Medical Aid Membership is Essential for Gap Cover

December 16, 2021

We hear many frightening accounts of what goes on it state hospitals in South Africa. Fear of landing up in one of these hospitals plagues many South Africans. And they join a medical aid to avoid ending up in a state hospital. Certainly, if you want to enjoy good medical care in South Africa, you have medical aid membership, or put yourself at the mercy of a state hospital. South Africa has good medical schemes, with some of the top ones being among others:

  • Bonitas
  • Fedhealth
  • Medshield
  • Discovery Health
  • Momentum Health

Medical aids like these are attractive choices to make because they’ve been around for a long time, they are solvent, and they can pay out your claims. Before taking out medical aid membership, you need to look at costs and features so that you choose the one that suits your needs the best.

A medical aid is an expensive investment, so you need to do your research before you commit to one of them. Even these medical schemes, good though they are – can’t pay everything out in full. Medical Aid Membership is Compulsory for Medical Gap CoverSome medical aid members reckon that medical aids use the ignorance of some of their members to avoid paying bills that they are legally obliged to pay.

However, you feel about a medical aid, becoming a member of a registered medical scheme gives you the peace that you have some assurance of decent cover when there’s a medical emergency.

Your Medical Aid Membership Doesn’t Always Pay in Full

You need gap cover for when your medical doesn’t pay for treatment in full. Gap cover pays for the shortfall. You need to belong to a medical scheme to buy gap cover. Gap cover isn’t part of your medical aid. It isn’t governed by the Council for Medical Schemes but by the rules of the Short-term Insurance Act.

You have to belong to a medical scheme to have gap cover but having a gap policy doesn’t mean you have to belong to one of these leading medical schemes mentioned above. You can chop and change medical aid but keep your gap cover.

You need to be a member of a medical scheme to qualify for medical gap cover. If you are a medical aid member, please complete and send the form on this page to get a gap cover quote

Affordable Cover That Gets You Out of Trouble

The costs of gap cover vary, but research will show that generally gap cover starts in the region of R120 a month depending on the cover you take. There are exclusions with gap cover, things such as:

  • suicide attempts
  • taking narcotics
  • cosmetic surgery

Gap cover DOES NOT cover these things. Different gap cover policies also offer varying maximum entry ages.

Gap cover differs from one provider to the next. One thing is sure though – you HAVE to belong to a medical aid scheme to benefit from it.


There is no regulation of specialists in South Africa. Fortunately, gap cover will cover you from those who charge patients as much as 500% over the scheme’s rate. Without gap cover, you’ll have to pay this sum, and you might be made bankrupt with these amounts, were it not for gap cover.

To request your medical gap cover quote, please complete and submit the form on this page

All info was correct at time of publishing