Does Linksave form part of my medical aid?

No, Linksave Gap cover is a short- term insurance product that falls under the Accident and Health Policy of the Short- Term Insurance Act No. 53 of 1998.

Will Linksave cover me if I only have a hospital cash plan and do not belong to a registered medical scheme?

No, Linksave Gap cover increases the benefit offered by a medical scheme. Regrettably, without a recognised registered medical aid plan, you cannot have gap cover.

My child dependant has reached the age of 21 and my medical scheme has changed their status to that of an adult. How does Linksave deal with this change?

Linksave allows unmarried children, provided they are on the principal’s medical aid, to remain on their parent’s Gap Comprehensive policy until they turn 27, irrespective of whether they are full-time students or not. Once the child turns 27, they may be added as an adult dependant on the gap policy provided they are on the principal’s medical aid. However, if they are mentally or physical disabled and wholly dependent on the principal medical scheme member, proof of the disability will be required to remain on gap cover as a dependant.

My parents are currently listed as adult dependants on my medical scheme. Are they covered under my Linksave Gap cover policy as well?

No, your parents are not automatically covered by your Linksave Gap cover. However, you may add them to your Linksave Comprehensive policy as adult dependants at reduced rates.

My grandchild is covered by my medical aid. Will they also be covered by my Linksave Gap cover?

Cover for the grandchild is subject to them being legally adopted or fostered by the principal medical scheme member. The eligible child conditions will then be applicable.

Are my Linksave Gap cover premium payments tax deductible?

No, Section 18 (1) of the Income Tax Act allows a deduction for contributions to a medical scheme registered in terms of the Medical Schemes Act of 1998. The Gap Cover Series is defined as Accident and Health products in the Short-Term Insurance Act.

What happens if my Linksave premium is returned by the bank?

If a debit is unsuccessful, we’ll run an automatic second debit the following month, which will include the arrears and the new month’s premium. The Linksave policy will be automatically terminated following a third consecutive return of premiums.

How do I cancel my Linksave Gap cover?

You are required to provide Linksave with 30-days written notice of intention to cancel your policy.

My husband, who is the principal member on our Linksave Gap policy, passed away as a result of an accident. We cannot presently afford to continue with the policy premiums, but would like to keep our Linksave Gap cover. Is there any way you can assist?

Yes, amongst the benefits on your policy is a 6-month medical aid premium assist up to a limited amount, as well as a 6-month gap premium waiver on the life of the principal member. You will therefore enjoy full policy benefits as long as you remain on a medical aid scheme. If you are currently on the Linksave Comprehensive Family cover, and are the only dependant on your late husband’s gap cover, you can also downgrade your cover (and therefore lower your premium) to the Linksave Comprehensive Individual cover. The same benefits will apply where the gap cover principal member has suffered total and permanent disability.

I am 76 years old and would like to apply for Linksave Gap cover. May I do so?

Yes, we offer senior rates to new members who are 75 years or older at the date of inception.

I have recently changed my bank account. What does Linksave require in this regard?

You are required to provide Linksave with a Change of Banking Details form as soon as possible, which you can fax or email to Linksave.

My wife is currently pregnant. Can I apply for Linksave Gap cover and have the childbirth procedure covered by my policy?

No, there is a 12-month exclusion that is applied to all pre-existing conditions, including hospitalisation due to pregnancy and/or childbirth. This will apply to your policy from date of entry.

Can I claim immediately after I have been accepted onto cover?

No, a 3-month general waiting period applies to all new policies for all procedures except hospital admissions as a result of an accident.

My child has been suffering from recurring ear infections in the 12 months prior to me applying for a Linksave Gap cover policy. Will their upcoming grommet procedure with the ENT be covered by my policy in the first year?

No, there is a 12-month pre-existing condition exclusion applied to your policy from inception. No claim will be entertained for any procedure that is related to treatment or advice received by you or your dependants in the 12 months prior to the policy inception date.

I am an existing Linksave policyholder and my spouse has recently been admitted to hospital due to depression. Will they be covered in terms of our Linksave Gap cover policy?

No, depression is one of the listed exclusions that apply to your policy.

Besides the 3 waiting periods stated on the application form, are there any other exclusions I need to be aware of?

Yes, there are currently certain exclusions and they are contained in the Master Policy document. Please ensure that you take note of them all.

My child is due to undergo a cochlear implant and I am aware that my medical scheme provides limited cover in this regard. What cover will I enjoy under my Linksave Sub-limit benefits on my policy?

As your medical scheme has listed this procedure as having limited cover, the Linksave Comprehensive option will provide additional cover to assist you with this shortfall, subject to the Overall Annual Limit, in terms of your policy.

I would like to apply for the Cancer Treatment Protocols on my policy. My spouse, however, was treated for cervical cancer 2 years ago. Will she still qualify for cover?

Should you or your dependants have ever suffered from or been treated for any form of cancer in the past, that dependant will have a 12-month cancer remission exclusion applied under this policy benefit. The exclusion period will be calculated from the official documented date on the treating physician’s letter of remission bearing the member’s details.

As an existing Linksave policyholder, am I obliged to inform Linksave of an upcoming in-hospital procedure?

No, as Linksave Gap cover is a short-term insurance policy, any claims need to be intimated after the event. You will be liable to settle any shortfalls with your service providers upfront and claim back from your policy benefits thereafter.

I am due for an operation. How do I get the authorisation number?

Regrettably we do not provide pre-authorisations on claims. Please consult your medical aid for such. Alternatively contact your medical aid broker for assistance.

How long do I have to submit a claim form to Linksave after undergoing an in-hospital procedure?

Linksave requires written advice by means of a Gap Claim form within 6 months of admission to hospital or within 6 months of the date of the procedure.

Must I submit all the relevant claim documents to Linksave at one time, or can I send documents as I get them?

In order to submit a claim to Linksave, a fully completed Claim form at very least must be submitted. Thereafter, you have 12 months from the date of the hospital admission/procedure to submit all the documents necessary to process the claim. If all the relevant documents have not been received 12 months from the date of the hospital admission/procedure, the claim will prescribe.

How long will it take Linksave to have my claim paid out to me?

In the event that Linksave receives all required documentation upfront, we will endeavour to reimburse you within 7 working days.

I have recently undergone an in-hospital procedure and my attending doctor has requested that I settle their account immediately. In the event that I submit the account to Linksave, will you settle the account directly?

Linksave reserves the right to negotiate a discount with the doctor in which case the account will be settled directly. Where Linksave doesn’t negotiate a discount, the benefit will be paid to the policyholder.

Can I claim for routine visits to my GP?

No, shortfalls on consultations and treatment are only covered by your Linksave Gap cover policy during admission into a hospital ward.

Does my Linksave Gap cover policy pay for any/all shortfalls not covered by my medical aid?

No, primarily, shortfalls created by specialist charges for in-hospital procedures are covered by your policy within certain limits (as defined in your policy document). Generally, out-of-hospital procedures, day-to-day consultations and related shortfalls are not covered.

I have an existing Linksave policy with co-payment benefits and have been advised by my medical scheme that I will be required to make a co-payment on admission to hospital for a planned in-hospital procedure. Will my Linksave policy cover this shortfall?

Yes, most in-hospital procedures where you are required to make a co-payment will be reimbursed to you in terms of the definitions contained in the policy document.

My specialist has charged at 480% of the medical scheme’s health rate for an in-hospital procedure. Will the whole shortfall be covered by my Linksave policy?

Yes, the Linksave policy will provide you with cover for the difference from the scheme reimbursement rate (the amount paid by your medical aid) up to an additional 500% of the medical scheme’s health rate.

My medical scheme has asked me to make payment for an In-hospital procedure in full as they don’t provide cover on this particular procedure. Will my Linksave policy pay the amount that has been excluded by my medical scheme?

No, only co-payments or deductibles levied by your medical scheme are covered under this policy. Where no payment at all is made by your medical scheme for a particular procedure, there will be no benefit due under this policy.