Bridge the Gap in
Your Medical Cover.
Even the best medical aids don't cover everything. Specialists often charge up to 500% of the standard medical aid rate. Gap Cover protects your savings from these unexpected out-of-pocket expenses.
Important: You Need a Medical Aid First
By law, you cannot take out a Gap Cover policy unless you are an active member of a registered South African Medical Aid scheme.
Don't have one yet? No problem. As your trusted one-stop financial services provider, we can help you secure the perfect Medical Aid and pair it with the right Gap Cover simultaneously.
Why You Need It
The Medical Aid Shortfall
When you go to the hospital, your medical aid pays the surgeon and anesthetist at the "Scheme Rate" (100% or 200%). However, private specialists often charge 300% to 500% of this rate. You are personally liable for the difference.
Without Gap Cover
- ✗You pay massive out-of-pocket shortfalls for surgeons and anesthetists.
- ✗You are responsible for upfront hospital co-payments and deductibles.
- ✗Sub-limits on internal prostheses (like joint replacements) come out of your savings.
- ✗Cancer treatment co-payments can quickly drain your finances.
With Gap Cover
- ✓Shortfalls up to 500% of the medical aid rate are covered in full.
- ✓Hospital admission co-payments and MRI/CT scan deductibles are refunded.
- ✓Enhanced cover for internal prostheses and specialized treatments.
- ✓Additional funding for oncology (cancer) co-payments.
Comprehensive Protection
What does Gap Cover actually pay for?
Tariff Shortfalls
Covers the difference between what your medical aid pays and what the specialist charges (up to 500% of the scheme rate) while you are in the hospital.
Co-payments & Deductibles
Refunds the upfront fees your medical aid requires you to pay for certain procedures, hospital admissions, or specialized scans (MRI/CT).
Casualty / Trauma
Provides cover for emergency room visits resulting from accidents or trauma, which many standard medical aid plans do not cover in full.
Got Questions?
Frequently Asked Questions
Don't wait for a medical emergency.
For a fraction of your medical aid premium, you can secure complete peace of mind. Let us find the right Gap Cover for you and your family today.
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