Checklist for Gap Cover: Medical Aid Members Only

December 18, 2021

Before we give you a checklist for gap cover, get this. We’re told that by 2026 we won’t have comprehensive medical aid anymore and everyone will have to make use of the National Health Insurance.

Every resident of South Africa and even refugees will have access core health services, even if it is at the expense of South African taxpayers.  The idea is for the NHI  plan to eradicate inequality in the healthcare sectors.

The NHI – Doomed before it Starts?

But we all know that ultimately the NHI will be just another state-owned enterprise that will face fraud and corruption.  We have to be realistic in South Africa with all its dilapidated hospitals and shoddy hospital management systems as they are an example to us of how the current government operates in this country.

Yes, the government is still forging ahead with its controversial plans for NHI, even though there are many experts who say it appears as though it is doomed to fail.

Checklist for Gap Cover

Everyone is waiting for the state to decide on what healthcare services this will involve,  what kind of fees doctors can expect and what medication prices will be.  While all this is raging on, chances are that 2026 will come and go and we still won’t be any closer to a proper running NHI.

Checklist for gap cover: Hold on to your Medical Aid Plan

It is important to hold onto your medical aid plan and your gap cover – for now!

If you are new to medical aid you may believe that medical aids pay for all your treatments in full, but they don’t.

They jave to provide members with a minimum level of cover by law. These are PMBs, or Prescribed Minimum Benefits.

Medical aids seem to be paying less and less for treatments. It’s not ethical for doctors to refuse treatment before they receive an upfront co-payment, but this is what is happening. Thank goodness medical gap cover isn’t going anywhere soon.

Certainly, while medical aids are getting out of paying what they should pay for, you need gap cover, and it is available to you right now..

This medical top-up insurance is a low-cost insurance product that you take out for this very reason – your medical aid won’t pay for all costs for hospital procedures or emergency surgery.

Checklist for gap cover

Having Gap Cover isn’t just something helpful to have – it is of critical importance. You don’t want to be one of these people who needs surgery but you can’t have it because there is a co-payment to take care of first.

In 2020, the gap between what the medical aid schemes fund and what the specialist in hospital charges has become so massive, that a person cant ignore gap cover. It can save you sinking into a financial crisis.

No waiting periods if you apply now

It doesn’t matter who you are, if you buy gap cover there is always a 3 month general waiting period come what may. If you are a Rutherford client, and you take out gap cover during September, you will benefit from the 3-month waiting period waiver.

This is seriously worth speaking to your financial adviser about. With gap cover, you can sleep easier at night not having to worry about treatments you need but which you don’t have the financial means to go ahead with.


By completing and submitting the form on this page you request your gap cover quote.
We will send you the details then assist you to sign up for gap cover. Act now!


All info was correct at time of publishing