Top ten gap products in South Africa

September 23, 2022

An increasing number of people have begun to realise how vital it is to add one of the top ten gap products to their medical aid benefits. And they do this with a short-term plan called Gap Cover.

There is always a difference between what your medical aid scheme pays for hospital bills and what the specialists charge. Gap cover pays that difference. It can also pay for extras such as scans and counselling.

The Top Ten Gap Products

Top ten gap products in South Africa for medical aid members
Gap cover is for medical aid members only

Let’s look at the top Gap cover plans in the country.  they apply to all medical aids in South Africa including Discovery, Bonitas and GEMS.

Note that these plans can have extra dental and cancer benefits added but the fee is higher.

  1. Zestlife

R506 to R770 monthly covers you for:

  • Hospital events
  • Shortfall on doctors’ fee
  • Co-payments for hospital treatments
  • Once-off oncology payment
  • R50.000 death by accident or injury

Zestlife Gap Cover 2024

 

  1. Stratum

R101 to R303 monthly covers you for:

  • 200% more than what your health scheme pays, and what you are billed
  • R3.000 annual dental benefit
  • R2.000 annual MRI, CT and PET scan benefit
  • Pathology
  • Physiotherapy
  • Items like bandages, gauze and surgical gloves
  • Hospital medicine

Turnberry and Ambledown

Turnberry

R99.87 to R156.35 monthly covers you for:

  • Health expense shortfalls of up to 350%
  • R3.000 casualty benefit
  • Health Scheme fees waiver of up to R5.500 monthly for six months in the event of death or total disability
  • Gap Premium Waiver for six months in the event of death or total disability

 

Ambledown

R267.33 to R423.68 monthly covers you for:

  • R150.000 per member yearly
  • R50.000 dread disease
  • A six-month fee waiver

Complimed and KaeloXelus

R196.71 to R339.95 monthly covers you for:

  • In and out of hospital
  • Cancer diagnosis
  • Health Scheme fee waiver
  • Gap Premium waiver
  • Personal accident

 

  1. KaeloXelus

R350 a month per family covers you for:

  • Oncology treatment shortfalls
  • Medical bill shortfalls
  • Co-Payments
  • Sub-limits

Sirago and Discovery

Sirago

R206 to R353 monthly covers you for:

  • Medical expense shortfalls
  • Co-payments
  • Out-patient and emergency treatment
  • Hospital account shortfalls
  • Sub-limit enhancer benefits

 

Discovery

For R65 monthly you get added Gap Cover. And R90 monthly buys the basic Gap Cover policy. What you choose adds on and extends certain health cover options at a fee you can afford. Note these plans can be subject to waiting periods.

Old Mutual and Sanlam

Old Mutual

Gap Cover from R186.62 per family monthly. Or R242.11 a month for a family member over the age of 60. This covers you for:

  • R150.000 per member yearly
  • Up to 500% of medical aid tariff shortfalls
  • Co-payments for scans
  • R40.000 yearly for sub-limit shortfalls
  • R150.000 annual oncology per member
  • R5.000 dental work per member yearly

 

Sanlam

R252 to R605 monthly covers you for:

  • 500% above medical aid tariff shortfalls
  • R44.000 sub-limit per event for hospital treatment shortfalls
  • No limit cover for treatment with co-payments

If you are a member of a medical aid scheme you qualify for a Gap Cover quote. Fill in the form on this page then submit it to get a quote. Act now!

All info was correct at time of publishing