Gap Cover Plans FAQ

December 11, 2021

In the process of getting additional coverage there arises a list of gap cover FAQ.

Some questions can be unique to your personal needs and specifications.

The rest, however, will probably correlate with the questions asked by so many before you and those following after you.


The following article focuses on these questions, which is being asked on a frequent basis.


What does gap insurance consist of? – Gap Cover FAQ

It is an insurance that facilitates in assisting you with the excess sum on your medical bill after your medical aid’s share has been deducted.

Gap Cover FAQ

The invoice contains the total of your hospitalisation, which consists of all charges by medical practitioners.

This insurance covers your hospitalised procedure up to five times the original medical aid basic pricing structure.

The plan will not exceed 1 million rands per year.


Gap Cover FAQ – Why is this kind of insurance essential?

Your medical aid, unfortunately, will only advance coverage for a certain amount, which leaves you with an outstanding balance.

This unsettled amount then needs to be paid from your pocket.

Investing in this extra (gap) insurance will enable you to be essentially covered in settling the bill, fully, without involving your personal bank account.

Does this coverage inevitably insure provision for extra medical fees?

Unfortunately, it does not provide for any extra fees.

There is, however, a specified policy that will cater for those additional costs.


Gap Cover FAQ – What establishes the approved tariffs of medical aids?

There is a medical aid committee that produces a selective coding system, which provides the recommendation of pricing the aid adheres to.


Are determined yearly boundaries valid in the case of gap insurance?

The plan will not exceed 1 million rands per year.

There is, however, the possibility of revising this determined sum at varying time periods.


Gap Cover FAQ – Does the gap coverage provide for the minimum recommended health assistance?

No, it, unfortunately, does not make provision for the minimum recommended health assistance, which was instituted by medical aids.


What is the monthly fee for this insurance?

Here are Zestlife’s 2024 premiums:

Zestlife Gap Cover 2024





Will this insurance rise in their monthly charge?

It is affirmative that a possible rise will take place on a yearly basis.


Gap Cover FAQ – Does the plan include other added expenses?

Your once-a-month instalment will already include the necessary admin and transitional charges, which excludes the existence of any other hidden expenses.


When do I need to pay the first instalment?

From the first month of coverage, you will start making your monthly payments.

The date your payment is due will be listed on the application.

Make sure you are sure when your payment is due, to prevent any misunderstandings.


Is there any health check-ups that I need to submit to in being insured for this coverage?

There is no need for any check-ups.

You can get insured straight away.

In submitting a claim, however, there may be specified documentation necessary.


What is the necessary documentation in submitting a claim?

  • Claim request;
  • Doctor’s results;
  • Hospitalisation invoice;
  • Health insurer’s submitted claim, approval, participation record;
  • Outstanding balance due.


To get a FREE gap cover quote, please complete and send the form on this page

All info was correct at time of publishing