If you are a medical aid member in South Africa looking for protection beyond basic coverage, TRA’s Vital Cover Plus is designed to provide enhanced entry-level gap cover with essential extra benefits.
Vital Cover Plus adds in-network co-payment cover, sub-limit cover for internal prostheses, and an oncology co-payment benefit on top of TRA’s core gap cover protection. The headline difference, though, is the jump in tariff cover: from 300% on Basic Cover to 700% of medical scheme tariff on Vital Cover Plus, which is enough to settle the vast majority of specialist shortfalls in South Africa in full.
What Is Vital Cover Plus?
Vital Cover Plus is TRA’s enhanced entry-level gap cover policy, available from R394 per month, for policies where the oldest beneficiary is under 65, and R591 per month for over-65s in 2026. The same premium covers individuals and families.
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 certain treatments. Gap cover is not a substitute for medical aid. It is a supplementary insurance product that enhances the benefits of medical aid membership.
Benefits & Features (Updated for 2026)
- Above tariff cover: Covers up to 700% of medical scheme tariff for in-hospital shortfalls (subject to the aggregate annual limit of R219 845 per insured person per annum). For more on what tariff percentages mean, see gap cover tariff percentages explained
- Casualty cover: Emergency visits to casualty units (accidents only), up to R9 700 per policy per annum (including children under 8 for emergency/ after-hours treatment)
- Casualty follow-up consultations: 1 follow-up consultation per policy per annum at an ER unit (accident-related only)
- Oncology gap benefit: Unlimited coverage for medical aid approved oncology treatment plans, subject to the aggregate annual limit
- Oncology co-payment benefit (in-network): Up to R14 333 per policy per annum
- Co-payment cover (in-network): Up to R14 335 per policy per annum for procedures like a gastroscopy/colonoscopy
- Sub-limit benefit for internal prostheses: Up to R5 775 per policy per annum
- Tariff shortfalls for theatre and ward fees, consumables, laparoscopic/endoscopic equipment: Up to R1 050 per policy per annum
- Targeted pain relief during surgery or severe trauma: Unlimited, subject to the aggregate annual limit
- Hospitalised psychiatric care: Tariff shortfall cover for in-hospital mental health admissions, up to 21 days
- Dental benefit: Cover for authorised in-hospital dental procedures (unlimited, subject to the aggregate annual limit, and subject to strict terms and conditions/limited cover as stipulated in the policy document)
- Specialist consultation shortfalls: Up to 2 consultations per policy per annum (R500 max per consult)
- Accidental death cover: R11 000 for main member/spouse, R6 060 for dependants
- Policy extender: Full gap cover premium covered for 12 months after the accidental death of the main policyholder
- Medical aid contribution waiver: Up to R4 850 per month for 6 months, in the case of the accidental death of the main policyholder
- Access to TRA Assist: Home Drive (6 trips per annum, 50km radius), Panic Button, Medical Health and Trauma Counselling Line, Roadside Security Assistance, mobile app for claims submission
- Travel insurance: Comprehensive travel insurance underwritten by Guardrisk Insurance Company Limited is included at no additional cost for policyholders under 71
Waiting Periods & Limits
- No general three-month waiting period
- 10 months for the specified condition list (joint replacement, pregnancy, oncology and others; see our brochure for the full list)
- 9 months for a first-time cancer diagnosis made before the policy starts
- 6 months for any other pre-existing condition Aggregate annual limit: R219 845 per insured person per annum in 2026
Who Qualifies for Vital Cover Plus?
- Members of registered medical aid schemes (not health insurance or primary care products)
- No entry age limit. Premiums are based on the age of the oldest beneficiary
- Cover extends to a spouse and dependants on the same medical scheme, or to a married couple or proven common-law partners on different medical aids (with an affidavit confirming 12 months of cohabitation)
What Is Not Covered on Vital Cover Plus?
Vital Cover Plus does not include the following benefits, which are available on Super Cover Plus and Absolute Cover Plus:
- Out-of-network co-payment cover
- MRI/CT/PET scan co-payment or sub-limit cover
- Sub-limit cover for colonoscopies and gastroscopies
- Step-down facility benefit
- Global fee benefit (for robotic surgery and similar)
- Oncology extender benefit
- Oncology “new-tech” benefit
- Breast reconstruction surgery cover
- Premature birth benefit
- Maternity follow-up consultations
- Private ward benefit
- Out-of-network ambulance shortfall cover
Always check the official 2026 TRA brochure for full details and exclusions.
Why Choose TRA’s Vital Cover Plus to Complement Your Medical Aid?
Team up with TRA, a trusted gap cover provider with a track record of supporting South African families, and receive:
- Enhanced entry-level gap cover with 700% tariff protection
- Superior protection against medical aid shortfalls and hospital expenses
- In-network co-payment cover and internal prostheses sub-limit cover
- Oncology gap and oncology co-payment cover
- Complete protection for loved ones with accidental death, policy extender and medical aid contribution waiver benefits
- Travel insurance for policyholders under 71 included at no additional cost
- Advanced mobile app, TRA Assist
See how TRA pairs perfectly with your medical aid at gapcovertool.co.za
Frequently Asked Questions About Vital Cover Plus
How much does Vital Cover Plus cost in 2026?
R394 per month for policies where the oldest beneficiary is under 65, and R591 per month for over-65 policyholders. The premium is the same for individual or family policies.
What is the difference between Basic Cover 300 and Vital Cover Plus?
Vital Cover Plus moves the tariff shortfall cover from 300% to 700% of scheme tariff, adds in-network co-payment cover (up to R14 335 per year), adds sub-limit cover for internal prostheses (up to R5 775 per year), adds an oncology co-payment benefit (up to R14 333 per year), and adds the medical aid contribution waiver (up to R4 850 per month for six months) in the case of accidental death of the main policyholder. Casualty cover is also higher.
Will Vital Cover Plus cover my specialist’s bill?
In most cases, yes. For example, a specialist like an anesthetist often charges between 300% and 700% of scheme tariff for in-hospital procedures, and Vital Cover Plus settles tariff shortfalls up to 700%. Basic Cover 300, by contrast, would leave a shortfall for charges above 300%.
Does Vital Cover Plus include MRI or CT scan cover?
No. Co-payment and sub-limit cover for MRI, CT and PET scans is available on Super Cover Plus and Absolute Cover Plus. If your medical aid charges a co-payment on scans, consider one of those plans. Speak to your broker/intermediary for more information.
Can I claim immediately on a new Vital Cover Plus policy?
There is no general three-month waiting period. New TRA policyholders can claim from the start date on anything that is not on the ten-month condition-specific list and not related to a pre-existing condition. For the full breakdown of which conditions sit on which waiting period, see our article on gap cover and pre-existing conditions.
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 are still on the right 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 of the top-tier plans.
From R394 per month, TRA’s Vital Cover Plus is one of the most cost-effective 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.
