If you have exhausted your medical aid funds allocation for the year then you definitely need Gap Cover.
In fact, how many South Africans can claim to have covered all their medical expenses for a year without having to dip into their own pockets?
The answer is simple. Very few people in this country enjoy 100% cover from their medical aid schemes. So they have to find the additional funds to foot unexpected medical expenses.
But, for a very affordable extra monthly premium, South Africans can avoid unexpected and crippling additional financial medical costs. All it takes is an affordable Gap Cover policy.
Complete and submit the form on this page to request your online gap insurance quote
How do I qualify for Gap Cover?
Gap Insurance is a short-term insurance policy and is only granted to people who are members of an existing medical aid scheme. So, unfortunately, if you are not a medical aid member you do not qualify for this type of insurance. However, once you obtain Gap Cover you are free to change from one medical aid scheme to another. And that will not without jeopardise your short-term insurance benefits.
Gap Cover in a nutshell
Think of Gap Cover as you would of a short-term top-up insurance policy. It pays the difference between tariffs stipulated by medical aid schemes and the final bill imposed by members of the medical profession. For *example, a medical aid scheme may stipulate the tariff for an appendectomy at R50,000 but the final bill, including hospital and theatre costs as well as professional medical attention and treatment, could be a whopping R85,000, leaving you, the medical aid member, with a shortfall of R35,000 to cover the costs of the unexpected operation. Gap Cover insurance pays in that difference, leaving the policyholder free of any additional stress while recuperating from the operation.
Be sure to read the fineprint carefully before choosing your Gap Cover provider. That is because, like medical aid schemes, this form of short-term insurance also includes pre-existing conditions. You won’t have cover for these within a certain time period. For example, most Gap Cover policies exclude the medical expenses involved with pregnancies for the first 12 months after taking out the policy. These exclusions can also apply to certain medical conditions.
Other Gap Cover exclusions
Most Gap policies have exclusion clauses and it is your responsibility to make sure that you obtain the cover that best suits your own personal needs. Included in the exclusions clause are:
- Drug abuse
- Cosmetic surgery
- Mental illness
- Taking part in dangerous sports and past-times
- Police and military duty
What about age restrictions?
Depending on your service provider, there are age limits imposed by some insurance companies while others are more lenient but premium costs will be higher for older people.
How do I apply for Gap Cover?
Provided that you are a member of a South African medical scheme, you can obtain a Gap Cover quote by simply completing and returning the online application form that appears on this page.
*The figures reflected here are just an example and are not meant to relay the actual cost of an appendectomy.