About Zestlife Gap Cover
November 20, 2024
What do I need to know about Zestlife Gap Cover?
- No maximum age
- If someone is a dependent on your medical aid, they can be covered under your gap cover
- If you are single, you may qualify for a discount in premiums
- Monthly premiums are low – below R500 generally
- You can choose the Universal plan or the Essential plan
The cost of living in South Africa seems to be increasing on a daily basis. The applies especially when it comes to medical costs and hospitalisation costs in particular. But most South Africans who are on a medical aid never worry about that. The medical aid pays in full for hospitalization costs, after all.
Except that the Medical Aid Doesn’t Always Pay in Full
As many people find out when they face a mound of bills after a trip to the hospital, the medical aid doesn’t always pay in full.
They pay the rates that they have predetermined that the procedure should cost. They set these rates in advance, and they 
base that assessment on historical data. This, in itself, means that medical aid pays out according to older rates and that this payment is already out of whack.
Think about it for a minute. They determined the rates that they would pay for procedures in 2017, towards the end of 2016. What happens if the doctors, surgeons, etc. increased their rates in the interim? Because of this, if you go to the doctor in October of 2022, your medical aid will pay out rates that are already at least ten months old.
And, as if that wasn’t enough, specialists, surgeons, etc. are not obliged to charge those same rates. If they do, you are in luck, and your medical aid will pay in full. If they do not, you are going to have to pay the money in yourself.
What is the Solution?
By preparing ahead of time, you won’t have to hope to win the lotto to pay off your medical debt. Much about Zestlife’s gap cover products will do that for you. The cover will pay the difference between what your medical scheme paid and what you were charged, up to certain limits.
You can choose the Essential gap cover produc and the Universal gap cover products.
The Essential Plan is the basic option when it comes to these policies. The plan pays for in-hospital expenses that are not paid in full. The cover is limited to three times what the medical scheme paid out. Zestlife will also pay for some out-of-hospital procedures and also for qualifying co-payments.
More About Zestlife Gap Cover
Alternatively, you can choose the Universal plan This is the more comprehensive option and covers you for a lot more.
For example, the cover for in-hospital expenses is five times what your medical aid paid out and, in addition, you also have cover if you use an out-of-network hospital. It also includes a premium waiver benefit that is quite special – it will cover both your gap cover and medical aid premiums.
Here are the 2025 premiums for each plan:
All in all, learn about Zestlife gap cover. The company has shown that they are looking for innovative solutions to help South Africans access better medical care.
Next step: complete and submit the form on this page to get an accurate Zestlife quote fast!
All info was correct at time of publishing