Gap Cover in South Africa

November 29, 2024

What is it that makes gap cover in South Africa so important! People with medical aid often believe they have complete cover for any medical treatment they have.

They only find out the truth when they receive a huge medical bill which they can’t pay. They probably never realised that specialists could charge far more for in-hospital procedures than what their medical scheme will pay.

The difference between the unregulated amount the private doctor charges and your medical scheme tariff creates an excess amount. And,  no matter how large it is, you have to pay it.

ONLY Medical aid members can apply for medical gap cover here. Just complete and send the form on this page NOW and we will send you a quote

Gap Cover in South Africa – The Shortfall can Sink You

The only way to ensure that you’re not thrown off guard is to invest in gap cover. Medical gap cover is a short-term insurance product that will cover the shortfall. Fortunately gap cover is available. But it is a wise idea to compare gap cover amongst the major gap cover suppliers. That way you will find the solution that suits you best.

Gap Cover in South Africa – Trust Sanlam to come to the Rescue

Sanlam MedicGap Cover in South Africaal Aid started in 1918. However, today they are a diversified financial services provider who caters for all market segments around the world.

Their Sanlam Medical Aid is firmly established. Other medical aids require you to choose a plan. But with Sanlam you fill in a form and they match a medical plan based on the information you supply.

Gap Cover in South Africa – Two Frustrating Things with Sanlam Gap Cover

If you belong to a registered medical aid scheme, you can apply for gap cover. There are good reasons to join Sanlam medical gap cover, one being that the cover extends to the principal member and the entire family.

There are two requirements with gap cover from Sanlam –

●   the cover is only available to people under the age of 60
●   possibly the waiting period of 3 months which can stretch up to 12 months is another drawback if you are looking for treatment for pre-existing conditions.

With Sanlam Gap Cover, this product will cover the difference between what specialists charge for in-hospital procedures which is way beyond the Medical Scheme Rates (MSR) and what your medical aid will pay. In fact, in most cases, the cost for in-hospital procedures exceeds the mean medical aid rate by 4 or 5 times.

Without Gap Cover, you Will be Amazed at What Your Final Bill Looks Like

By taking out Sanlam Gap Cover in South Africa, you can know that you aren’t going to be left with an enormous excess amount to pay. It is quite staggering when you consider that some medical specialists charge as much as 400% of MSR rates.

That means that if your medical aid only covers 100% of MSR rates, the shortfall of 300% will be payable by you. Sanlam Gap cover will cover this outstanding amount.

Gap Cover in South Africa – Small Amounts which can Make a Huge Difference

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.

These are just a small amount when you consider the expense of medical treatments and how some of the shortfalls between what the medical aid charges and what the specialist charges can run into thousands of rand.

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

ONLY Medical aid members (of any registered medical scheme) can apply for a gap cover quote by completing and sending the form on this page NOW

All info was correct at time of publishing