Zestlife Gap Cover For South African Medical Aid Members

    One of the most critical factors about medical aid insurance is the list of exclusions. Here we will have a look at Zestlife gap insurance.

    That is why it is so important to read the fine print of medical aid contracts.

    Exclusions are pretty standard to most medical aid schemes and this is also true of Zestlife Gap Cover.


    What are Zestlife’s Exclusions?

    Zestlife Medical Gap Insurance

    • Cosmetic surgery or obesity – surgery, treatments or exploratory examinations don’t have cover.
    • Mental illnesses, stress, depression or insanity don’t have cover.
    • Suicides or self-inflicted injuries don’t have cover.
    • Medical costs for drug abuse or narcotics are not covered unless prescribed by a medical practitioner
    • Diagnostic procedures like X-Rays, laboratory tests, routine check-ups and annual visits to doctors don’t have cover.
    • Problems related to the abuse of alcohol such as alcoholism don’t have cover.
    • Claims relating to nuclear weapons or illness resulting from radiation don’t have cover.
    • Gap Cover excludes incidents involving riots, labour disputes and strikes
    • Events involving speeding or racing trials don’t have cover.
    • Also, private or home nursing costs don’t have cover.


    Zestlife will, however, cover the gap between the amount a medical aid will pay and the additional costs imposed by the medical profession provided that the claimant receives authorization from his/her medical aid prior to the medical procedure.

    What Does Gap Insurance Cover?

    1. Gap insurance covers the difference between the recommended tariff stipulated by the medical scheme and the charges imposed by the medical profession.
    2. Specialists, anaesthetists and private hospitals do not have to adhere to the tariffs and can charge the patient up to five times more than what the medical aid scheme is prepared to pay.
    3. Gap cover insurance costs South African medical scheme members as little as R245 a month for everyone on the plan.

    Who Qualifies? – Zestlife Gap Insurance

    Applicants must be a member of a medical aid scheme like GEMS or Momentum to qualify for Zestlife Gap Cover.

    Zestlife Gap Cover Leads the Field

    So Zestlife prides itself as a leader in the gap cover industry, assisting wherever possible to bridge the financial difference between medical aid tariffs and final bills imposed by members of the medical profession.


    To get a FREE gap cover quote, complete the form on this page and click on the “Get a Quote” button.