Claims FAQ's

Does GapX issue a guarantee of payment prior to a procedure?
No GapX does not provide a guarantee of payment. We can only assess your claim once you have undergone a procedure and the Medical Scheme has settled their ...
Tue, 23 Jun, 2020 at 4:08 PM
Do I need to get pre-authorisation to claim?
No, we do not require pre-authorisation for a claim to be submitted. Once your Medical Scheme has processed the claim you can submit any shortfall to us to ...
Tue, 23 Jun, 2020 at 4:14 PM
Will you cover any claims where the medical scheme has rejected the claim?
No, unfortunately not.  Claims that have been rejected by your Medical Scheme won't be covered under your GapX policy. This excludes claims against...
Tue, 23 Jun, 2020 at 6:35 PM
Can I claim where the full amount was paid from my medical savings account?
Yes, any amount charged over and above the medical scheme rate and paid from your medical savings account (MSA) can be submitted to GapX to be assessed in l...
Tue, 23 Jun, 2020 at 6:36 PM
What is the difference between a penalty fee and a co-payment?
A co-payment is a fixed amount or percentage excess imposed in terms of your Medical Scheme Rules for undergoing a specific procedure whether in or out of h...
Tue, 23 Jun, 2020 at 6:38 PM
How do I submit a claim
Claims can be submitted and tracked on our customer portal. To access your policy on the customer portal you can use the My Policy tab on our website, o...
Tue, 11 Aug, 2020 at 9:06 PM