Why Medical Aid Members Need Medical Gap Cover

December 15, 2021

Do you think your medical aid cover will cover you fully if you fall sick or suffer an injury? Well, then you should investigate medical gap cover quotes.

Do you think that a medical aid will take care of your medical bills no matter what? Then you haven’t read the fine print. Your medical plan does have a limit to what it covers.

In technical terms, it’s referred to as MST or Medical Scheme Tariff. If your medical expenses rise above this amount, as they will do in some cases, you will have to pay the excess yourself.

Get a gap cover quotes right away to ensure you have cover.

Medical aid members can apply for a gap cover quote
by completing and sending the form on this page

With the Cost of Living Rising steadily the Cost of Being Ill is Equally Expensive

Anyone who has been in this position will tell you how stressful and frustrating it is to faithfully pay your premiums and still have to scratch about for money to pay for medical treatment. Medical Gap Cover Quotes

Depending on the kind of therapy in question, the subscriber may have to pay as much as their medical scheme’s MST from their pocket.

A natural childbirth in a hospital can cost as much as R14,000 but the average MST most insurers offer for childbirth is about R7,000.

That means you have to raise the remaining R7,000 from your savings or borrow it. From this example, you can see how significant that gap can occur between the MST and the real cost of treatment can be.

That is Why You Need to Get Medical Gap Cover Quotes

Just to be clear, any gap cover that you buy will not replace your regular medical medical aid  cover; it only caters for its shortfalls. The good news is that you can belong to any medical scheme to benefit from the gap cover.

So if you belong to Discovery Health, GEMS, Medshield, Genesis, Selfmed or any other of the registered medical schemes, then you may take out gap cover.

Members of other Medical Aid Schemes can sign up for it

There are many reasons you should look into signing up for medical gap cover and get gap cover quotes.

For instance, here are the enhanced benefits for Zestlife Universal Gap Cover in 2019:

  • Overall regulatory maximum for medical expense shortfall cover increased from R150 000 to R160 000.
  • Cancer lump sum increased from R25 000 to R30 000.
  • Casualty benefit increased from R10 000 to R20 000. Casualty visit must be within 48 hours of the accident.
  • Medical Aid and Gap Cover Premium Waiver maximum increased from R6 500 toR7 300.
  • Medical Aid and Gap Cover Premium Waiver limited to accidental only, but the payment period increased from 3 to 12 months. This change was due to legal requirements.
  • Accidental dentistry maximum increased from R15 750 to R19 250 and amount per tooth increased from R2 250 to R2 750.
  • Non-Designated Service Provider co-payment increased from R8 600 to R9 300.
  • Oncology co-payment maximum increased from 20% to 25%.
  • Cover for robotic procedures up to R30 000.
  • Cover for procedures in day clinics.
  • New Oncology Benefit to cover 20% of treatment cost when oncology limit is exceeded.
  • Varicose veins have been added as an out-of-hospital procedure that is covered.


And here are Zestlife’s premiums for 2024 to give an idea of gap cover quotes:

Zestlife Gap Cover 2024


So, with all this information and a little investigating from your side – you will soon be smiling again.

Medical aid members can apply for medical gap cover quotes
by completing and sending the form on this page

All info was correct at time of publishing