Here are the top 9 gap cover plans in South Africa.
An increasing number of South Africans are realising how important it is to supplement their medical aid benefits with a short-term Gap Cover policy.
These policies pay in the difference of what your medical aid will pay for hospital procedures and treatments and the amounts actually charged by your healthcare professionals.
Gap Cover buys you peace of mind because it pays in the shortfalls between your medical scheme’s tariff rates and the final cost for unforeseen hospital expenses and specialist fees. It can also cover extras such as scans and counselling.
Top 9 Gap Cover Plans
Let’s take a look at the top 10 Gap products in the country. Please note that all of these policies can have extra dental and cancer benefits added but the premium will be higher.
- Zestlife
Zestlife covers you for:
- Hospital procedures
- Shortfalls on doctors’fees
- Co-payments for hospital treatments
- Once-off oncology benefit payment
- R50 000 accidental death or injury cover
Zestlife prices for 2025:
2. Stratum
You are covered for:
- 200 per cent more than what your medical aid pays and what you are billed for your healthcare needs
- R3,000 annual dental benefit
- R2,000 annual MRI, CT and PET scan benefit
- Pathology
- Physiotherapy
- Consumables like bandages, gauze and surgical gloves
- Hospital-related medication
3. Turnberry
You are covered for:
- Medical expense shortfalls of up to 350%
- R3,000 casualty benefit
- Medical Scheme contribution waiver monthly for six months in the event of accidental death or total disability
- Gap Premium Waiver for six months in the event of accidental death or total disability
4. Ambledown
You are covered for:
- A set amount per person annually
- A set amount for dread disease benefit
- A six-month premium waiver benefit
You are covered for:
- In and out of hospital benefits
- Cancer diagnosis benefit
- Medical Scheme contribution waiver
- Gap Premium waiver
- Personal accident benefit
5. KaeloXelus
At R350 a month per family, you are covered for:
- Oncology treatment shortfalls
- Medical bill shortfalls
- Co-Payments
- Sub-limits
6. Sirago
You are covered for:
- Medical expense shortfalls
- Co-payments
- Out-patient and emergency treatment
- Hospital account shortfalls
- Sub-limit enhancer benefits
7. Discovery
You can get Discovery Supplementary Gap Cover or the basic Discovery Gap Cover policy. These options will supplement and extend certain health insurance options at an affordable premium. Please note that these products can be subject to waiting periods.
8. Old Mutual
Gap Cover from a very affordable is available from Old Mutual. You are covered for:
- Set amount per beneficiary annually
- Up to 500% of medical aid tariff shortfalls
- Co-payments for scans
- Set amount per policy annually for sub-limits shortfalls
- Set amount annual oncology benefit per beneficiary
- Set amount dental surgery benefit per member annually
9. Sanlam
Get a quote from Sanlam. You are covered for:
- Maximum of 500% above medical aid tariff shortfalls
- Sub-limits per event for in-hospital treatment shortfalls
- Unlimited cover for specified procedures for which there are co-payments
If you are a member of a medical aid you qualify for a Gap Cover quote when completing the form on this page.