Gap cover for Johannesburg residents
December 14, 2021
What is gap cover for Johannesburg residents?
- Avoid financially crippling shortfalls for medical treatment
- Obtain gap cover for up to 500% of medical scheme payment tariffs
- Oncology benefits, including lump sum payments
- Enjoy co-payment benefits for costs such as hospital admissions
- Entry-levels products for low to middle-income earners
When it comes to gap cover, Johannesburg residents have been served for more than a decade by Stratum Benefits.
Established in 2006, Stratum Benefits is an award-winning short-term insurance company with more than 202 000 members.
Stratum Benefits was named Product Supplier of the Year: Health Insurance Category, in 2016.
Apart from its Johannesburg head office, Stratum Benefits has satellite offices in all major South African cities and has paid out over R210 million in insurance claims.
Key benefits from Stratum
- Stratum’s gap cover has been structured to safeguard beneficiaries from having to pay crippling financial shortfalls between the cost of medical procedures and payments made by their medical aid schemes.
- All Stratum gap cover options pay up to an additional 500 percent of medical fees not covered by medical schemes,
PLUS it gives members access to trauma and casualty counselling proportionate to monthly premiums. - Stratum’s gap cover insurance also includes a once-off lump sum payment for beneficiaries who are diagnosed with cancer for the first time.
More comprehensive gap cover includes:
- Co-payments
- Sub-limit benefits for specialised radiology and prosthesis
- Additional oncology benefits
- Premium waiver benefits
- Accidental death benefits
Stratum products for Johannesburg residents
Stratum gap cover is available in different tiers:
- Entry-level for low to middle-income earners.
- Premium products for enhanced protection but higher monthly premiums.
Base gap cover
This is Stratum’s entry-level product and offers:
- Up to 500% shortfall cover for the difference between costs imposed by the medical profession and payment ceilings imposed by medical schemes
- Trauma and casualty counselling benefits of up to R5 000 per policy annually, respectively
- R5 000 once-off payment for members diagnosed with cancer for the first time
Co-Evolution gap cover
- Up to 500% shortfall cover for the difference between costs imposed by the medical profession and payment ceilings imposed by medical schemes
- Trauma and casualty counselling benefits of up to R6 000 per policy annually, respectively
- R5 000 once-off payment for members diagnosed with cancer for the first time
- Co-payments and deductibles of up to R40 000 per policy annually
Elite gap cover
- Stratum’s Elite gap cover offers more enhanced oncology benefits, co-payments, trauma and casualty cover, as well as a sub-limit benefit for internal prostheses.
- It also includes MRI and CT scans.
Other Elite benefits include:
- Unlimited co-payments, as well as an additional R8 250 per policy annually for volunteering to use a hospital or day clinic not designated by the members’ medical scheme
- Trauma and casualty benefits of up to R10 000 per policy annually
- Oncology benefits of up to R450 000 per person annually
- Oncology optimiser benefit of up to R100 000 per person annually
- Once-off lump sum payment of R30 000 for first-time cancer diagnosis
- Sub-limit internal prosthesis cover of up to R60 000 per person annually
- Sub-limit cover of up to R2 500 per CT or MRI scan per policy annually, limited to two scans
- One year premium waiver benefits
- Six months medical scheme waiver benefits, limited to R4 500 monthly
Stratum’s additional gap cover products for Johannesburg residents
- Hospital Optimiser that increases the annual hospital limit to R2 million per policy annually
- Access Optimiser to cover the cost of necessary medical procedures excluded by medical schemes
- Dental Assure to cover the cost of basic and affordable specialised dental and eye care procedures
What are the waiting periods?
- Waiting periods of six months for pre-existing medical conditions
- Waiting periods of 10 months for specified medical conditions
Complete and submit the form on this page to get a quick gap cover quote
All info was correct at time of publishing