Covering the Gap Will Save You a Fortune in Medical Expenses

December 14, 2021

Covering the gap depends on rates the National Health Reference Price List (NHRPL) specifies for your Medical Aid plan.

However, your plan may fall short of the amount.  Covering the gap is how to meet the shortfall.

Hospital and doctors, as well as other medical service providers, do not have to stick to these rates.

That means that they can charge as much as 300% above what the NHRPL prices are. And you have to pay the outstanding amount personally.

If you are a Medical Aid member, you can apply for one FREE medical gap cover quote NOW. Just complete and send the form on this page

It’s No Good Thinking You Have Full Cover – Make Sure You’re Covering the Gap

Covering the Gap with Medical Gap CoverYou might think that you have cover for any medical eventuality, but you are not.

That means you will be liable for the shortfall.

Many medical companies have arisen to help cover this gap-

Here is a very brief summary of what these companies offer 

Covering the Gap – Complimed Gap Cover

Complimed’s Gap Cover includes different packages such as the Gap Supreme cover at R300 per month and the Gap Senior cover at R225 a month. If you are a Keycare medical aid member with Discovery, then the LPE Listed procedure enhancer at R180 is virtually the only policy for you.

Covering the gap this way will cover you for all procedures that your medical aid won’t cover. The Supreme package from Complimed is also an excellent comprehensive product to consider, and interested people should look at brochures from Complimed for more details.

Covering the Gap – Liberty Gap Cover

Liberty offers the ZestLife Gap Cover package. Covering the gap with this package costs R207 per month, and if you like, you can also include benefits such as an additional cancer benefit which will cost you an extra R48 per month.

There is also an extra benefit known as the Medical Premium Waiver Benefit along with dentistry cover which will be an additional R238 per month.

All applicants will get cover without question, and there are no age limits. Wives who are on different medical schemes can also have cover under the same policy that you have.

Covering the Gap – Stratum Gap Cover

The gap cover offer by Stratum is also well designed and comprehensive. Stratum provides their BASE 500 cover. Covering the gap with Stratum this way is called this because it will pay the difference between 100% to 500% of your tariffs.

Their Co-Evolution cover is if you want the tariff benefits plus the copayment benefits. Their comprehensive benefit will cover you for oncology needs plus the tariff and co-payment benefits.

Most medical aids impose sub-limits on some hospital procedures. But the Sub-Limit benefit included with all the other benefits is included in Stratum’s Elite option.

Covering the Gap – Sanlam Gap Cover

Sanlam Gap Cover offers the Comprehensive Gap Cover at R252 (younger than 60 years) and R605 (60 years and older).  This includes in-hospital treatment and some out-of-hospital treatment benefits.  Enhanced hospital cash benefits are only available to Sanlam Reality members.

For more information on the list of additional benefits and exclusions please check out the PDF document at SPF757_Gap Cover_Top Performer May 2018


Gap cover in South Africa aims to supplement your medical scheme cover. The advantage of taking out gap cover with these companies is that the rates are reasonable.

By taking gap cover, you are covering the gap and ensuring your family, and you don’t have huge excess medical bills to settle.

If you are a Medical Aid member, you can apply for one FREE medical gap cover quote NOW. Just complete and send the form on this page

All info was correct at time of publishing