Medical Gap Cover Pros and Cons

It’s no secret that private healthcare is expensive for the average South African and that many medical aid plans fail to provide full coverage for healthcare costs. To keep medical aid premiums lower, people turn to medical Gap cover plans to help with the shortfall that might arise on their medical bills. Gap insurance is a supplemental health insurance product that can often provide an extra cushion of protection against high medical costs that might not be fully covered by your medical aid. However, there are pros and cons to Gap insurance that need to be considered according to your requirements:

The advantages of supplemental insurance plans

Gap insurance might be a good idea for you or your family if:


  • You are anticipating to be hospitalised at some point in the future

If you are expecting a baby or planning to have surgery, gap insurance could cover hospital costs associated with the medical care you will receive.


  • You are above the age of 65

Individuals over the age of 65 are advised to get additional insurance on top of their medical aid, as they are more likely to need it.

The disadvantages of medical Gap cover

  • Exclusions and limitations

If you are comparing medical Gap insurance, ensure that you look at each plan’s exclusions and limitations. Certain pre-existing conditions are not covered, as well as emergency services.


  • Waiting periods

Gap insurance typically has various waiting periods before your coverage will be active. Be sure to take these waiting periods into account if you anticipate a situation in which you might need immediate coverage.


Total Risk Administrators has different medical Gap insurance packages that you can choose from:

  • Basic Cover 300, starting at R99 p/m
  • Vital Cover Plus, starting at R235 p/m
  • Super Cover Plus, starting at R265 p/m
  • Absolute Cover Plus, starting at R480 p/m

For more information on our medical Gap cover policies, have a look at our TRA Gap Cover brochure. If you would like to speak to one of our specialists, contact Total Risk Administrators today:

Note: All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being. The information and opinions expressed here are believed to be accurate, based on the best judgment available to the authors, and readers who fail to consult with appropriate health authorities assume the risk of any injuries. Errors and Omissions Excepted. Terms and Conditions Apply. Please follow the link to our terms and conditions: