Gap Cover

What is it?

A short-term policy that covers the shortfall of your medical aid for hospitalisation, medical treatment and some out of hospital procedures.

Why do you want one?

As you may know, medical aid doesn’t always cover all of your medical costs, especially when it comes to expensive specialist consultations and procedures. Doctors are also allowed to charge more than medical aid rates, which leaves the client paying in the shortfall or “gap”. Gap cover will help you with this shortfall.

Do you need it?

Yes, unless you could self-fund the shortfall in the event of hospitalisation or expensive medical treatments. If you have medical aid you should really consider gap cover. Medical practitioners can charge up to 600% more than medical aid rates! This leaves the patient with astronomical medical bills and their medical aid may not cover them all.

How much does it cost?

Gap cover costs on average, between R220 to R600 per family per month, but can differ depending on the provider. Always check the benefits to make sure you know what is provided. Some popular benefit options to look out for:

  • In-hospital treatment
  • Co-payment benefit
  • Additional cover for cancer
  • Emergency room visits
  • MRI, CT, radiotherapy
  • Dialysis
  • Chemotherapy

How can we help you?

Gap cover can be tricky to navigate. You need to carefully check all the wording, to see what is covered by the provider. We can help you navigate this process and ensure you’re covered when your medical aid is not available.

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