Why You Deserve the Best Gap Insurance for Medical Aid

    March 11, 2019

    Everyone should have the best possible medical care. However, ever-increasing costs are putting this out of the reach of many South Africans. Even if you have medical aid that’s often not enough. And that’s why medical aid members need the best gap insurance money can buy.

    The cost of belonging to a medical aid scheme can be exorbitant. And even then it will not fully cover medical overheads in cases of hospital procedures and other healthcare treatments. That’s because medical schemes work to a pre-defined tariff rate. And these rates always falls well below what medical professionals actually charge for their services.

    That is why it has become imperative for consumers to consider adding Gap Cover to their health insurance portfolios to safeguard the very real possibility of having to foot crippling additional and unexpected healthcare costs.

    Best Gap Insurance – Medical schemes and Gap Cover providers

    Best Gap Insurance in South Africa for Medical Aid Members Only

    The changing financial landscape of the South African healthcare market has seen medical aid providers, like Discovery, Momentum and Liberty, introducing Gap Cover short-term insurance policies to their product portfolios. Discovery, for example, is one of the country’s best Gap Cover service providers, insuring top-up payments for in-hospital procedures and treatments.


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    With Gap Cover, members can enjoy peace of mind. They know their short-term insurance policies will pay in the difference between what their medical aid schemes pay and what the medical professional actually charge for their services.

    Depending on the product chosen and the range of benefits you select, your Gap Cover policy will pay the additional charges related to:

    • Hospital admissions
    • Treatment costs
    • Prescribed Minimum Benefits
    • Additional hospitalisation costs

    Best Gap Insurance – Understanding tariff rates

    Many people find it confusing that while medical aid schemes say that they will pay 100 per cent of their health needs, in reality, this pay-out falls hopelessly short of the final cost. The reason for this is that medical professionals do not have to stick to medical aid scheme tariff rates and can impose whatever charges they see fit. The difference in these charges can more often than not exceed medical scheme tariff rates by 500 per cent.

    Best Gap Insurance – FAQs and Answers

    1. Who is eligible for Gap Cover?

    Anymember of a medical aid scheme qualifies for this form of short-term insurance.

    1. Does membership depend on family size?

    No. The beneficiaries of your medical aid scheme fall under your Gap Cover policy.

    1. Do cancellation periods apply?

    Yes. Generally,cancellation periods range between 30 to 60 days.

    1. Is there a waiting period?

    Yes and no. Generally, however, most Gap Cover providers impose waiting periods of up to 90 days but this clause is waived by other insurance companies. Some companies will also waive the waiting period in cases of emergency medical needs.

    1. Are there limits imposed on benefits?

    Annual benefits are imposed but these vary depending on who you select as your insurance providerand the level of the benefits you choose.

    1. Must excess payments on benefits be made?

    Yes, excess payments on certain benefits can apply. Once again this is dependent on the insurance company you select and the value of the benefits you choose.

    If you are a member of a South African medical aid scheme you are eligible for Gap Cover. To receive the best gap insurance quote, complete the form on this page.

    All info was correct at time of publishing