Where to Buy Gap Cover in South Africa?

December 1, 2024

There is no shortage of gap cover providers in South Africa where to buy gap cover. Medical aids reimburse specialists at 100%  of medical aid rates. The problems come about when these specialists charge well more than these rates. As the medical aid member, without gap cover, you have to settle the difference. Sometimes these shortfalls can be so exorbitant that you would have to take a loan to settle it.

These gap cover policies provide benefits for members and their dependents who have cover from a registered medical aid scheme. But where to buy gap cover in South Africa?

There’s Affordable Gap Cover for You

There are many different gap cover companies. So you have to do research to find the one that suits your needs and your budget. There are some basic gap cover plans that will cost less than R300 a month.

They will cover the shortfall between the actual cost of specialist’s bills and the reimbursement rate applied by your Medical Aid up to 500% of medical aid rates.

Then you get gap cover which can be anything between R300 and R600 a family where you will find the likes of unlimited co-payment benefits, oncology benefits and sub-limits benefits among others. Each provider offers something different, so you need to compare and choice.

Where to Buy Gap Cover in South Africa

• The Liberty Gap Policy – covers the principal member of any registered medical scheme and all their dependents. You get 500% of Medical Scheme Tariff cover for in-hospital procedures as well as 50 out-patient procedures. With Liberty, although their gap cover takes care of shortfalls in treatment costs and co-payments, there are other benefits. So if you or your dependents get cancer for the first time, the policy pays a once-off payment.
• Multi-Prof – they are short-term insurance brokers whose client base consists of professionals like doctors, architects and engineers. Their gap cover is available to individuals who are on a medical aid scheme and who are younger than  65 years of age.
• Zestlife – a registered financial service provider. Zestlife Gap Cover offers two gap cover options – Essential and Universal. Here are their rates:

 

Don’t Believe You’re Fully Covered

Without Gap Cover you are personally liable for shortfalls – those amounts your medical scheme won’t cover. The truth is, you believe your medical aid should cover all your costs when you’re hospitalised, but this doesn’t happen. The Medical Scheme’s Tariffs (MST) and the tariffs of medical practitioners differ which means there is always going to be a shortfall.

You need gap cover which you’ll find at other providers such as Genesis medical aid, Sizwe medical aid and others. You just have to remember that gap cover policies will all exclude those claims arising from self-inflicted injuries, suicide, and cosmetic surgery among others.

So gap cover is readily available – you just have to make sure you understand the waiting periods and what is excluded.

To get a no-obligation gap cover quote just complete and send the form on this page

All info was correct at time of publishing