributions that you may need to pay towards an in-hospital procedure.
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These option benefits include full cover for in-hospital professional fee short payments, co-payments related to MRI & CT scans, as well as procedural admissions to hospital across a range of 200%, 400% & 500%. Through an array of cover levels, the Agility Gap & CoPay range allows access to benefits when they are most needed.
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The highly anticipated Hospital Booster Benefit has also been added to our product line and is available on the Combined 400, Combined 500 and Ultra options. This benefit includes cover for In-Hospital Sub-Limits, Robotic-Assisted Shortfalls and Private Room Upgrades.
Agility Gap & CoPay is a division of Agility Insurance Administrators (PTY) Ltd. Products are underwritten by GENRIC Insurance Company Ltd (FSP 43638) GENRIC Insurance Company Ltd is an Authorised Financial Service Provider.
GET IN TOUCH
+27 11 796 6464