Super cover plus - 2019

Premium Per Policy Per Month:

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Individuals

R227 p/m

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Families

R227 p/m

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Over 65’s*

R340 p/m

*age of main insured - for families & individuals

 

 

Super cover plus - 2020

Premium Per Policy Per Month:

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Individuals

R250 p/m

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Families

R250 p/m

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Over 65’s*

R360 p/m

*age of main insured - for families & individuals

The Super 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.*

Super cover plus benefits

Sometimes emergencies 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.
  • 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 2019: R7 500 / 2020: R10 000 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

These days most medical aid schemes impose a sub-limit on in-hospital internal prostheses costs. Members may be out of pocket and will have to cover these costs themselves.


  • Prosthesis sub-limit: This benefit provides an amount of up to R10 000 per policy per annum, subject to the annual limit*.
  • No other sub-limits are included in this benefit.

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.


2019

  • This benefit will provide an amount of R6 000 in the event of death of the insured and / or spouse, and R3 000 in the event of the death of the dependant, caused by violent, accidental, external, or visible means.

2020

  • This benefit will provide an amount of R7 500 in the event of death of the insured and / or spouse, and R3 750 in the event of the death of the dependant, caused by violent, accidental, external, or visible means.

2019

  • Benefits: Home Drive, Panic Button, Medical Health Line.
  • Click here for more information.

2020

  • Benefits: Home Drive (including Uber), Panic Button, Medical Health Line, Trauma Counselling Line and Claims Submissions.
  • Click here for more information.

These days most medical aid schemes insist that members pay an upfront amount for certain diagnostic and endoscopic procedures like gastroscopies and colonoscopies.


  • This amount is known as a co-payment or deductible.
  • This benefit will cover you for up to R50 000 per policy per annum (subject to the annual limit*) for co-payment or deductible costs imposed by your medical aid, provided you make use of your medical aid’s designated service provider network.
  • NO cover is provided where a policyholder voluntarily chooses to make use of a service provider that is not part of their medical aid’s service provider network.

Oncology Gap Benefit: Up to an aggregate of 2019: R158 000 / 2020: R165 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 Benefit: Up to R50 000 per policy per annum


  • The co-payment or deductible that your medical aid charges you for certain in-hospital procedures. This co-payment is NOT related to the scheme tariff and service provider charge shortfall or designated service provider none arrangements, OR
  • For claims where the medical aid will only pay a percentage for the approved treatment and the policyholder needs to pay the remaining percentage of the account.
  • All costs to be within the annual scheme oncology limit.
  • Oncology Extender Benefit: None
  • Breast Reconstruction Surgery 2020: Up to R10 000 per policy per annum

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 6 months after the death of the original policyholder.

This benefit provides an amount of up to Up to R5 000 per policy per annum.

*Annual Limit: The Basic Gap, Casualty, Co-Payment, Sub-Limit and Oncology Gap and Co-payment benefits are subject to the aggregate gap cover annual limit of 2019: R158 000 / 2020: 165 000 per insured person per annum. (This limit may change due to regulatory amendment)

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

A full list of 2020 terms and conditions can be viewed here.

co-payment & tariff gap example:
cervical disorder in 2019

Sashnee saved R89 591.78. By choosing Super Cover Plus, you can too.

Your medical aid, just like Sashnee’s, may impose a co-payment on Endoscopic or Laporoscopic Procedures, Hysterectomies as well as Colonoscopies.

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

Terms and conditions apply

Thanks to TRA, the GAP was covered!