Maintaining proper eye health is essential for overall well-being, as various serious health conditions can affect the eyes. These include cataracts, glaucoma, age-related macular degeneration, diabetic retinopathy, retinal detachment, corneal diseases, and more. Without proper treatment and management, these conditions can lead to vision problems or even blindness. Regular eye exams are a crucial step in preventing and managing these issues.
Maintaining eye health is critical in protecting your vision, but when these problems occur, it can be a costly exercise, even if you have comprehensive medical aid, because shortfalls resulting from surgery and specialists are increasingly common. Gap cover has become vital in providing protection from medical expense shortfalls such as those often seen with treatment related to these conditions, allowing you peace of mind to seek the care you need without concern that the resulting expenses will cripple your finances.
Cataracts – a leading cause of blindness
Cataracts are the single leading cause of blindness and visual impairment in South Africa, affecting around a quarter of a million people, according to the International Agency for the Prevention of Blindness. This common eye disorder affects people increasingly as they age, and factors such as high levels of sunlight exposure make it even more prevalent. While it is highly treatable and is covered as a Prescribed Minimum Benefit (PMB) condition by medical aids, this does not mean that patients will not experience medical expense shortfalls related to treatment.
The ophthalmologist, anaesthetist, and the hospital may not charge medical aid rates or be contracted into your medical aid, which means there may be shortfalls. In addition, some medical aid options have Designated Service Providers (DSPs), and choosing a different provider can result in a co-payment. Medical expense shortfalls can range from R20,000 to R40,000 for cataract surgery, which can in turn cause financial hardships, especially for people who are retired and living off pensions and savings. It’s important to note that these shortfalls apply to each event, so if you require surgery on one eye and then the other at a later date, you may face a repeat of these costs.
Retinal detachment can have serious consequences
Retinal detachment is a serious eye condition that occurs when the retina, the light-sensitive layer of tissue at the back of the eye, separates from the underlying supportive tissue. This separation disrupts the retina’s normal function. It is often the result of ageing or an accident and needs to be treated promptly as it can lead to significant visual impairment or even permanent blindness.
Retinal detachment is also a PMB but carries with it the same conditions as cataract surgery. If the ophthalmologist, anaesthetist, or hospital charges more than the scheme rate, or if they are a non-DSP, there may be significant shortfalls attached to treatment, which may exceed R30,000.
Safeguard your sight
Many other eye diseases and disorders, such as corneal ulcers, macular degeneration, glaucoma, and cancer, are covered as PMB conditions due to the importance of vision; however, as with cataracts and retinal detachment, medical expense shortfalls are often an unfortunate reality. When it comes to seeking medical treatment for serious eye conditions, gap cover can provide much-needed relief.
By providing additional cover for these medical expense shortfalls, gap cover offers significant peace of mind that you can get the treatment you need without the added burden of additional out-of-pocket expenses. Speak to your broker to help you find the right gap cover to complement your medical aid cover and protect both your sight and your finances.
About Turnberry Management Risk Solutions
Founded in 2001, Turnberry is a registered financial services provider (FSP no. 36571) that specialises in Accident and Health Insurance, Travel Insurance, and Funeral Cover.
With extensive experience across healthcare and insurance industries in South Africa, Turnberry offers unsurpassed service to Brokers and clients. Turnberry’s gap cover products are available to clients on all medical aid schemes, as they are independently provided and are therefore transferable in the event of a change in the client’s medical aid scheme.
Turnberry is well represented nationally, with its Head Office based in Bedfordview, Johannesburg with Business Development Managers in Cape Town and Durban. The Turnberry Team’s focus on outstanding client service comes from having extensive knowledge and experience in the financial services sector and is underwritten by Lombard Insurance Company Limited. Lombard Insurance Company Limited is an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.
