Stratum Gap Insurance Covers Those Medical Aid Co-Payments

December 18, 2021

Most people think that having medical aid covers them completely for all their medical care requirements. But that is entirely untrue. You could get stuck with co-payments if you land in hospital and need specialist care.

If a specialist charges you R2 000 for treatment and the medical scheme tariff is only R800, then someone has to cover the left-over amount which is R1200. Because the medical scheme won’t, you have to.

Banish medical aid co-payments

It is exactly why so many people have to resort to gap cover. It pays the gap or shortfall between what the specialist charges and what your medical scheme is prepared to pay.Co-payments for Medical Aid Are Covered by StratumFortunately, gap cover isn’t too expensive. You can only take it out if you belong to a registered medical scheme.

Gap cover comes from many different providers. It pays to do research so that you get the benefits and premiums that suit you best.

Gap cover from Stratum requires just one policy for the main member and their dependents. This medical gap cover is an insurance product from a medical insurance company.

Stratum’s gap cover enhances medical aid. It doesn’t resort under the regulations of the Medical Schemes Act. It falls under the Short- and Long-term Insurance Act.

Stratum’s gap cover is for all ages – even over 65’s.

Stratum offers different gap cover options to take care of your unique healthcare needs.

More about Stratum co-payments cover

Their gap cover options are Compact 200, Elite, Co-Evolution, Base and Access Optimiser Plus


This is Stratum’s premium gap cover option offering the most benefits. The cover provides an additional 500% cover when you have to foot the bill for medical treatments in hospital. Things that people really detest – co-payments and sub-limits – are paid for with the Elite plan.

Oncology cover is another important factor. Some other benefits you’ll enjoy are among others, cancer cover, preventative care cover, physical rehabilitation top-up cover, trauma counselling cover as well as accidental disability and death.

Base cover

Stratum’s Base cover is its foundation option. Even so, it still provides cover for the most frequent medical expense shortfalls.

Stratum’s Base cover takes care of shortfalls with dental-related procedures and for accidental injury. Also included is cancer treatment, pathology, physiotherapy, Prescribed Minimum Benefit (PMB) medical procedures and radiology.

Corporate cover

Stratum Benefits also offers gap cover for corporates where there are 10 in a group or more.  The gap cover plans are Corporate Compact, Corporate Elite Plus, Corporate Elite and Corporate Access Plus.

Waiting periods and exclusions for co-payments insurance

As with other gap cover providers Stratum has certain waiting periods. There is a 3-months general waiting period and a 12-month pre-existing conditions waiting period.

There is an exclusion for pre-diagnosed cancer.

Also, for the first 12 months that you join Stratum there will be exclusions for certain treatments such as hernia ops, tonsillectomy, hysterectomy, joint replacement, pregnancy, grommets and adenoids.

Rated in the top 10

When you do research on South Africa’s top 10 gap cover providers, Stratum is always ranked there. And why not? Their Casualty Benefit is something quite unusual. This is because most medical aid schemes don’t even cover casualty treatment.

Another thing, people appreciate the range of gap cover solutions Stratum offers. The gap cover can save you forking out money from your own pocket when you land up in hospital.

South Africans know by now the importance of gap cover, and if you’re stuck for knowing where to start looking, Stratum is a good place to start your search.


Get your gap cover insurance quote online here. Complete and submit the form on this page so we can give you a customised quote and sign you up. Act now!


All info was correct at time of publishing