Reliable
Gap Cover

Gap Cover is an insurance policy that covers the gap between what your medical aid pays and what service providers charge for in-hospital expenses. Healthcare in South Africa is expensive, and most medical aids only cover part of the healthcare providers’ actual rate.

Gap Cover offers you extra protection, covering the shortfall of your medical aid.
However, Gap Cover is not a medical aid and does not replace your medical aid.
Waiting periods may apply.

Unique benefits of our gap cover
Cover up to 700%

Cover up to 700%

Fast Claim Payouts

Fast Claim
Payouts

Easy Claims Process

Easy Claims
Process

Excellent Service

Excellent
Service

Out-of-hospital Benefits

Out-of-hospital
Benefits

Affordable Prices From R380 p/m

Affordable Prices
From R99 p/m

Automatic Claim Submission

Automatic Claim
Submission

SOUTH AFRICAN
GAP COVER PRODUCTSby TRA that cover your needs
SOUTH AFRICAN
GAP COVER PRODUCTSby TRA that cover
your needs
Basic Cover 300
Our Entry Level Product

STANDARD BENEFITS
Gap Cover
Tariff Shortfalls for Theatre and Ward Fees, Consumables, Laparoscopic/Endoscopic Equipment
Shortfalls on Specialist Consultations
Casualty Cover and Casualty follow-up consultations
Oncology Gap
Accidental Death Cover
Policy Extender
TRA Assist powered by MobiMed
Travel benefit

From R99/m

Young family sitting on the couch smiling
Basic Cover 300
Our Entry Level Product
Young family sitting on the couch smiling

STANDARD BENEFITS
Gap Cover
Tariff Shortfalls for Theatre and Ward Fees, Consumables, Laparoscopic/Endoscopic Equipment
Shortfalls on Specialist Consultations
Casualty Cover and Casualty follow-up consultations
Oncology Gap
Accidental Death Cover
Policy Extender
TRA Assist powered by MobiMed
Travel benefit

From R99/m

Compare all products
Basic Cover 300 Vital Cover Plus Super Cover Plus Absolute Cover Plus
Gap Cover Annual Limit

R210 580 in aggregate per
insured person per annum*
(p/a)
Gap Cover Percentage* 300% 700% 700% 700%
Tariff Shortfalls for Theatre
and Ward Fees, Consumables,
Laparoscopic/Endoscopic Equipment*

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.)

R500* per
policy p/a*

R1 000* per
policy p/a*

Up to R3 000* per
policy p/a*

Up to R5 000* per
policy p/a*

PMB's*
Covered, subject to medical
aid review
Shortfalls on Specialist Consultations*
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)

1 consult per
policy p/a*

2 consult per
policy p/a*

3 consult per
policy p/a*

4 consult per
policy p/a*

Emergency Medical Services (ambulance)*
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 p/a*

CO-PAYMENTS /
DEDUCTIBLES*

DSP’s (Voluntary use of
designated service provider
networks)

Up to R13 650* per
policy p/a*

Up to R63 000* per
policy p/a*

Unlimited*

CO-PAYMENTS /
DEDUCTIBLES*

NON DSP’s (Voluntary use of
non-designated service
provider networks)

1 co-payment
per policy
per annum.
Up to R5 250*

2 Co-payments /
deductibles per
policy per annum
to a combined
maximum of R16
800*

CO-PAYMENT BENEFIT*: OUT
OF HOSPITAL/MRI/CT/PET
SCANS

1 MRI / CT / PET
scan per policy p/a
up to R12 600*

2 scans per
policy
p/a. Unlimited
but subject to the
aggregate annual
limit per insured
person p/a*

SUB-LIMITS*: INTERNAL
PROSTHESES

Up to R5 775* per
policy p/a

Up to R11 550* per
policy p/a

Unlimited
Up to R68
250* per event

SUB-LIMITS*: MRI / CT / PET
SCAN

1
MRI, CT or PET
scan up to
R3 780* per scan

2
MRI, CT or PET
scan up
to R6 300*
per scan

SUB-LIMITS*:
COLONOSCOPIES AND
GASTROSCOPIES

Up to R13 650* per
policy per annum

Up to R3 780* per
event

Up to R23 100* per
insured person per annum

Up to R6 300* per
event

DENTAL BENEFIT*
Unlimited but subject to
the aggregate annual limit
per insured person p/a
Casualty Unit Benefit (Casualty/ER Unit linked to a hospital)
  • Accidents only.
  • Children under the age of 8 ONLY - May be admitted for any treatment between the hours of 7pm to 7am from Monday to Friday, from 7pm on a Friday until 7am on a Monday, and all day on a public holiday.

Up to R3 465* per
policy p/a

Up to R9 240* per
policy p/a

Up to R13 650* per
policy p/a

Up to R23 100* per
policy p/a

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 p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

GLOBAL FEE BENEFIT*

Up to R12 600* per
policy p/a

Up to R25 200* per
policy p/a

ONCOLOGY GAP BENEFIT*
(Subject to medical aid
approved treatment plan
being covered up to scheme
tariff and within annual
scheme oncology limit)

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

ONCOLOGY CO-PAYMENT
BENEFIT (IN NETWORK)*

Up to R13 650* per
policy p/a

Up to R63 000* per
policy p/a

Unlimited*

ONCOLOGY CO-PAYMENT
BENEFIT* (OUT OF
NETWORK)

1 co-payment per
policy per annum.
Up to R5 250*

2 Co-payments per
policy per annum
up to a combined
limit of R16 800*

ONCOLOGY EXTENDER
BENEFIT*

(Includes ANY costs above
annual scheme oncology
limit but subject to scheme
covering up to this limit)

Up to R36 750* per
policy per
annum

Unlimited*

ONCOLOGY “NEW-TECH”
BENEFIT*

Up to R8 610* per
policy p/a

Up to R17 325* per
policy p/a

ONCOLOGY GAP BENEFIT:
BREAST RECONSTRUCTION
SURGERY*

Up to R18 900* per
policy p/a

Up to R36 750* per
policy p/a

MEDICAL AID CONTRIBUTION WAIVER
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 R4 620 per month.

6 months.
Up to a max of R5 775 per month.

6 months.
Up to a max of R6 930 per month.

Maternity Follow-Up Consultations
Cover for the shortfall on a specialist shortfall (OBGYN/Paediatrician) account related to a consultation in the rooms within 6 weeks after childbirth

Up to R7 00* per
policy p/a

Up to R1 250* per
policy p/a

Private Ward Benefit
The shortfall between the General Ward Rate and the Private Ward Rate for hospitalisation where an admission to a Private Ward occurred.
For Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2 100 per day, for a total of 3 consecutive days

For Non-Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2100 per day, for a total of 3 consecutive days

ACCIDENTAL DEATH
Insured / Spouse

R7 350

R10 500

R21 000

R31 500

ACCIDENTAL DEATH
Dependant

R4 200

R5 775

R8 400

R21 000

POLICY EXTENDER
(Additional 12 month gap
cover premiums covered
upon accidental death of
policyholder)
TRAVEL BENEFIT
Emergency Medical and
Related expenses up to R1 000
000.
Theft, Damage or loss by
Airline R5 000.
/ Single item limit: R1 500.
Baggage Delay (more than 4 hours) R500
Baggage Delay (more than 24 hours)
R1 000
TRA ASSIST POWERED BY
MobiMed
Home Drive (including
Uber), Panic Button (includes a Roadguard service),
Medical Health Line & Trauma Counselling Line
(includes a COVID-19
CARE LINE) and Claims
Submissions.
Monthly Premiums:
Under 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 380 R 620
Premium per
Individual per policy
per month
R 99
Premium per
Family per policy
per month
R 180
Over 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 540 R 570 R 770
Vital Cover Plus
Our 2nd entry level product

ALL BASIC COVER BENEFITS PLUS
In Network Co-Payment Cover (including for Oncology)
Sub-Limit Cover (internal prostheses)
Medical Aid Contribution Waiver

From R360/m
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Vital Cover Plus
Our 2nd entry level product
Young family sitting on the couch smiling

ALL BASIC COVER BENEFITS PLUS
In Network Co-Payment Cover (including for Oncology)
Sub-Limit Cover (internal prostheses)
Medical Aid Contribution Waiver

From R360/m

Compare all products
Basic Cover 300 Vital Cover Plus Super Cover Plus Absolute Cover Plus
Gap Cover Annual Limit

R210 580 in aggregate per
insured person per annum*
(p/a)
Gap Cover Percentage* 300% 700% 700% 700%
Tariff Shortfalls for Theatre
and Ward Fees, Consumables,
Laparoscopic/Endoscopic Equipment*

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.)

R500* per
policy p/a*

R1 000* per
policy p/a*

Up to R3 000* per
policy p/a*

Up to R5 000* per
policy p/a*

PMB's*
Covered, subject to medical
aid review
Shortfalls on Specialist Consultations*
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)

1 consult per
policy p/a*

2 consult per
policy p/a*

3 consult per
policy p/a*

4 consult per
policy p/a*

Emergency Medical Services (ambulance)*
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 p/a*

CO-PAYMENTS /
DEDUCTIBLES*

DSP’s (Voluntary use of
designated service provider
networks)

Up to R13 650* per
policy p/a*

Up to R63 000* per
policy p/a*

Unlimited*

CO-PAYMENTS /
DEDUCTIBLES*

NON DSP’s (Voluntary use of
non-designated service
provider networks)

1 co-payment
per policy
per annum.
Up to R5 250*

2 Co-payments /
deductibles per
policy per annum
to a combined
maximum of R16
800*

CO-PAYMENT BENEFIT*: OUT
OF HOSPITAL/MRI/CT/PET
SCANS

1 MRI / CT / PET
scan per policy p/a
up to R12 600*

2 scans per
policy
p/a. Unlimited
but subject to the
aggregate annual
limit per insured
person p/a*

SUB-LIMITS*: INTERNAL
PROSTHESES

Up to R5 775* per
policy p/a

Up to R11 550* per
policy p/a

Unlimited
Up to R68
250* per event

SUB-LIMITS*: MRI / CT / PET
SCAN

1
MRI, CT or PET
scan up to
R3 780* per scan

2
MRI, CT or PET
scan up
to R6 300*
per scan

SUB-LIMITS*:
COLONOSCOPIES AND
GASTROSCOPIES

Up to R13 650* per
policy per annum

Up to R3 780* per
event

Up to R23 100* per
insured person per annum

Up to R6 300* per
event

DENTAL BENEFIT*
Unlimited but subject to
the aggregate annual limit
per insured person p/a
Casualty Unit Benefit (Casualty/ER Unit linked to a hospital)
  • Accidents only.
  • Children under the age of 8 ONLY - May be admitted for any treatment between the hours of 7pm to 7am from Monday to Friday, from 7pm on a Friday until 7am on a Monday, and all day on a public holiday.

Up to R3 465* per
policy p/a

Up to R9 240* per
policy p/a

Up to R13 650* per
policy p/a

Up to R23 100* per
policy p/a

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 p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

GLOBAL FEE BENEFIT*

Up to R12 600* per
policy p/a

Up to R25 200* per
policy p/a

ONCOLOGY GAP BENEFIT*
(Subject to medical aid
approved treatment plan
being covered up to scheme
tariff and within annual
scheme oncology limit)

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

ONCOLOGY CO-PAYMENT
BENEFIT (IN NETWORK)*

Up to R13 650* per
policy p/a

Up to R63 000* per
policy p/a

Unlimited*

ONCOLOGY CO-PAYMENT
BENEFIT* (OUT OF
NETWORK)

1 co-payment per
policy per annum.
Up to R5 250*

2 Co-payments per
policy per annum
up to a combined
limit of R16 800*

ONCOLOGY EXTENDER
BENEFIT*

(Includes ANY costs above
annual scheme oncology
limit but subject to scheme
covering up to this limit)

Up to R36 750* per
policy per
annum

Unlimited*

ONCOLOGY “NEW-TECH”
BENEFIT*

Up to R8 610* per
policy p/a

Up to R17 325* per
policy p/a

ONCOLOGY GAP BENEFIT:
BREAST RECONSTRUCTION
SURGERY*

Up to R18 900* per
policy p/a

Up to R36 750* per
policy p/a

MEDICAL AID CONTRIBUTION WAIVER
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 R4 620 per month.

6 months.
Up to a max of R5 775 per month.

6 months.
Up to a max of R6 930 per month.

Maternity Follow-Up Consultations
Cover for the shortfall on a specialist shortfall (OBGYN/Paediatrician) account related to a consultation in the rooms within 6 weeks after childbirth

Up to R7 00* per
policy p/a

Up to R1 250* per
policy p/a

Private Ward Benefit
The shortfall between the General Ward Rate and the Private Ward Rate for hospitalisation where an admission to a Private Ward occurred.
For Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2 100 per day, for a total of 3 consecutive days

For Non-Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2100 per day, for a total of 3 consecutive days

ACCIDENTAL DEATH
Insured / Spouse

R7 350

R10 500

R21 000

R31 500

ACCIDENTAL DEATH
Dependant

R4 200

R5 775

R8 400

R21 000

POLICY EXTENDER
(Additional 12 month gap
cover premiums covered
upon accidental death of
policyholder)
TRAVEL BENEFIT
Emergency Medical and
Related expenses up to R1 000
000.
Theft, Damage or loss by
Airline R5 000.
/ Single item limit: R1 500.
Baggage Delay (more than 4 hours) R500
Baggage Delay (more than 24 hours)
R1 000
TRA ASSIST POWERED BY
MobiMed
Home Drive (including
Uber), Panic Button (includes a Roadguard service),
Medical Health Line & Trauma Counselling Line
(includes a COVID-19
CARE LINE) and Claims
Submissions.
Monthly Premiums:
Under 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 380 R 620
Premium per
Individual per policy
per month
R 99
Premium per
Family per policy
per month
R 180
Over 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 540 R 570 R 770
Super Cover Plus
Our mid-range product

ALL VITAL COVER BENEFITS PLUS
Out of Network Co-Payment Cover (including for Oncology)
Co-Payment: Out of Hospital MRI/CT/PET Scans
Sub-Limit Cover for MRI/CT/PET scans and Colonoscopies and Gastroscopies
Global Fee Benefit
Oncology Extender Benefit
Oncology “New-Tech” Benefit
Oncology Gap Benefit for Breast Reconstruction Surgery
Maternity Follow-Up Consultations
Private Ward Benefit

From R380/m

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Super Cover Plus
Our mid-range product
Young family sitting on the couch smiling

ALL VITAL COVER BENEFITS PLUS
Out of Network Co-Payment Cover (including for Oncology)
Co-Payment: Out of Hospital MRI/CT/PET Scans
Sub-Limit Cover for MRI/CT/PET scans and Colonoscopies and Gastroscopies
Global Fee Benefit
Oncology Extender Benefit
Oncology “New-Tech” Benefit
Oncology Gap Benefit for Breast Reconstruction Surgery
Maternity Follow-Up Consultations
Private Ward Benefit

From R380/m

COMPARE ALL PRODUCTS
Basic Cover 300 Vital Cover Plus Super Cover Plus Absolute Cover Plus
Gap Cover Annual Limit

R210 580 in aggregate per
insured person per annum*
(p/a)
Gap Cover Percentage* 300% 700% 700% 700%
Tariff Shortfalls for Theatre
and Ward Fees, Consumables,
Laparoscopic/Endoscopic Equipment*

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.)

R500* per
policy p/a*

R1 000* per
policy p/a*

Up to R3 000* per
policy p/a*

Up to R5 000* per
policy p/a*

PMB's*
Covered, subject to medical
aid review
Shortfalls on Specialist Consultations*
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)

1 consult per
policy p/a*

2 consult per
policy p/a*

3 consult per
policy p/a*

4 consult per
policy p/a*

Emergency Medical Services (ambulance)*
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 p/a*

CO-PAYMENTS /
DEDUCTIBLES*

DSP’s (Voluntary use of
designated service provider
networks)

Up to R13 650* per
policy p/a*

Up to R63 000* per
policy p/a*

Unlimited*

CO-PAYMENTS /
DEDUCTIBLES*

NON DSP’s (Voluntary use of
non-designated service
provider networks)

1 co-payment
per policy
per annum.
Up to R5 250*

2 Co-payments /
deductibles per
policy per annum
to a combined
maximum of R16
800*

CO-PAYMENT BENEFIT*: OUT
OF HOSPITAL/MRI/CT/PET
SCANS

1 MRI / CT / PET
scan per policy p/a
up to R12 600*

2 scans per
policy
p/a. Unlimited
but subject to the
aggregate annual
limit per insured
person p/a*

SUB-LIMITS*: INTERNAL
PROSTHESES

Up to R5 775* per
policy p/a

Up to R11 550* per
policy p/a

Unlimited
Up to R68
250* per event

SUB-LIMITS*: MRI / CT / PET
SCAN

1
MRI, CT or PET
scan up to
R3 780* per scan

2
MRI, CT or PET
scan up
to R6 300*
per scan

SUB-LIMITS*:
COLONOSCOPIES AND
GASTROSCOPIES

Up to R13 650* per
policy per annum

Up to R3 780* per
event

Up to R23 100* per
insured person per annum

Up to R6 300* per
event

DENTAL BENEFIT*
Unlimited but subject to
the aggregate annual limit
per insured person p/a
Casualty Unit Benefit (Casualty/ER Unit linked to a hospital)
  • Accidents only.
  • Children under the age of 8 ONLY - May be admitted for any treatment between the hours of 7pm to 7am from Monday to Friday, from 7pm on a Friday until 7am on a Monday, and all day on a public holiday.

Up to R3 465* per
policy p/a

Up to R9 240* per
policy p/a

Up to R13 650* per
policy p/a

Up to R23 100* per
policy p/a

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 p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

GLOBAL FEE BENEFIT*

Up to R12 600* per
policy p/a

Up to R25 200* per
policy p/a

ONCOLOGY GAP BENEFIT*
(Subject to medical aid
approved treatment plan
being covered up to scheme
tariff and within annual
scheme oncology limit)

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

ONCOLOGY CO-PAYMENT
BENEFIT (IN NETWORK)*

Up to R13 650* per
policy p/a

Up to R63 000* per
policy p/a

Unlimited*

ONCOLOGY CO-PAYMENT
BENEFIT* (OUT OF
NETWORK)

1 co-payment per
policy per annum.
Up to R5 250*

2 Co-payments per
policy per annum
up to a combined
limit of R16 800*

ONCOLOGY EXTENDER
BENEFIT*

(Includes ANY costs above
annual scheme oncology
limit but subject to scheme
covering up to this limit)

Up to R36 750* per
policy per
annum

Unlimited*

ONCOLOGY “NEW-TECH”
BENEFIT*

Up to R8 610* per
policy p/a

Up to R17 325* per
policy p/a

ONCOLOGY GAP BENEFIT:
BREAST RECONSTRUCTION
SURGERY*

Up to R18 900* per
policy p/a

Up to R36 750* per
policy p/a

MEDICAL AID CONTRIBUTION WAIVER
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 R4 620 per month.

6 months.
Up to a max of R5 775 per month.

6 months.
Up to a max of R6 930 per month.

Maternity Follow-Up Consultations
Cover for the shortfall on a specialist shortfall (OBGYN/Paediatrician) account related to a consultation in the rooms within 6 weeks after childbirth

Up to R7 00* per
policy p/a

Up to R1 250* per
policy p/a

Private Ward Benefit
The shortfall between the General Ward Rate and the Private Ward Rate for hospitalisation where an admission to a Private Ward occurred.
For Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2 100 per day, for a total of 3 consecutive days

For Non-Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2100 per day, for a total of 3 consecutive days

ACCIDENTAL DEATH
Insured / Spouse

R7 350

R10 500

R21 000

R31 500

ACCIDENTAL DEATH
Dependant

R4 200

R5 775

R8 400

R21 000

POLICY EXTENDER
(Additional 12 month gap
cover premiums covered
upon accidental death of
policyholder)
TRAVEL BENEFIT
Emergency Medical and
Related expenses up to R1 000
000.
Theft, Damage or loss by
Airline R5 000.
/ Single item limit: R1 500.
Baggage Delay (more than 4 hours) R500
Baggage Delay (more than 24 hours)
R1 000
TRA ASSIST POWERED BY
MobiMed
Home Drive (including
Uber), Panic Button (includes a Roadguard service),
Medical Health Line & Trauma Counselling Line
(includes a COVID-19
CARE LINE) and Claims
Submissions.
Monthly Premiums:
Under 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 380 R 620
Premium per
Individual per policy
per month
R 99
Premium per
Family per policy
per month
R 180
Over 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 540 R 570 R 770
Absolute Cover Plus
Our flagship product

ALL SUPER COVER PLUS BENEFITS PLUS
Emergency Medical Services (ambulance)

From R620/m

Young family sitting on the couch smiling
Absolute Cover Plus
Our flagship product
Young family sitting on the couch smiling

ALL SUPER COVER PLUS BENEFITS WITH
HIGHER LIMIT AMOUNTS.

From R620/m

Compare all Products
Basic Cover 300 Vital Cover Plus Super Cover Plus Absolute Cover Plus
Gap Cover Annual Limit

R210 580 in aggregate per
insured person per annum*
(p/a)
Gap Cover Percentage* 300% 700% 700% 700%
Tariff Shortfalls for Theatre
and Ward Fees, Consumables,
Laparoscopic/Endoscopic Equipment*

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.)

R500* per
policy p/a*

R1 000* per
policy p/a*

Up to R3 000* per
policy p/a*

Up to R5 000* per
policy p/a*

PMB's*
Covered, subject to medical
aid review
Shortfalls on Specialist Consultations*
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)

1 consult per
policy p/a*

2 consult per
policy p/a*

3 consult per
policy p/a*

4 consult per
policy p/a*

Emergency Medical Services (ambulance)*
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 p/a*

CO-PAYMENTS /
DEDUCTIBLES*

DSP’s (Voluntary use of
designated service provider
networks)

Up to R13 650* per
policy p/a*

Up to R63 000* per
policy p/a*

Unlimited*

CO-PAYMENTS /
DEDUCTIBLES*

NON DSP’s (Voluntary use of
non-designated service
provider networks)

1 co-payment
per policy
per annum.
Up to R5 250*

2 Co-payments /
deductibles per
policy per annum
to a combined
maximum of R16
800*

CO-PAYMENT BENEFIT*: OUT
OF HOSPITAL/MRI/CT/PET
SCANS

1 MRI / CT / PET
scan per policy p/a
up to R12 600*

2 scans per
policy
p/a. Unlimited
but subject to the
aggregate annual
limit per insured
person p/a*

SUB-LIMITS*: INTERNAL
PROSTHESES

Up to R5 775* per
policy p/a

Up to R11 550* per
policy p/a

Unlimited
Up to R68
250* per event

SUB-LIMITS*: MRI / CT / PET
SCAN

1
MRI, CT or PET
scan up to
R3 780* per scan

2
MRI, CT or PET
scan up
to R6 300*
per scan

SUB-LIMITS*:
COLONOSCOPIES AND
GASTROSCOPIES

Up to R13 650* per
policy per annum

Up to R3 780* per
event

Up to R23 100* per
insured person per annum

Up to R6 300* per
event

DENTAL BENEFIT*
Unlimited but subject to
the aggregate annual limit
per insured person p/a
Casualty Unit Benefit (Casualty/ER Unit linked to a hospital)
  • Accidents only.
  • Children under the age of 8 ONLY - May be admitted for any treatment between the hours of 7pm to 7am from Monday to Friday, from 7pm on a Friday until 7am on a Monday, and all day on a public holiday.

Up to R3 465* per
policy p/a

Up to R9 240* per
policy p/a

Up to R13 650* per
policy p/a

Up to R23 100* per
policy p/a

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 p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

1 follow-up consultation
per policy p/a
at an ER unit
(accident-related only)

GLOBAL FEE BENEFIT*

Up to R12 600* per
policy p/a

Up to R25 200* per
policy p/a

ONCOLOGY GAP BENEFIT*
(Subject to medical aid
approved treatment plan
being covered up to scheme
tariff and within annual
scheme oncology limit)

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

Unlimited but subject to the aggregate annual limit per insured person per annum

ONCOLOGY CO-PAYMENT
BENEFIT (IN NETWORK)*

Up to R13 650* per
policy p/a

Up to R63 000* per
policy p/a

Unlimited*

ONCOLOGY CO-PAYMENT
BENEFIT* (OUT OF
NETWORK)

1 co-payment per
policy per annum.
Up to R5 250*

2 Co-payments per
policy per annum
up to a combined
limit of R16 800*

ONCOLOGY EXTENDER
BENEFIT*

(Includes ANY costs above
annual scheme oncology
limit but subject to scheme
covering up to this limit)

Up to R36 750* per
policy per
annum

Unlimited*

ONCOLOGY “NEW-TECH”
BENEFIT*

Up to R8 610* per
policy p/a

Up to R17 325* per
policy p/a

ONCOLOGY GAP BENEFIT:
BREAST RECONSTRUCTION
SURGERY*

Up to R18 900* per
policy p/a

Up to R36 750* per
policy p/a

MEDICAL AID CONTRIBUTION WAIVER
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 R4 620 per month.

6 months.
Up to a max of R5 775 per month.

6 months.
Up to a max of R6 930 per month.

Maternity Follow-Up Consultations
Cover for the shortfall on a specialist shortfall (OBGYN/Paediatrician) account related to a consultation in the rooms within 6 weeks after childbirth

Up to R7 00* per
policy p/a

Up to R1 250* per
policy p/a

Private Ward Benefit
The shortfall between the General Ward Rate and the Private Ward Rate for hospitalisation where an admission to a Private Ward occurred.
For Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2 100 per day, for a total of 3 consecutive days

For Non-Childbirth

Limited to a maximum of R525 per day, for a total of 3 consecutive days

Limited to a maximum of R2100 per day, for a total of 3 consecutive days

ACCIDENTAL DEATH
Insured / Spouse

R7 350

R10 500

R21 000

R31 500

ACCIDENTAL DEATH
Dependant

R4 200

R5 775

R8 400

R21 000

POLICY EXTENDER
(Additional 12 month gap
cover premiums covered
upon accidental death of
policyholder)
TRAVEL BENEFIT
Emergency Medical and
Related expenses up to R1 000
000.
Theft, Damage or loss by
Airline R5 000.
/ Single item limit: R1 500.
Baggage Delay (more than 4 hours) R500
Baggage Delay (more than 24 hours)
R1 000
TRA ASSIST POWERED BY
MobiMed
Home Drive (including
Uber), Panic Button (includes a Roadguard service),
Medical Health Line & Trauma Counselling Line
(includes a COVID-19
CARE LINE) and Claims
Submissions.
Monthly Premiums:
Under 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 380 R 620
Premium per
Individual per policy
per month
R 99
Premium per
Family per policy
per month
R 180
Over 65's (Based on the
age of the oldest Beneficiary)
premium per policy per month.
R 360 R 540 R 570 R 770

*SUBJECT TO AN AGGREGATE ANNUAL LIMIT OF R210 580 PER INSURED PERSON
This limit may be subject to regulatory amendment. Sub-Limits may apply. Refer to the Policy Document for full details of limitations and exclusions.
Terms and Conditions apply. This product comparison does not constitute advice. Consult your intermediary for guidance in choosing the product that is right for your needs. Prescribed Minimum Benefits (PMB’s) are covered. Errors and Omissions Excepted. A full list of 2025 terms and conditions can be viewed here

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Just tell us about yourself and your medical aid, and we’ll let you know if it’s important for you. Here, we make finding the right gap cover easy. With our simple tools and expert help, you’ll quickly find the perfect policy for your needs.

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DON’T STRESS!

WE COVER THE GAP BETWEEN WHAT YOUR DOCTOR CHARGES
AND WHAT YOUR MEDICAL AID PAYS.

WE COVER THE GAP BETWEEN WHAT YOUR DOCTOR CHARGES AND WHAT YOUR MEDICAL AID PAYS.

Gap Cover eliminates financial stress in case of hospitalisation by protecting you from medical shortfalls. Never assume that your medical aid will cover 100% of your in-hospital expenses.

Gap Cover covers the gap between your hospital expenses and your medical aid shortfalls.

Gap Cover eliminates financial stress in case of hospitalisation by protecting you from medical shortfalls. Never assume that your medical aid will cover 100% of your in-hospital expenses.

Gap Cover covers the gap between your hospital expenses and your medical aid shortfalls.

What are our customers saying?
What is the Net Promoter Score?

At TRA, we use the Net Promoter Score (NPS) to understand how likely you are to recommend us. We simply ask: “Would you recommend TRA to a friend or colleague?” Your answer helps us gauge your satisfaction and identify areas for improvement.

NPS recommendation - very likely indicator