Does Gap Cover pay for everything that my medical aid won’t cover?
All of our TRA Gap Cover Policies:
Are not medical aid schemes. The cover is not the same as that of a medical aid scheme. The cover is not a substitute for a medical scheme membership.
Gap Cover :
The shortfall that arises after your medical aid has processed your account and is due to service providers charging above scheme tariff for authorised in-hospital procedures. The cover is limited to a percentage of the original scheme tariff.
When are you not covered under your Gap Cover policy?:
Where your medical aid does not pay their portion of an account first from the Risk or Major Medical benefit. No claims processed from your Scheme’s day to day benefit will be covered - except for the Casualty benefit. (Please check your option benefits in the Schedule).