Medical Gap Cover from Stratum

December 9, 2021

Stratum medical gap cover is a low-cost insurance product that you need because your medical aid won’t  cover all the costs for a hospital procedure.

Anybody who has had the shock of discovering their medical aid doesn’t cover everything has finally resorted to gap cover. Importantly, you can say that having Gap Cover is of critical importance. Because without it, if your specialist were to recommend some treatment, you may well have to turn it down.

What’s more, gap cover can also keep you out of government hospitals, and will ensure you get decent treatment in a private facility.

What Stratum Medical Gap Cover Offers

You need gap cover – period. And there are several places where you can get this gap cover, and Stratum is one. They engineer their products so that they benefit your lifestyle to ensure they can cover your medical shortfall. Here we look at their gap cover products and expand on one or two of the kinds of cover they provide –

Stratum Medical Gap Cover Base –  you’re covered for medical procedures performed in hospital, in the doctor’s rooms or other registered facilities.
– PMBs are covered – Prescribed Minimum Benefits
– additional 500% cover. And there is no limitation to the number of times you can claim each year for account shortfalls related to:.

  • doctors or specialists
  • pathology
  • physiotherapy
  • basic radiology
  • MRI, CT and PET scans
  • disposable items – bandages, surgical gloves, etc.
  • medication

For example, the charge for childbirth will be R18 000. Here your medical scheme will only pay R12 000. But gap cover will pay the shortfall of R6 000 – an amount you would otherwise have to pay out of a your pocket.

Stratum Medical Gap Cover
Other benefits include the trauma, casualty and diagnosis benefits
Stratum Co-Evolution -Provides an additional 500%cover. No limit to the number of times you can claim each year for these account shortfalls.
Stratum Medical Gap Cover Elite – This benefit provides additional cover of 500% above the medical scheme

More Stratum Medical Gap Cover Plans

  • Stratum G-Force – Created for government employees.
  • Stratum Hospital Optimiser – This option has been crafted to provide additional cover when you have reached your medical scheme’s yearly hospital limit.
    – You will continue to receive cover in a private facility. The benefit covers your hospital accounts when your medical scheme doesn’t.
    – the plan covers you and your spouse even if you are on different medical schemes
    – covers all dependents registered on your medical scheme
  •  Stratum Medical Gap Cover Access Optimiser – This plan provides cover for your hospital and service providers’ accounts.
  • Stratum Primary Health Care Product Range – Essential Primary Plus – This plan is for individuals who fall within a particular income band and who can’t afford the rising costs of their premiums


For Employer Groups

Corporate Elite – co-payment benefit covers in- and out of hospital procedures. Significantly, you’ll be covered for one co-payment for the voluntary use of a hospital outside your medical scheme’s network
Corporate Access – cover for your hospital and service providers’ accounts to R80 000 per year.
Corporate Essential – short term insurance policy with day to day, emergency and accidental cover


So it doesn’t matter which gap cover plan you opt for; gap cover doesn’t automatically cover everything. But there are exclusions. For instance, this will be for those hospital accounts where the hospital charged more than what your medical scheme paid. Take note: gap cover also doesn’t cover things such as obesity, depression, artificial insemination, drug and alcohol addiction, hormone treatments, wheelchairs, crutches, etc.

Read up on gap cover and understand the different plans, their features and their certain exclusions in the Master Policy document. Indeed, you may as well get to know gap cover very well, because unless the medical scheme scenario changes in South Africa, then certainly gap cover is something that you desperately need.

If you don’t want to lose thousands of Rands in medical costs because your medical aid doesn’t pay, then take a look at Stratum’s affordable gap cover and put your mind at rest.

Request your medical gap cover quote. Just complete and then send the form on this page

All info was correct at time of publishing