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. NEXT ON HEALTH24X The value of digital technology in addressing quality care 2017-05-17 04:48 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 Lifestyle Floater alert: Here’s what it means if your poop floats News 35 women fall pregnant despite using contraception app News 5 diseases you risk getting if we run out of water Lifestyle 5 photos of your cervix you need to see Fitness 4 sprint workouts to help you get faster News QUIZ: How many of these random health facts do you know? From our sponsors Managing diabetes in the workplace Back-to-school with diabetes Discover treatments that can help reduce acne What can I do to reduce or remove acne marks? Live healthier Terrific Tea! » Rooibos makes cocktails healthier Rooibos: an alternative energy drink More than 10 reasons why rooibos is good for you Today marks the first annual National Rooibos Day, which aims to raise awareness of the health benefits and many uses of rooibos tea. Healthy? Are you sure? » 5 diseases we can get from animals Could your salon visit make you sick? 7 terrifying diseases you could have without knowing it Not all serious illnesses come with tell-tale symptoms. There are diseases that can turn your body into a ticking time-bomb while you're unaware of any danger.