Sanlam Medical Shortfall Cover Information

    Sanlam offers one of the most affordable gap cover insurance policies available in South Africa with premiums starting as low as R130 monthly. Called Sanlam medical shortfall cover.

    This gap cover fills the gaping void between amounts charged by doctors for in-hospital procedures and limits imposed by medical aid schemes.

    So many South Africans with medical aid exceed funds available yearly and have to pay the difference, adding enormous financial strain to family budgets.

    Sanlam Medical Shortfall CoverHowever, Sanlam can solve that problem and offers affordable options to suit all pockets.

    Founded in 1918, Sanlam is one of the biggest financial services groups in the country, and the cost of its gap cover premiums is difficult to beat when compared with other companies.


    The two gap products available are:

    • Comprehensive Gap Cover- (R152 per family monthly)
    • Standard Gap Cover (R125 per family monthly)


    These are available to people who belong to Discovery or Momentum Health. However, members of any other South African medical scheme are also eligible to apply for Sanlam’s gap cover insurance.

    Qualification Requirements

    • A member of a registered medical scheme
    • A maximum of 60 years or younger
    • Coverage of dependents requires that the principal, spouse and children up to the age of 26 years all belong to the same medical aid scheme
    • A waiting period of 12 months for pre-existing conditions and maternity benefits


    Sanlam does not cover specialised dentistry. So this benefit only applies to members of its Comprehensive Plan and it only includes cases involving tumours, cancer or trauma.

    Treatments excluded by Sanlam medical shortfall cover

    • Cosmetic Surgery unless medically described as necessary
    • Obesity treatments and claims older than six months


    Payments on authorised claims are made directly into the main member’s account. So only in-hospital care claims are covered.

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    For a FREE gap cover quote, fill in the form on this page