Cheap Gap Cover for Medical Schemes and Which to Choose

December 19, 2021

More and more South Africans are beginning to realise the importance of Gap Cover. Here is a quick look at the top South African Gap Cover providers you also have to consider to join that offer cheap gap cover for medical schemes.


What is Gap Cover? – Cheap gap cover for medical schemes

Gap Cover exists to meet the difference between the prices charged by healthcare practitioners while also covering the predetermined limits of your existing medical scheme.

This kind of short-term insurance is ideal for:

  • Unexpected hospital costs.
  • Will help you cover for fees for specialist and also medical providers.
  • Also, covers medical scans.
  • Counselling


Gap Cover wCheap Gap Cover for Medical Schemesill give you peace of mind and will be able to pay for any medical expenses that you haven’t taken into account.  Let us take a look at the Top 5 South African Gap Cover Providers.


Zestlife offers excellent gap cover for medical aid members.


  • They provide gap cover for in-hospital procedures
  • Gap Cover for specialist medical practitioner fees
  • Hospital treatment co-payments
  • A one-time payment in case of cancer

Zestlife Universal Gap Cover’s 2019 benefits enhancements include:

  • Overall regulatory maximum for medical expense shortfall cover increased from R150 000 to R160 000.
  • Cancer lump sum increased from R25 000 to R30 000.
  • Casualty benefit increased from R10 000 to R20 000. Casualty visit must be within 48 hours of the accident.
  • Medical Aid and Gap Cover Premium Waiver maximum increased from R6 500 toR7 300.
  • Medical Aid and Gap Cover Premium Waiver limited to accidental only, but the payment period increased from 3 to 12 months. This change was due to legal requirements.
  • Accidental dentistry maximum increased from R15 750 to R19 250 and amount per tooth increased from R2 250 to R2 750.
  • Non-Designated Service Provider co-payment increased from R8 600 to R9 300.
  • Oncology co-payment maximum increased from 20% to 25%.
  • Cover for robotic procedures up to R30 000.
  • Cover for procedures in day clinics.
  • New Oncology Benefit to cover 20% of treatment cost when oncology limit is exceeded.
  • Varicose veins have been added as an out-of-hospital procedure that is covered.


There are two Zestlife packages. Here are the 2024 premiums:

Zestlife Gap Cover 2024



All Stratum Gap Cover plans offer:

  • Gap Cover to meet the difference between specialists’ and doctors’ rates and approved medical aid payments
  • Cover for co-payments


Stratum’s more advanced packages also offer:

  • CT and also MRI scan cover.
  • A wide range of options for in-hospital treatments and procedures



Offering up to 500% of in-hospital cover while also being at a low price.

The standard Turnberry Elect-A-Care covers various deductibles, including:

  • Dentistry
  • Scopes and scans
  • In-hospital payments


Optionally, Turnberry Elect-A-Care-Plus offers assistance with a variety of deductibles, including certain benefits relating to out-of-hospital expenses, in addition to in-hospital cover for co-payments


The Essential range of gap cover is another of South Africa’s leading providers, and has two alternative options:

Essential Elite membership offers:

  • 500% gap cover, with an annual limite
  • Excludes co-payment and sub-limit options


Essential Prestige  offers unlimited gap cover annually for the principal member and family


Another superior South African provider, Ambledown offers cover up to an annual limit per family, including gap cover for:

  • Also includes all in-hospital treatments.
  • Outpatient chemotherapy and radiotherapy and cancer treatment.
  • Out-patient kidney dialysis.
  • Also providing up to 500% cover of medical scheme rates.


Other Outstanding Gap Cover Options – Cheap gap cover for medical schemes


With affordable package options, Complimed is a basic Gap Cover option that makes an excellent addition to your existing medical aid scheme. An extremely affordable plan, Complimed offers extended options to any existing medical aid members.


The Xelus Fusion cover has been specially created to serve the needs of employers and also employees. A specific group cover plan, Fusion can offer cover for all kinds of payment gaps, irrespective of the specific medical aid.


Sirago is an affordable and dependable Gap Cover policy option. Sirago imposes no maximum age for entry and offers unlimited annual cover. In addition to standard medical providers’ fees, Sirago also covers in-hospital optometry and dental cover.


Another of South Africa’s top 10 providers of Gap Cover, the Jenius scheme offers a straightforward option to pay for whatever differences arise between medical aid tariffs and actual charges incurred during your hospital stay.


An established provider of Gap Cover, Talksure provides an accessible means of meeting unexpected medical costs.

Remember to fill in and then submit the form on this page to get your one free gap cover quote.

All info was correct at time of publishing