Gap Cover
Our Flagship Gap Cover Product
Absolute Cover Plus is our flagship product which provides Gap cover, Casualty cover, Co-Payment cover and Sub-Limit cover, as well as a separate Oncology benefit that provides Oncology Gap cover, Oncology Co-Payment cover and Oncology Extender cover.
Individuals
R620/m
Families
R620/m
Over 65's
R770/m
The Absolute Cover Plus option covers up to 700% above medical aid scheme tariff.
This means that if your service provider charges anything up to 7 times what your medical aid will
cover, TRA will provide for this GAP, subject to the annual limit. Waiting periods may apply.
Cover up
to 700%
Fast Claim
Payouts
Easy Claims
Process
Excellent
Service
Out-of-hospital
Benefits
Affordable Prices
From R620 p/m
Automatic Claim
Submission
Applies to authorised in-hospital and in-lieu of hospital procedures, where the medical aid pays a portion of the fees from its in-hospital or major medical benefit. (Includes MRI/ CT/PET scans consumables.)
R5 000 per policy per annum.
Cover for the shortfall on a specialist account related to the consultation in the rooms before a member is going for an in-hospital procedure.
Limited to the following number of consults p.p.p.a (up to a max of R500 per consult).
4 consults per policy per annum.
Sometimes accidents occur and you need to rush to casualty.
Your medical aid does not always cover the total costs in full. Whether payment comes from your medical scheme savings account or day-to-day benefit, the gap will be covered, provided it is for an ACCIDENT, and the treatment provided is at a casualty unit linked to a hospital.
Sometimes, your medical aid will not account for anything regarding this casualty visit, leaving you to cover the bill in full.
This benefit will cover you for up to R23 100 per policy per annum (subject to the annual limit*), EVEN IF YOUR MEDICAL AID COVERS NOTHING.
Children under the age of 8 ONLY – May be admitted for any treatment at a casualty unit linked to a hospital between the hours of 7 pm to 7 am from Monday to Friday, from 7 pm on a Friday until 7 am on a Monday, and all day on a public holiday.
Casualty follow-up consultations
(The initial treatment must have taken place in a casualty/ER unit linked to a hospital following an accident.)
1 follow-up consultation per policy per annum at an ER unit (accident-related only).
The shortfall related to the use of Out-of-Network (Non-DSP) emergency medical services.
Unlimited but subject to the aggregate annual limit per insured person per annum.
These days most medical aid schemes impose a sub-limit on in-hospital prostheses costs and some even limit the monetary amount that is available for MRI and CT and PET scans. In both cases, members may be out of pocket and will have to cover these costs themselves.
Oncology Co-Payment Benefit:
Oncology Co-Payment Benefit (In Network): Unlimited per policy per annum but subject to R210 580 per insured person per annum.
Oncology Co-Payment Benefit (Out Of Network i.e. voluntary use of a non-designated service provider): 2 co-payments per policy per annum up to a combined limit of R16 800.
Oncology Extender Benefit: Includes ANY approved costs above annual scheme oncology limit but subject to the medical aid scheme covering up to this limit. Unlimited per policy per annum but subject to R210 580 per insured person per annum.
Oncology “New Tech” Benefit: We cover the shortfall / co-payment on new technology oncology treatment (specifically Keytruda®,Xalkori®, Tagrisso®, Yervoy®, Zelboraf®, Imbruvica®). Subject to a medical aid authorised treatment plan and designated service providers being utilised. Up to R17 325 per policy per annum
The shortfall between the General Ward Rate and the Private Ward Rate for hospitalisation where an admission to a Private Ward occurred.
For Childbirth and for Non-Childbirth: Limited to a maximum of R525 per day, for a total of 3 consecutive days.
Provides cover towards a policyholder’s medical aid contribution in the case of the accidental death of the main policyholder. Cover is limited to the lower of the actual medical aid contribution or the maximum amount allowed. 6 months. Up to a max. of R6 930 per month.
Cover for the shortfall on a specialist (OBGYN/Paediatrician) account related to a consultation in the rooms within 6 weeks after childbirth.
Up to R1 250 per consultation per policy per annum.
*Annual Limit: The Basic Gap, Maternity ward, Global fee, Co-Payments, Sub-Limits, Casualty and Oncology Gap benefits
are subject to the aggregate gap cover annual limit of R210 580 per insured person per annum.
(This limit may change due to regulatory amendment).
*Annual Limit: The Basic Gap, Maternity ward, Global fee, Co-Payments, Sub-Limits, Casualty and Oncology Gap benefits are subject to the aggregate gap cover annual limit of R210 580 per insured person per annum. (This limit may change due to regulatory amendment).
A full list of 2025 terms and conditions can be viewed here .
Judy saved R110 316.11. By choosing Absolute Cover Plus, you can too.
Eliminate the financial worry from the stress of a hospital operation or stay.
Attending Doctor
Orthopaedic Surgeon
Anaesthetist
Subtotal
Private Rate
R 121 227.71
R 27 642.94
R 148 920.65
Medical Aid Tariff
R 39 143.44
R 11 998.10
R 51 141.54
Gap Cover
R 82 134.27
R 15 644.84
R 97 779.11
Your Share
R 0
R 0
R 0
Medical Aid Sub Limit for Internal Prosthesis
Medical Aid Sub Limit for Internal Prosthesis
Total
R 42 537.00
R 148 920.65
R 30 000.00
R 51 141.54
R 12 537.00
R 110 316.11
R 0
R 0
Terms & Conditions Apply.
Judy saved R110 316.11. By choosing Absolute Cover Plus, you can too.
Your medical aid, just like Judy’s, may impose a sub-limit fee for Hip or Knee Replacements, as well as Pacemaker and Stent Operations.
Eliminate the financial worry from the stress of a hospital operation or stay.
Terms & Conditions Apply.
Gap Cover is an insurance policy that covers the difference between
what your medical aid pays and what service providers charge for
in-hospital expenses.
Gap Cover is an insurance policy that covers the difference between what your medical aid pays and what service providers charge for in-hospital expenses.
Medical aid schemes often leave a gap (known as medical shortfalls) between what the medical aid pays and the actual
TRA has partnered with MobiMed to bring you the TRA Assist App, designed to provide exciting and essential services to
If you ask several people if they know what gap cover is, many might have a general idea, but often,
16 Jersey Drive, Longmeadow
Business Estate East
16 Jersey Drive, Longmeadow
Business Estate East
16 Jersey Drive, Longmeadow
Business Estate East
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