Sanlam Medical Shortfall Cover Information

    July 1, 2018

    Sanlam offers one of the most affordable gap cover insurance policies available in South Africa. The product is 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.

    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.

    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

     

    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 

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

     

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

    All info was correct at time of publishing