If you’re a medical aid member in South Africa looking for protection beyond the basic coverage, TRA’s Vital Cover Plus Gap Cover is designed to provide comprehensive entry-level gap cover with essential benefits to its policyholders.
Some of these benefits include casualty cover, co-payment cover, sub-limit cover, and a separate oncology benefit that provides Oncology Gap cover and oncology co-payment cover.
What Is Vital Cover Plus?
Vital Cover Plus is TRA’s enhanced entry-level gap cover policy available at R360 per month for families and individuals. Gap Cover works alongside your registered medical aid, covering the difference between what your medical aid pays and what private healthcare providers charge for in-hospital procedures, specialist consultations, and various treatments.
Gap cover is not a substitute for medical aid, but an essential supplement to enhance the benefits of medical aid members.
Benefits & Features (Updated 2025)
- Covers up to 700% of medical scheme tariff for in-hospital shortfalls (aggregate annual limit: R219,845 per insured person per annum)
- Casualty cover: Emergency visits to casualty units, up to R9,240 per policy per annum (including children under 8 for after-hours treatment)
- Oncology gap benefit: Unlimited coverage, subject to an aggregate annual limit for approved treatment plans
- Oncology co-payment benefit: Up to R13,650 per policy per annum for in-network procedures
- Co-payment cover: Up to R13,650 per policy per annum for diagnostic and endoscopic procedures
- Sub-limit benefit: Internal prostheses coverage up to R5,775 per policy per annum
- Accidental death cover: R10,500 for main member/spouse, R5,775 for dependants
- Policy extender: Pays gap cover premiums for 12 months after the main policyholder’s death
- Medical aid contribution waiver: Up to R5775 per month for 6 months
- Specialist consultation shortfalls: Up to 2 consultations per policy per annum (R500 per consult)
- Tariff shortfalls for theatre and ward fees: R1,000 per policy per annum
- Casualty follow-up consultations: 1 consultation per policy per annum
- Access to TRA Assist: Home Drive (Uber), Panic Button, Medical Health & Trauma Counselling, Roadside Security Assistance
Waiting Periods & Limits
- No general waiting period – TRA does not apply a standard 3-month waiting period
- Specific waiting periods: 10 months for specific conditions/procedures e.g. joint replacement, pregnancy etc.; 9 months Oncology; 6 months for pre-existing conditions
- Aggregate annual limit: R219,845 per insured person per annum
- Sub-limits apply to specific procedures and benefits (see official policy documents for details)
Who Qualifies for Vital Cover Plus?
- Members of registered medical aid schemes (not health insurance or primary care products)
- No entry age limit; different premiums apply for those over/under 65
- Cover extends to spouse and dependants who are on the same medical scheme (except for married/proven common law partners)
What’s Not Covered?
- Routine GP visits
- Cosmetic procedures (non-medical)
- Out-of-hospital dental treatments (unless accident-related)
- Mental health disorders
- Anything not partially paid by medical aid
Always check the official 2025 TRA brochure for full details and exclusions.
Why Choose TRA’s Vital Cover Plus to Compliment Your Medical Aid Scheme?
Team up with a TRA, a trusted gap cover provider with a reputation for supporting South African families, and receive:
- Enhanced entry-level gap cover for medical aid members with comprehensive benefits
- Superior protection against medical aid shortfalls and hospital expenses
- Excellent oncology coverage with additional gap cover benefits within the annual limit
- Complete protection for loved ones, with accidental death and extended policy benefits
- Travel insurance for policyholders up to the age of 71 is included at no additional cost
- Advanced mobile app, TRA Assist, with comprehensive assistance services
- Ideal step-up from our basic coverage option with enhanced co-payment and casualty benefits
See how TRA pairs perfectly with your medical aid here: gapcovertool.co.za
How to Apply
Applying for Vital Cover Plus is simple. One or more members of your family can apply online, and TRA’s team is ready to provide support. Review your medical aid plan and gap cover policy annually to ensure you’re getting the best cover for your needs.
Protect Yourself from Medical Aid Shortfalls with TRA Gap Cover
TRA’s Vital Cover Plus is the enhanced, reliable choice for medical aid members who want protection against rising healthcare costs without the premium cost of top-tier plans.
For only R360 per month, TRA Gap Cover Vital Cover Plus is one of the best ways to protect your family from financial strain and medical expense shortfalls.
For further information, contact your intermediary or visit the TRA Gap Cover page.
