What is Gap cover?

Gap Cover is a short-term insurance product that covers the difference between the medical aid rate and private rates charged by doctors or specialists for in-hospital treatment. It will settle up to a maximum of an additional 500% of the National Health Reference Price List rate.

Why do I need Gap cover?

If you belong to a Medical Aid you would assume that you are fully covered for in-hospital treatment. However, depending on the Medical plan you are paying for, you may only be covered for 100% of the scheme rate. One would think that 100% would cover all your expenses but doctors or specialists in South Africa have the right to charge 200%, 300% even sometimes up to 500% of the National Health Reference Price List rate! So while you are thinking your Medical Aid has it all covered… in reality you will have to pay the difference from your own pocket. This is where Gap cover helps you out.

What does it cost?

Depending on the Service provider, product and benefits you choose your premium would also change.  We offer products from:

• Kaelo Western Gap
• Ambledown
• Stratum
• Sirago
• Liberty Gap / Zest Life

Am I too old for Gap Cover?

New legislation prevents Gap cover providers to put a restriction on age, like they did in the past.  Therefore, there is no age restriction to take out Gap cover!

Curious about the benefits and costs? Contact us for a full plan comparison.
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