How Zestlife Gap Cover Works for Your Family

    What is Zestlife gap cover?

    • Zestlife gap policies offer many advantages
    • Gap cover for both in-and-out-of-hospital procedures

    Gap cover from Zestlife is affordable and this is how Zestlife gap cover works: it insures policyholders against unforeseen out-of-pocket expenses resulting from medical procedures.

    So gap policies cover the difference between what medical schemes are prepared to pay and what members of the medical profession end up charging for their services.

     

    Key benefits of how Zestlife gap cover works

    Primarily, gap policies cover medical procedures undertaken in a hospital or at out-patient facilities.

    How Zestlife gap cover worksImportantly, a Zestlife policy also protects families from financial worries in the event of:

    • Illness
    • Injury
    • Disability
    • Accidental death

    Zestlife gap policies offer benefits that include:

    • Payments up to five times more than stipulated by the Medical Scheme Tariff (MST) for procedures while hospitalised
    • It covers outpatient treatments such as MRI, CT and PET scans, cataract removal, kidney dialysis, colonoscopy
    • Zestlife covers co-payments for inhospital admissions.

    Top-of-the-range policies include cover for:

    • Cancer
    • Casualty
    • Dental procedures after an accident
    • Internal prosthesis
    • Waivers on medical premiums

    Essential Gap Policy

    • In-hospital and out-of-hospital cover
    • Medical Aid co-payment cover but NOT when a Designated Service Provider is not used
    • Accidental death and permanent disability cover of a R50 000 lump sum, cover ends at age 65
    • Trauma counselling cover of R750 per session

    Universal Gap Cover

    Universal covers all of the benefits of a Standard policy, but includes:

    • R20 000 for breast reconstruction following a mastectomy
    • R30 000 maximum for internal prosthesis per policy annually
    • And also, in-hospital dentistry expense shortfall cover

    Lump sum extras

    Also, policyholders, at an additional cost, can opt for optional lump sum extras to cover:

    • Extended lump sum cancer cover paying out R75 000 or R175 000 for R68 and R130 per month respectively.
    • Also, extended dentistry cover for R259 per month.
    • Medical premium waiver cover for cover for 24 months or 60 months for R165 and R289 respectively.

    Prescribed Minimum Benefits (PMBs)

    PMBs are clearly defined in every medical aid contract and include about 300 different procedures undertaken in a hospital.

    Medical schemes must, by law, cover PMBs.

    Significantly, these include emergency procedures by network DSPs.

     

    Please complete and submit the form on this page to get a personalised gap cover quote