Jenius Gap Cover for South African Medical Aid Members
December 14, 2021
Jenius gap cover protects you from those unexpected healthcare costs that medical schemes don’t cover.
Significantly, medical shortfall insurance (another name for it) is necessary when your medical aid only pays for treatments at lower rates than charged by medical specialists.
For instance, your hospital plan imposes co-payments for certain treatments and procedures, or your health insurance provider has limits on the amount they will pay for some treatments
So apply for a policy NOW by completing and sending the form on this page. Remember: for medical aid members only
Jenius Gap Cover for Those Unforeseen Medical Costs you Never Expected
Jenius gap cover will help to protect you from those unexpected costs and is the perfect addition to your Discovery medical aid policy. And there is also a range of additional benefits and cover for when you need it.
Individuals under 60 years of age or groups below 65 years of age can apply for Jenus gap cover. However, that is provided that all members who are applying do belong to a medical aid scheme.
Terms for Gap Medical Cover
As with most gap cover insurance policies, there is a general three-month waiting period and 12-month maternity exclusion with Jenius gap cover.
There is also a 12-month exclusion for pre-existing conditions and a complete exclusion for pre-diagnosed cancers.
Importantly, Jenius gap cover provides medical aid gap cover for the principal member, your wife and children provided. But that is provided you are all on the same medical aid.
Some Limits to Jenius Gap Cover
- There is an overall annual gap cover limit per Jenius gap cover policy
- Cancer co-payments cover up to 20% per annum with a set maximum
- The sub-limit enhancer is limited a certain limit per incident
- There aren’t any annual sub-limit co-payments with Jenius shortfall cover
- Tariff cover of up to 500% of the medical aid tariff
- Hospital consumables are limited to a set amount
- Cancer or oncology related surgery is covered up to 600% with Jenius gap cover
Jenius Gap Cover Benefits Include –
- No sub-limit for blood tests
- Cancer surgery covered up to 600% with no sub-limit
- PET, CT and MRI scans covered up to 500%
- All co-payments up to 20%
- In-hospital sub-limits up with a set ceiling
- Six-month waiver on premiums on the permanent disability or death of a gap medical cover member
- R20 000 accidental death or permanent disability gap cover
- R10 000 permanent disability or death due to illness cover
- Jenius shortfall cover offers 600% cover for post trauma reconstructive surgery to the face as well as intracranial neurosurgery and surgical correction of birth defects.
- R10 000 payout in the event of premature birth
- Dental reconstruction cover if surgery is due to trauma or oncology.
Jenius gap cover offers an overall limit per year per family.
Apply for your own medical gap cover quote NOW by completing and sending the form on this page. NOTE: Medical aid members only!
All info was correct at time of publishing