Plandirect Medical Gap Cover Explained

December 18, 2021

Because people pay such large premiums for their medical aid each month, they simply expect to have these medical aids pay their medical bills in full. So here in this article, we will have a look at Plandirect medical gap insurance.

Unfortunately, many medical aid members have discovered that something is missing with their medical aid. So they’ve discovered what it is – a huge gap between what their specialist charges them and what the medical aid will pay according to the National Health Reference Price List (NHRPL).

There is always a risk that exists – even for young, healthy individuals. A catastrophic Plandirect Medical Gap Insurancehealth issue or an injury can put you in a hospital with massive medical bills to settle. Rehabilitation which can continue for weeks or months may be necessary too. Many people have gone into debt for this kind of events and for not having gap cover.

Also, Many South Africans have discovered that a small monthly premium towards gap cover each month will protect them from this nightmarish scenario. So South Africans have simply come to realise that their financial planning simply has to include gap cover.

Medical gap cover in South Africa can cost anything from R80 a month to R400 a month. So to benefit from gap cover, you will need to belong to a registered medical aid.

Compare the Best Gap Cover – Plandirect Medical Gap Insurance

Also, Plandirect allows you to compare medical gap cover from all the major Financial Services Product suppliers in South Africa. You’ll be able to find gap cover aligned to your unique needs. All Plandirect’s service providers have dealings with major South African providers. Also, they invite you to use their DIY calculators to find the product that will address your unique circumstances and which will be at suit-your-pocket prices.

Gap Cover – a short-term product

Plandirect will tell you to never assume that your medical scheme will cover the full cost for your medical treatments. Medical schemes pay specialists at a rate of between 100% and 300%. Medical practitioners charge in excess of these rates. So this is what creates that gap between the actual cost of treatment and the amount that the medical schemes pay. It’s you who will be liable for this shortfall.

  • Plandirect’s products are compatible with all registered South African medical schemes
  • an additional gap benefit of 500% is provided


Plandirect offers a choice of different options – these cater for individuals,  families and groups. You can choose between –

  • Senior 500
  • G-Force
  • Base 500
  • Co-Evolution 500
  • Elite
  • Comprehensive
  • Hospital Optimiser
  • Oncology Plus


You Dare Not be Without Gap Cover – Plandirect Medical Gap Insurance

So specialists in the private health care industry can charge what they want, which can be well over  medical scheme tariffs. Whether you like the concept of gap cover or not, the set-up in South Africa makes it that gap cover is critical to you – as vital as the blood that flows through your veins.

The Stark Reality

So all medical scheme members are at risk of going into massive financial debt without gap cover. Gap Cover is short-term insurance. Its an enhancement to your medical aid. It is also something which is guaranteed to protect you from having for fork up thousands of Rands for medical treatment you believed your medical aid would cover.


To get a FREE gap cover quote, complete the form on this page.

All info was correct at time of publishing