Inexpensive Gap Insurance for Medical Schemes in South Africa

November 26, 2024

The whole point of gap cover is that it should be inexpensive. Otherwise your arithmetic would not work.

If medical gap cover were pricey it would be more sensible to opt for a better and more expensive plan from your medical scheme.

For instance, you could upgrade from a hospital plan at Discovery Health to a Comprehensive plan and pay the difference.

However, for paying a small premium to a gap insurance company you can buy a cheap gap cover policy and “turbocharge” your medical plan that way.

How inexpensive is gap cover?

A monthly gap premium should amount to no more than the equivalent of 5% to 10% of your monthly medical aid premium. So if you are paying R4500 monthly then your gap plan should cost no more than R300 to R600 per month. A single gap cover policy insures the co-payments of all the beneficiaries/members on your medical plan.

Why is gap cover so affordable?

Gap cover is entirely different from medical aid. Medical schemes are statutorily created according to the Medical Schemes Act. The Council for Medical Schemes administers the schemes. Short-term insurance companies offer gap cover (also called top-up cover, co-payment cover or shortfall cover). The companies have nothing to do with the health industry. They merely insure your co-payment risk.

Are there other reasons why gap cover is reasonably priced?

Medical aid members with gap cover share the risk of high co-payments with all the other customers in the gap cover company’s pool of policy holders. It is comparatively rare for patients to face major co-payments, so insurance companies can charge low premiums.

The first step to signing up for gap cover is to talk to an expert. Contact us by completing and submitting the contact form on this page. We will be in touch to discuss your requirements. Act now!

All info was correct at time of publishing