Basic Cover 300 - Gap Cover | Total Risk Administrators

Basic cover 300

Premium Per Policy Per Month:

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Individuals

R99 p/m

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Families

R165 p/m

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Over 65's

R330 p/m

*age of main insured - for families & individuals

The Basic Cover 300 option covers up to 300% above medical aid scheme tariff.

This means that if your service provider charges anything up to 3 times what your medical aid will cover, TRA will provide for this GAP, subject to the annual limit.*

Basic Cover 300 Benefits

    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 the 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 R2 750 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

    Accidents happen! Unfortunately, some severe accidents may even result in death. The situation is made worse if that person was the main breadwinner. Costs can run into the thousands and often funds are tied up to an estate.


  • This benefit will provide an amount of R5 000 in the event of death of the insured and / or spouse, and R2 500 in the event of the death of the dependant, caused by violent, accidental, external, or visible means.
  • Benefits: Home Drive, Uber, Panic Button, Medical Health Line, Trauma Counselling Line (including a COVID-19 care line) and Claims Submissions.
  • Click here for more information.

Oncology Gap Benefit: Up to an aggregate of R171 000 per insured person per annum. The shortfall that arises after your medical aid has processed your account and is due to service providers charging above scheme tariff for medical aid approved oncology treatment plans (NB: Subject to: the gap cover percentage; and medical aid approved treatment plan being covered up to scheme tariff and within annual scheme oncology limit).


  • Oncology Co-Payment: No Benefit
  • Oncology Extender Benefit: No Benefit
  • Breast Reconstruction Surgery: No Benefit
  • Maternity Private Ward Benefit: No Benefit
  • Covid-19 Isolation Hotel Benefit: No Benefit

    We often hear of cases where one of our policyholders passes away, leaving their loved ones to pick up the pieces. They are left with the challenge to make sure that the gap cover they were used to is funded for a period of time.


  • This benefit will provide for your gap cover premiums for a period of 9 months after the accidental death of the original policyholder.

*Annual Limit: The Basic Gap, Casualty and Oncology Gap benefits are subject to the aggregate gap cover annual limit R171 000 per insured person per annum. (This limit may change due to regulatory amendment).

A full list of 2021 terms and conditions can be viewed here.

Gap cover example:
hiatus hernia repair in 2019

Michelle saved R 9086.36. By choosing Basic Cover 300, you can too.

Your medical aid, just like Michelle’s, may not cover 100% of the private rate of the medical practitioner, resulting in a shortfall payment due from you.

Eliminate the financial worry from the stress of a hospital operation or stay.

TERMS AND CONDITIONS APPLY

Thanks to TRA, the GAP was covered!