Medical Gap Cover Insurance in South Africa

Medical gap cover insurance helps to pay medical bills' shortfalls, that aren't fully covered by your medical aid.

 Medical Aid Gap Cover Insurance
Medical Gap Cover Insurance - For the unexpected shortfall

Need Medical Gap Cover Insurance Assistance?

Medical Gap Cover Insurance is NOT a medical aid/scheme, but rather short-term insurance that covers you in the event that your medical aid doesn't cover all your costs.

Given the spiralling costs of private healthcare and shortfalls in medical aid cover, Gap Cover Insurance has become an essential protection for South Africans and their families. It's designed to cover the often significant 'gap' (or shortfall) between what healthcare professionals charge and what medical aid schemes are prepared to cover.

Note that Gap Cover is not a medical aid/scheme and the cover is also not the same as that of a medical scheme, but it is an optional short-term Insurance product designed to help you avoid unexpected shortfalls.

When choosing a Gap Cover Insurance provider, look for a short-term insurance company that is financially stable, has a sizeable customer base and attracts positive reviews.

Some Questions to Consider:
1. Is there cover for procedures conducted out of hospital?
2. What is the overall Gap Cover limit?
3. What is the maximum entry and benefit age?
4. Are there first time cancer benefits?
5. What are the waiting periods?
6. What is excluded from Gap Cover?

Being a specialist niche area, finding a Gap Cover Insurance partner for your family’s requirements is no easy task, because dozens of products are offered by providers in South Africa. These options may be confusing...

In fact, the smartest thing you can do is -- Get a specialist broker to do it for you!

Also, note the following guidelines, tips and considerations applicable to Gap Cover Insurance:

  • Medical service providers, like doctors, can charge an average of 5 times (or 500%) the medical aid rate, leaving you to pay the difference out of your own pocket. They may also request certain procedures and scopes, such as an MRI scans and gastroscopy scopes, which would require a co-payment. Gap Cover can assist in cases like these.
  • Gap Cover not only covers shortfalls (or gaps) and co-payments for medical practitioners in the event of hospitalisation involving surgery or medical treatment, but also certain procedures performed out-of-hospital.
  • Gap Cover also have products that offer cover for cancer diagnosis and treatement, internal prosthesis, casualty room treatment, accidental death, road accident cover, or disability and trauma counselling.
  • There are different Gap Cover Insurance products on offer, with different maximum entry ages, waiting periods, claim limits and exclusions of certain pre-existing conditions - to name just a few. Discuss your individual needs with your Broker.
  • The more expensive plans have additional benefits available, such as cover for co-payments and accidental death benefits.
  • Note: It is important that you fully understand your particular product. Ensure to discuss all the conditions in detail with your Broker.
 Medical Aid Gap Cover Insurance - Products
Investigate the various Gap Cover Insurance Products available
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