Gap Cover
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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.
Cover up to 700%
Fast Claim
Payouts
Easy Claims
Process
Excellent
Service
Out-of-hospital
Benefits
Affordable Prices
From R99 p/m
Automatic Claim
Submission
STANDARD BENEFITS
Gap Cover
Casualty Cover
Oncology Gap
Policy Extender
Accidental Death Cover
TRA Assist Powered by MobiMed
From R99/m
STANDARD BENEFITS
Gap Cover
Casualty Cover
Oncology Gap
Policy Extender
Accidental Death Cover
TRA Assist Powered by MobiMed
From R99/m
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% |
PMB's* Covered, subject to medical aid review |
||||
CO-PAYMENTS / DEDUCTIBLES* DSP’s (Voluntary use of designated service provider networks) |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
CO-PAYMENTS / DEDUCTIBLES* NON DSP’s (Voluntary use of non-designated service provider networks) |
1 co-payment |
2 Co-payments / |
||
CO-PAYMENT BENEFIT*: OUT OF HOSPITAL/MRI/CT/PET SCANS |
1 MRI / CT / PET |
2 scans per |
||
SUB-LIMITS*: INTERNAL PROSTHESES |
Up to R5 500* per |
Up to R11 000* per |
Unlimited |
|
SUB-LIMITS*: MRI / CT / PET SCAN |
1 |
2 |
||
SUB-LIMITS*: COLONOSCOPIES AND GASTROSCOPIES |
Up to R13 000* per
Up to R3 600* per |
Up to R22 000* per
Up to R6 000* per |
||
DENTAL BENEFIT* Unlimited but subject to the aggregate annual limit per insured person p/a |
||||
CASUALTY UNIT BENEFIT* |
Up to R3 300* per |
Up to R8 800* per |
Up to R13 000* per |
Up to R22 000* per |
GLOBAL FEE BENEFIT* |
Up to R12 000* per |
Up to R24 000* per |
||
ONCOLOGY GAP BENEFIT* (Subject to medical aid approved treatment plan being covered up to scheme tariff and within annual scheme oncology limit) |
Up to an |
Up to an |
Up to an |
Up to an |
ONCOLOGY CO-PAYMENT BENEFIT (IN NETWORK)* |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
ONCOLOGY CO-PAYMENT BENEFIT* (OUT OF NETWORK) |
1 co-payment per |
2 Co-payments per |
||
ONCOLOGY EXTENDER BENEFIT* (Includes ANY costs above annual scheme oncology limit but subject to scheme covering up to this limit) |
Up to R35 000* per |
Unlimited* |
||
ONCOLOGY “NEW-TECH” BENEFIT* |
Up to R8 200* per |
Up to R16 500* per |
||
ONCOLOGY GAP BENEFIT: BREAST RECONSTRUCTION SURGERY* |
Up to R18 000* per |
Up to R35 000* per |
||
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. |
6 months. |
6 months. |
|
MATERNITY PRIVATE WARD BENEFIT* |
Limited to a |
Limited to a |
||
ACCIDENTAL DEATH Insured / Spouse |
R7 000 |
R10 000 |
R20 000 |
R30 000 |
ACCIDENTAL DEATH Dependant |
R4 000 |
R5 500 |
R8 000 |
R20 000 |
POLICY EXTENDER (Additional 12 month gap cover premiums covered upon accidental death of policyholder) |
||||
TRAVEL BENEFIT Benefits include but are not limited to: |
||||
Emergency Medical and Related expenses : R600 000. Excess R500 |
||||
COVID-19 Extension: Emergency inpatient or outpatient treatment due to COVID-19 R600 000. |
||||
Medical evacuation, repatriation or transportation to a medical centre - FULL COST covered when arranged by Hepstar. |
||||
Hospital Cash benefit R500 per day (max R3 000). |
||||
Inconvenience Cover: Baggage Cover: R5 000 for theft, damage or loss by travel supplier. |
||||
TRA ASSIST POWERED BY MobiMed Home Drive (including Uber), Panic Button, 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 300 | R 330 | R 590 | |
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 450 | R 490 | R 730 |
ALL BASIC COVER BENEFITS PLUS
In Network Co-Payment Cover
Sub-Limit Cover
From R300/m
ALL BASIC COVER BENEFITS PLUS
In Network Co-Payment Cover
Sub-Limit Cover
From R300/m
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% |
PMB's* Covered, subject to medical aid review |
||||
CO-PAYMENTS / DEDUCTIBLES* DSP’s (Voluntary use of designated service provider networks) |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
CO-PAYMENTS / DEDUCTIBLES* NON DSP’s (Voluntary use of non-designated service provider networks) |
1 co-payment |
2 Co-payments / |
||
CO-PAYMENT BENEFIT*: OUT OF HOSPITAL/MRI/CT/PET SCANS |
1 MRI / CT / PET |
2 scans per |
||
SUB-LIMITS*: INTERNAL PROSTHESES |
Up to R5 500* per |
Up to R11 000* per |
Unlimited |
|
SUB-LIMITS*: MRI / CT / PET SCAN |
1 |
2 |
||
SUB-LIMITS*: COLONOSCOPIES AND GASTROSCOPIES |
Up to R13 000* per
Up to R3 600* per |
Up to R22 000* per
Up to R6 000* per |
||
DENTAL BENEFIT* Unlimited but subject to the aggregate annual limit per insured person p/a |
||||
CASUALTY UNIT BENEFIT* |
Up to R3 300* per |
Up to R8 800* per |
Up to R13 000* per |
Up to R22 000* per |
GLOBAL FEE BENEFIT* |
Up to R12 000* per |
Up to R24 000* per |
||
ONCOLOGY GAP BENEFIT* (Subject to medical aid approved treatment plan being covered up to scheme tariff and within annual scheme oncology limit) |
Up to an |
Up to an |
Up to an |
Up to an |
ONCOLOGY CO-PAYMENT BENEFIT (IN NETWORK)* |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
ONCOLOGY CO-PAYMENT BENEFIT* (OUT OF NETWORK) |
1 co-payment per |
2 Co-payments per |
||
ONCOLOGY EXTENDER BENEFIT* (Includes ANY costs above annual scheme oncology limit but subject to scheme covering up to this limit) |
Up to R35 000* per |
Unlimited* |
||
ONCOLOGY “NEW-TECH” BENEFIT* |
Up to R8 200* per |
Up to R16 500* per |
||
ONCOLOGY GAP BENEFIT: BREAST RECONSTRUCTION SURGERY* |
Up to R18 000* per |
Up to R35 000* per |
||
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. |
6 months. |
6 months. |
|
MATERNITY PRIVATE WARD BENEFIT* |
Limited to a |
Limited to a |
||
ACCIDENTAL DEATH Insured / Spouse |
R7 000 |
R10 000 |
R20 000 |
R30 000 |
ACCIDENTAL DEATH Dependant |
R4 000 |
R5 500 |
R8 000 |
R20 000 |
POLICY EXTENDER (Additional 12 month gap cover premiums covered upon accidental death of policyholder) |
||||
TRAVEL BENEFIT Benefits include but are not limited to: |
||||
Emergency Medical and Related expenses : R600 000. Excess R500 |
||||
COVID-19 Extension: Emergency inpatient or outpatient treatment due to COVID-19 R600 000. |
||||
Medical evacuation, repatriation or transportation to a medical centre - FULL COST covered when arranged by Hepstar. |
||||
Hospital Cash benefit R500 per day (max R3 000). |
||||
Inconvenience Cover: Baggage Cover: R5 000 for theft, damage or loss by travel supplier. |
||||
TRA ASSIST POWERED BY MobiMed Home Drive (including Uber), Panic Button, 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 300 | R 330 | R 590 | |
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 450 | R 490 | R 730 |
ALL VITAL COVER BENEFITS PLUS
Global Fee Benefit
Breast Reconstruction Surgery Benefit
Co-Payment: Out Of Hospital MRI/CT/PET Scans
Out of Network Co-Payment Cover
Oncology “New Tech” Benefit
Oncology Extender Benefits
Maternity Private Ward Benefit
From R330/m
ALL VITAL COVER BENEFITS PLUS
Global Fee Benefit
Breast Reconstruction Surgery Benefit
Co-Payment: Out Of Hospital MRI/CT/PET Scans (2023)
Out of Network Co-Payment Cover
Oncology “New Tech” Benefit
Oncology Extender Benefits
Maternity Private Ward Benefit
From R330/m
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% |
PMB's* Covered, subject to medical aid review |
||||
CO-PAYMENTS / DEDUCTIBLES* DSP’s (Voluntary use of designated service provider networks) |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
CO-PAYMENTS / DEDUCTIBLES* NON DSP’s (Voluntary use of non-designated service provider networks) |
1 co-payment |
2 Co-payments / |
||
CO-PAYMENT BENEFIT*: OUT OF HOSPITAL/MRI/CT/PET SCANS |
1 MRI / CT / PET |
2 scans per |
||
SUB-LIMITS*: INTERNAL PROSTHESES |
Up to R5 500* per |
Up to R11 000* per |
Unlimited |
|
SUB-LIMITS*: MRI / CT / PET SCAN |
1 |
2 |
||
SUB-LIMITS*: COLONOSCOPIES AND GASTROSCOPIES |
Up to R13 000* per
Up to R3 600* per |
Up to R22 000* per
Up to R6 000* per |
||
DENTAL BENEFIT* Unlimited but subject to the aggregate annual limit per insured person p/a |
||||
CASUALTY UNIT BENEFIT* |
Up to R3 300* per |
Up to R8 800* per |
Up to R13 000* per |
Up to R22 000* per |
GLOBAL FEE BENEFIT* |
Up to R12 000* per |
Up to R24 000* per |
||
ONCOLOGY GAP BENEFIT* (Subject to medical aid approved treatment plan being covered up to scheme tariff and within annual scheme oncology limit) |
Up to an |
Up to an |
Up to an |
Up to an |
ONCOLOGY CO-PAYMENT BENEFIT (IN NETWORK)* |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
ONCOLOGY CO-PAYMENT BENEFIT* (OUT OF NETWORK) |
1 co-payment per |
2 Co-payments per |
||
ONCOLOGY EXTENDER BENEFIT* (Includes ANY costs above annual scheme oncology limit but subject to scheme covering up to this limit) |
Up to R35 000* per |
Unlimited* |
||
ONCOLOGY “NEW-TECH” BENEFIT* |
Up to R8 200* per |
Up to R16 500* per |
||
ONCOLOGY GAP BENEFIT: BREAST RECONSTRUCTION SURGERY* |
Up to R18 000* per |
Up to R35 000* per |
||
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. |
6 months. |
6 months. |
|
MATERNITY PRIVATE WARD BENEFIT* |
Limited to a |
Limited to a |
||
ACCIDENTAL DEATH Insured / Spouse |
R7 000 |
R10 000 |
R20 000 |
R30 000 |
ACCIDENTAL DEATH Dependant |
R4 000 |
R5 500 |
R8 000 |
R20 000 |
POLICY EXTENDER (Additional 12 month gap cover premiums covered upon accidental death of policyholder) |
||||
TRAVEL BENEFIT Benefits include but are not limited to: |
||||
Emergency Medical and Related expenses : R600 000. Excess R500 |
||||
COVID-19 Extension: Emergency inpatient or outpatient treatment due to COVID-19 R600 000. |
||||
Medical evacuation, repatriation or transportation to a medical centre - FULL COST covered when arranged by Hepstar. |
||||
Hospital Cash benefit R500 per day (max R3 000). |
||||
Inconvenience Cover: Baggage Cover: R5 000 for theft, damage or loss by travel supplier. |
||||
TRA ASSIST POWERED BY MobiMed Home Drive (including Uber), Panic Button, 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 300 | R 330 | R 590 | |
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 450 | R 490 | R 730 |
ALL SUPER COVER PLUS BENEFITS WITH
HIGHER LIMIT AMOUNTS.
From R590/m
ALL SUPER COVER PLUS BENEFITS WITH
HIGHER LIMIT AMOUNTS.
From R590/m
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% |
PMB's* Covered, subject to medical aid review |
||||
CO-PAYMENTS / DEDUCTIBLES* DSP’s (Voluntary use of designated service provider networks) |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
CO-PAYMENTS / DEDUCTIBLES* NON DSP’s (Voluntary use of non-designated service provider networks) |
1 co-payment |
2 Co-payments / |
||
CO-PAYMENT BENEFIT*: OUT OF HOSPITAL/MRI/CT/PET SCANS |
1 MRI / CT / PET |
2 scans per |
||
SUB-LIMITS*: INTERNAL PROSTHESES |
Up to R5 500* per |
Up to R11 000* per |
Unlimited |
|
SUB-LIMITS*: MRI / CT / PET SCAN |
1 |
2 |
||
SUB-LIMITS*: COLONOSCOPIES AND GASTROSCOPIES |
Up to R13 000* per
Up to R3 600* per |
Up to R22 000* per
Up to R6 000* per |
||
DENTAL BENEFIT* Unlimited but subject to the aggregate annual limit per insured person p/a |
||||
CASUALTY UNIT BENEFIT* |
Up to R3 300* per |
Up to R8 800* per |
Up to R13 000* per |
Up to R22 000* per |
GLOBAL FEE BENEFIT* |
Up to R12 000* per |
Up to R24 000* per |
||
ONCOLOGY GAP BENEFIT* (Subject to medical aid approved treatment plan being covered up to scheme tariff and within annual scheme oncology limit) |
Up to an |
Up to an |
Up to an |
Up to an |
ONCOLOGY CO-PAYMENT BENEFIT (IN NETWORK)* |
Up to R13 000* per |
Up to R60 000* per |
Unlimited* |
|
ONCOLOGY CO-PAYMENT BENEFIT* (OUT OF NETWORK) |
1 co-payment per |
2 Co-payments per |
||
ONCOLOGY EXTENDER BENEFIT* (Includes ANY costs above annual scheme oncology limit but subject to scheme covering up to this limit) |
Up to R35 000* per |
Unlimited* |
||
ONCOLOGY “NEW-TECH” BENEFIT* |
Up to R8 200* per |
Up to R16 500* per |
||
ONCOLOGY GAP BENEFIT: BREAST RECONSTRUCTION SURGERY* |
Up to R18 000* per |
Up to R35 000* per |
||
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. |
6 months. |
6 months. |
|
MATERNITY PRIVATE WARD BENEFIT* |
Limited to a |
Limited to a |
||
ACCIDENTAL DEATH Insured / Spouse |
R7 000 |
R10 000 |
R20 000 |
R30 000 |
ACCIDENTAL DEATH Dependant |
R4 000 |
R5 500 |
R8 000 |
R20 000 |
POLICY EXTENDER (Additional 12 month gap cover premiums covered upon accidental death of policyholder) |
||||
TRAVEL BENEFIT Benefits include but are not limited to: |
||||
Emergency Medical and Related expenses : R600 000. Excess R500 |
||||
COVID-19 Extension: Emergency inpatient or outpatient treatment due to COVID-19 R600 000. |
||||
Medical evacuation, repatriation or transportation to a medical centre - FULL COST covered when arranged by Hepstar. |
||||
Hospital Cash benefit R500 per day (max R3 000). |
||||
Inconvenience Cover: Baggage Cover: R5 000 for theft, damage or loss by travel supplier. |
||||
TRA ASSIST POWERED BY MobiMed Home Drive (including Uber), Panic Button, 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 300 | R 330 | R 590 | |
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 450 | R 490 | R 730 |
*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 2024 terms and conditions can be viewed here.
With TRA, signing up for Gap Cover is a breeze. In just 5 minutes, you can secure comprehensive coverage that fills the gaps in your medical aid shortfalls.
Not sure if you need Gap Cover?
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.
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.
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.
Gap Cover is an affordable health insurance policy that gives you and your family peace of mind when you need it most.
Gap Cover is becoming a necessity in South Africa as doctors and medical aids continue to increase their rates exponentially each year.
Gap Cover is not a medical aid plan but has helped hundreds of South Africans avoid financial debt. You can visit our Hellopeter page to find out how our policyholders feel about our service and Gap Cover products.
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.
In this article, we will unpack the gap cover offerings of Total Risk Administrators (TRA) and Turnberry Gap Cover. We
This article will unpack the medical gap cover insurance offerings from two prominent providers: Total Risk Administrators (TRA) Gap Cover
Gap cover essentially helps to cover the shortfalls between what your medical aid pays and the actual costs of medical
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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Copyright © 2024. | Terms and Conditions Apply. | Errors and Omissions Excepted.
Copyright © 2024. | Terms and Conditions Apply. | Errors and Omissions Excepted.
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