Gap Cover for Cape Medical Plan

December 14, 2021

Being on a medical aid is a wonderful luxury for anyone in South Africa today. Everybody would like to belong to a medical aid, but not all South Africans can afford it anymore. Here we will have a look at Gap cover for Cape medical plan.

The Cape Medical Plan knows that South Africa’s healthcare industry is full of challenges but they want to at least provide members with effective medical cover. They like to keep their products easy to understand.

Even though Cape Medical Plan offers wonderful health cover which provides value for money, they aren’t just an open book on products and services. There are limits on how they pay for certain products and you’ll find that there are exclusions on the cover for cosmetic surgery for instance.

They offer –

  • HealthPact Premium Plan -hospital cover only and +- R1 700 a month
  • HealthPact Silver Plan – hospital cover with a medical savings account and +- R1 800 a month
  • Also the HealthPact Select Plan -hospital cover with day-to-day benefits and medical savings account and +- R5 200 a month


When it comes to hospital accommodation, all 3 plans will pay up to 100% of the plans tariff in intensive care or general wards.

100% doesn’t Mean ‘Paid in Full’ – Gap Cover for Cape Medical Plan

Gap Cover For Cape Medical PlanIf a medical aid scheme says it offers cover for procedures in hospital at 100%, this doesn’t mean that your bills will be paid in full. If your specialist charges you more than what your medical aid will pay, you will have to pay the shortfall yourself.

Taking out short-term insurance or gap cover will take care of these shortfalls. Each medical scheme has their own rate which is created in accordance with the NHRPL or National Health Reference Price List as their guideline. Those doctors who have contracted out of the medical aid charge private rates and these are most times much higher than medical aid rates.

You’ve got some Good Options – Gap Cover for Cape Medical Plan

Gap Cover has become an integral part of the healthcare industry and for Cape Medical Aid members. Those who belong to a medical aid will find that South Africa has some awesome gap cover providers of which Zestlife, Stratum, Turnberry, and Sanlam are just some.

These are all reputable providers and they have all the experience and skills to make sure you have the best gap cover which will pay for those shortfall amounts that you can’t pay.

Affordability is what Gap Cover is about – Gap Cover for Cape Medical Plan

Take a look at Sanlam for instance. They’ve been around since 1918, and as a financial services group, they offer gap cover among their products. Cape medical plan members qualify for Sanlam gap cover. In fact, you have to belong to a registered medical aid to have gap cover in the first place.

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

You need to be always doing research on gap cover providers to see what their offerings are against the premiums you pay.

Wherever you get your gap cover from, just having it ensures that you’ve got help with paying for those massive hospital bills that your medical aid isn’t going to pay.


To get a gap cover quote, complete the form on this page and click on the “Get a Quote” button

All info was correct at time of publishing