Useful points about co-payment insurance for medical aid

December 14, 2021

You may be considering how to enhance your medical aid membership without jumping up to a higher-cost option. Here are some useful points about how gap cover – also called co-payment cover, top-up insurance or shortfall assurance – can give your medical aid membership membership wings, cheaply.

Useful points and practical tips to guide you

Here follow ten valuable tips about medical gap insurance:

  1. The main thrust of gap cover is to preserve your finances. By insuring the co-payment gap, i.e. the yawning divide between what hospitals and specialists charge, and what your medical aid is willing to pay, you avoid having to make massive out-of-pocket payments.
  2. It is handy to know that only existing medical aid members qualify for gap cover. This is not a Useful Points to Consider Regarding Medical Gap Coverstandalone product. It would be useless as such. Your expert gap cover broker (more about that later) will make sure you are on a legitimate medical aid. For more information about registered medical schemes in South Africa, go here.
  3. One of the most attractive features of gap cover is that a single policy covers everyone on the plan. So if you have spouse and children on the plan, one policy covers them all. Also helpful is the fact that the level of the medical aid option itself determines the gap cover premium, not how many people are on the scheme.
  4. An oft-overlooked detail about gap cover is its affordability. It is easy to make a rough estimate of the monthly premium you can expect to pay for gap cover. Expect to pay approximately the equivalent of ten percent of your monthly medical aid premium each month for your gap policy.
  5. Another constructive fact about gap insurance is that it is simple. Unlike medical aid, there are only a couple of options and one or two possible enhancements (such as for cancer treatments or accident cover).


Get your gap cover quote now by completing and submitting the form on this page. We will get back to you fast with a quick quote. A useful point is that all quotes and sign-ups are done by phone and email.

All info was correct at time of publishing