Gap cover keeps you financially secure – Why you need it

March 1, 2022

Why do I need gap cover? The rates your medical aid work to are much lower than what specialists charge, that’s why.

Without gap cover, you have to pay the shortfall. Therefore, gap cover is an insurance policy to complement your medical aid. Unless you’re super rich, you’ll never be able to pay specialist bills.

You also need help to deal with co-payments before treatment begins. Without gap cover, you may well have to sell your assets to pay your medical costs

Medical aid providers don’t always cover in-hospital bills in full. With treatment being so costly, gap cover is no longer a “maybe”, but a critically important “must have” cover.

Why do I need Gap cover when I have a Medical aid plan?

Why do I needMost people don’t realise how their medical aid works and very few understand what 100% cover means. They think that if their plan says it will pay up to 100% of the scheme rate it will pay in full.

Not at all. For instance, if your specialist charges you a rate of 300% and your cover pays 100%, you’re going to have to find the 200%. This is precisely why gap cover is so important. No medical aid member can afford to be without it.

Specialists charge what they like as they are rules, leading to rates being higher than what your medical aid covers.

Gap cover is a Supplement to your Medical Aid and Does not Replace it

Gap cover doesn’t take the place of medical aid. It adds to it, and only people who already belong to a medical aid can buy gap cover. It is no longer enough to have a medical aid plan – gap cover has become a vital product.

One of the top gap cover providers in South Africa is Sanlam. Established way back in 1918 already. they are trustworthy and reputable.

Sanlam makes it easy to get gap cover, allowing you to choose between two options –

Sanlam Gap Cover offers the Comprehensive Gap Cover at R252 (younger than 60 years) and R605 (60 years and older).  This includes in-hospital treatment and some out-of-hospital treatment benefits.  Enhanced hospital cash benefits are only available to Sanlam Reality members.

For more information on the list of additional benefits and exclusions please check out the PDF document at SPF757_Gap Cover_Top Performer May 2018

Why do I need to get answers?

There is so much to get to know about gap cover, so it’s useful to get answers. You’ll discover that Sanlam gap cover doesn’t cover every treatment you may need. Cosmetic surgery isn’t included, except of course if you require a mastectomy.

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Also, special dental work, cancer, tumours or trauma are only paid for on Sanlam’s Comprehensive plan. Claims older than six months won’t be covered.

Gap cover,­ Your loyal Supporter

Sanlam is in the business of planning for tomorrow. They can’t promise you a long, healthy life, but they can promise to offer you their support when you require medical treatment. For just R166 a month you’re covered for up to 500% of scheme tariff with Standard cover. Premiums are the same for single members and members with dependants.

Remember, your gap cover from Sanlam won’t cover anything that your medical aid excludes such as cosmetic surgery, for instance. What your gap cover does, is to top up a shortfall on approved procedures, specialists or medications. Anybody who is a member of a medical aid plan should go forward with the protection of medical gap cover.


Complete and then submit the form on this page to get a gap cover quote now!


All info was correct at time of publishing