Professionals add gap cover to medical aid membership

December 19, 2021

Roughly 97 percent of professionals in South Africa add gap cover to their medical aid membership. The shortfall insurance product – also called top-up cover – ensures that medical aid members never need to make co-payments.

Co-payments, you will recall, are the amounts that medical aids will not pay for specialist care, hospital stays and other healthcare expenses. They are, in short, the amounts that medical aid members must pay out of their own pockets.

All professionals who belong to medical aid schemes qualify

If you belong to the Professional Providence Society (PPS) medical aid or any other medical scheme, then you qualify for gap insurance. Note that medical aids themselves may not, by law, sell gap cover. Only short-term insurers market the product, which is underwritten by organisations such as Guardrisk, Liberty and so on.

Professionals usually belong to leading medical schemes such as Discovery Health, Selfmed or Bonitas. You can check here to make sure you belong to a registered medical scheme in South Africa, which is a prerequisite for buying into a gap cover policy.

Woman with Laptops Showing that Professionals Can Sign Up for Gap Insurance Online

More gap cover info for the professional

  • Every individual on your medical aid gets cover from a single shortfall cover policy
  • Claims are done by phone and email – the same methods by which you get a quote and sign up for gap cover
  • The monthly gap premiums relate to your particular medical aid option. The good news is that you can get away with a cheaper option by covering shortfalls with gap cover
  • Gap cover premiums are affordable, typically amounting to the equivalent of 10% of your monthly medical scheme premium
  • From the above, you would be right to conclude that gap cover is a smart, innovative product. No wonder it is the top-selling short-term insurance product available in Sout Africa, ranking second only to car insurance.


Get your gap cover quote now. Use the form on this page
to contact a professional broker. Act now!



All info was correct at time of publishing