Home > Medical schemes > FAQs Updated 29 April 2013 What is a self-payment gap? Have you exhausted your day-to-day benefits and moved into your self-payment gap? Here's what it means. 3 Like us on Facebook » Subscribe to the newsletter » Ask CyberDoc » Quiz How long will you live? » Medical history Bacteria gallery This is the time of year when many medical scheme members have exhausted their day-to-day benefits, and move into the so-called 'self-payment gap'.If for argument's sake you have R3500 in your medical savings day-to-day account and you have used it all, many schemes have instituted what they call a 'self-payment gap'.Most full medical schemes give their members a medical savings account, which is anything from 15 - 25% of their contributions.It may not exceed 25%, according to medical scheme regulations. Once this is exhausted, you move into the territory of the self-payment gap. This self-payment gap varies in size according to the scheme and the option you have chosen.Up to a pre-determined limit (which is different for every scheme) you will be liable for the payments until you reach what is called a threshold.These are called above-threshold benefits and once you through the self-payment gap many schemes will resume paying for day-to-day medical expenses up to a certain limit.It must be noted that the threshold is determined by the number of dependants you have registered as the main member. And so is the size of the self-payment gap. The more dependants you have, the bigger the self-payment gap - but it also takes longer to get there, as your contributions would be higher than those of a single member.Do remember that your scheme will still pay for things such as chronic medication, hospitalisation and other benefits not covered from the medical savings account.It is important that you continue to submit claims to your medical scheme even when you are in the self-payment gap, otherwise they will not know when you have gone through it and qualify for above-threshold benefits.Most schemes have introduced this system in the last few years, largely because of a general change in claim patterns experienced across the industry. More in Medical schemes How do I select the option that's best for me? More: Medical schemesFAQs advertisement Read Health24’s Comments Policy Comment on this story 3 comments Comments have been closed for this article. Logout Comment 0 characters remaining Share on Facebook Loading comments... Other news Parenting Rise in teen suicide attempts in Canada not copycat behaviour News No queues, no fuss, bringing healthcare to your door Medical SEE: 12 Things you didn't know about the brain Medical Healthy living reduces everyone's risk of colon cancer Medical Why type 2 diabetics should take a walk after dinner Lifestyle 5 summer essentials to add to your child’s school bag From our sponsors Keep an eye on your vision Which skin products are better, ‘medical grade’ or ‘over-the-counter’? Win 1 of 6 R5000 cash prizes Win Skin Renewal voucher Live healthier Exercise benefits for seniors » Working out in the concrete jungle Even a little exercise may help prevent dementia Here’s an unexpected way to boost your memory: running Seniors who exercise recover more quickly from injury or illness When sedentary older adults got into an exercise routine, it curbed their risk of suffering a disabling injury or illness and helped them recover if anything did happen to them. No relief for MS » Drug shows promise against MS in mouse study Vitamin D may slow multiple sclerosis Obesity in girls tied to higher MS risk Exercise may not lower women's risk of MS A Harvard study showed no evidence to support the idea that exercise lowers the risk of multiple sclerosis.