Gap Cover for Hospital Plan Members in South Africa

December 9, 2021

Gap cover for hospital plan members means never having to pay cash for a hospital stay or specialist treatment again.

You know your medical aid or hospital plan from a medical scheme doesn’t cover all hospital care expenses. That’s why the insurance industry invented medical gap cover for hospital plan members. It is a strictly South African invention. It works like this.

How Gap Cover for Hospital Plan Works

If you are a member of a South African medical scheme registered with the Council for Medical Schemes, then you are eligible for medical gap cover, also called shortfall cover.

Gap Cover for Hospital Plan Members in South Africa

Especially if you belong to a hospital cover option from a medical aid, as opposed to full-blown medical scheme membership, you need gap cover.

That is because if you land in the hospital, your medical aid will not cover all the expenses.

And many South Africans have learned that to their detriment.

Some Hospital Plans Eligible for Medical Gap Cover


The bottom line is that if you belong to a medical scheme – any medical scheme in South Africa – no matter if you have proper medical aid or just a hospital plan from one of the registered medical aids, you can get gap cover. Hospital plan members should get it.

Why Gap Cover is Vital

Even if the documentation from your medical scheme says you are 100% covered for hospital stays, you should know that this does not mean the medical aid will cover all your bills.

All it will do is pay 100% of the expenses according to the rating scale for the medical scheme in question.

Another medical aid option might pay 200%, 300% or 400% of the rating scale.  And even that might be too little to cover all the hospital and specialist costs, among other expenses.

But by taking out gap cover for hospital plan members (or if you belong to a full medical aid), you will not have to cough up cash when you are at your most vulnerable.

Gap Cover for Hospital Plan Members is Cheap

Not only are monthly medical shortfall cover premiums low (the price of a meal for two at a chain restaurant) but you need only one policy for all the members on the medical aid. So that means your spouse, children and any dependents on your medical aid get gap cover automatically.

So say goodbye to out-of-pocket medical expenses. Just get gap cover for hospital plan members now!

To request a gap cover quote now, just complete and send the form on this page

All info was correct at time of publishing