Sanlam Medical Gap Cover Personal Insurance

December 19, 2021

How does Sanlam medical aid gap cover work?

  • It pays the portion that your medical aid will not.
  • Cover starts at R252 per month
  • You must already be a member of a registered medical aid
  • Your policy covers you, your spouse, and children who are 27 or less.
  • You can opt to include others by application

What, these days, can you buy for R250? A few cups of coffee, a meal for yourself in a nice restaurant. Nothing that is really going to make it possible for you to invest in your future, though, is there?

Except that, with gap cover from Sanlam starting at only R252, there is a lot that you can do to protect your future. Maybe give up coffee for a week or skip the latte you have at the weekend.

Sanlam Gap Cover offers the Comprehensive Gap Cover at R252 (younger than 60 years) and R605 (60 years and older).  This includes in-hospital treatment and some out-of-hospital treatment benefits.  Enhanced hospital cash benefits are only available to Sanlam Reality members.

For more information on the list of additional benefits and exclusions please check out the PDF document at SPF757_Gap Cover_Top Performer May 2018 or read more here 

 In this article, we are going to show you not only why you can afford this policy but also why you can’t afford not having it.

My Medical Aid Pays Everything

Great, then you don’t need Sanlam medical aid gap cover. Just a quick question, though – do you have to pay a co-payment for medicine? Do you have to pay a leftover portion to your medical doctor, even though the medical aid has paid its bit?

Sanlam Medical Aid Gap CoverAre you linked into a specific network when it comes to medical and a predetermined formulary? If so, what about medications that are not on the formulary for your medical aid?

Now, when you are dealing with normal, day to day illnesses, like a sore throat, this is not such a big deal. But what happens when you start needing more specialized care, like a tonsillectomy, for example?  It also means booking time in a hospital and the operating theatre.

If these fees are more than what the medical will pay out, you will need to pay the difference.

Do I Need Gap Cover?

Maybe you will get lucky and come across a specialist or hospital that charges strictly according to the standard medical tariffs. And maybe you could win the lottery. The chances are about the same.

The medical standard rates are published by the Department of Health and represent an average of the cost of each treatment at each care facility nationwide. Some doctors charge more, some less and so the average may not be representative of the doctor in your area.

Your doctor uses these recommendations as a guideline to base his costs on. He can charge whatever he likes. And, what the medical aid doesn’t pay, you must pay yourself.

And, when dealing with hospitalization, we are talking thousands of Rand.


Can I Apply for Sanlam Medical Aid Gap Cover?

If the following conditions are met, you would be allowed to apply for Sanlam medical aid gap cover:

  • You are a current member of any of the registered medical aids in South Africa
  • Your spouse has this policy, and you do not have one of your own.
  • There are no age limits, but if you are 60 or over, you will pay a premium of R400 monthly.


Sanlam is a trusted name in the South African insurance industry, and they offer a quality option for those looking to prepare for every situation.

Please complete and submit the form on this page to get a gap cover quote right away



All info was correct at time of publishing