How gap cover helps medical scheme members in South Africa has a huge impact on the medical scheme members. Health care costs in South Africa are so outrageously high and furthermore, medical schemes are unable to cover in-hospital specialist bills in full. Without gap cover, this is creating serious financial burdens for many cash-strapped South Africans. We can, therefore, be thankful that there are many short-term insurance solutions that mercifully cover all those in-hospital shortfalls.
Some Gap Cover Providers
- Stratum
- Ambledown
- Turnberry
- Essential Gap Cover
- Zestlife and others
This gap cover doesn’t form part of your medical aid and it’s a very valuable addition to it. Also, gap cover is a short-term insurance product that falls under the Accident and Health Policy of the Short Term Insurance Act.
Zestlife is an authorised financial service provider with policies underwritten by Guardrisk Insurance Company Ltd.
What Zestlife offers:
They will tell you that the only solution for medical scheme members to insure themselves against shortfalls is to consider gap cover seriously. Zestlife offers:
- co-payment cover
- cover for the entire family
- 500% of Medical Scheme Tariff
- also a medical premium waiver – this is important as it ensures you enjoy ongoing medical cover in the event of disability or even death. This special purpose life cover caters specifically for the ongoing cost of your family’s health care.
Here are Zestlife’s 2025 rates:
Eligibility requirements for gap cover from Zestlife requires:
- that you belong to a registered medical scheme
- no medical examination required to get gap cover
Exclusions
There are some exclusions, however, but these come with most gap cover providers. For instance, Zestlife won’t pay out if you claims relate to suicide, self-injury, cosmetic surgery, etc.
Therefore, no matter which medical aid plan you have, you’re going to find out that it doesn’t always pay in full for when you land up in the hospital. In conclusion, with gap cover, you never have to be responsible for paying in-hospital bills that your medical aid doesn’t pay.
While gap cover is an important supplement to medical aid, first speak to a Medical Aid Consultant about it to gain a real understanding of how it will work for you and how medical gap cover helps.
For a free gap cover quote fill in your details in the form provided and click on the GET A QUOTE button.