What is Gap Cover?
Gap Cover, also known as “medical gap” is any expense to your own pocket that your medical aid doesn’t cover during your stay in hospital – this includes the difference between the total fee charged by the doctor and your medical aid.
Why do I need Gap Cover?
Your medical aid’s best friend: Gap Cover is something you should seriously consider, as most medical aid’s often only cover a portion of any procedure that you may have. Emergency or not, the amount covered is at the doctor, hospital, or clinic’s discretion.
When should I consider getting Gap Cover?
Without your health, you have nothing. Accidents happen and emergencies can occur at any time, especially when you least expect it. If your medical aid only covers a portion of certain procedures, this is when gap cover is needed most.
Here is just an example of how Gap Cover can help you when your medical aid falls short:
| Procedure | Cost | Medical Aid Payout | Shortfall | Gap Claim |
|---|---|---|---|---|
| Appendectomy | R3,441.46 | R1,388.20 | R2,052.26 | R2,052.26 |
| Caesarean Section | R12,605 | R4,192.10 | R8,413.76 | R8,413.76 |
| Coronary Bypass | R40,751.80 | R13,587.60 | R27,164.20 | R27,164.20 |
| Hysterectomy | R12,997.80 | R4,751.00 | R8,226.80 | R8,226.80 |
| Tonsillectomy | R12,297.70 | R4,119.91 | R8,177.79 | R8,177.79 |
| Wisdom Teeth Removal | R6,260.00 | R1,958.50 | R4,301.50 | R4,301.50 |
The key benefits of having Gap Cover:
- Up to 500% cover of the medical aid tariff
- Cover for MRI, CT, PET scans, kidney dialysis, colonoscopy, cataract removal, vasectomy, childbirth in a non-hospital setting, and dozens of other procedures
- No waiting period
- Benefits are paid within 15 working days.
How do I get Gap Cover?
It’s easy. All you need to do is fill out an application form (top right corner), and one of our reputable agents will give you a call back with the best quote from one our clients.
