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Medical Gap Insurance Plan Requirement

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If you want peace of mind to know that your medical expense shortfalls will be covered, then medical gap insurance is for you. Gap products are group supplemental health plans to cover these shortfalls that may exist between what your medical aid covers and your actual medical costs. Medical Gap Insurance does have a few requirements:

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> You need to be an existing medical aid member of a registered medical aid scheme (you cannot get Gap Insurance without having medical aid as it is not a substitute for a medical scheme membership).

> Generally, if you have a pre-existing condition you will be able to get Gap Health Insurance, as long as you do not submit any claims relating to your pre-existing condition during the specified waiting period.

> Generally, any claims relating to pregnancy and childbirth, including caesarean delivery, can only be submitted after the first 10-12 months of membership for any Gap Cover Policy.

> Should you be concerned about a family member having a pre-existing condition and not being able to qualify as a member of the Medical Gap Policy, don’t worry unnecessarily. As long as your family member does not submit any claims within the stipulated waiting period that relates to their pre-existing condition, and are either your spouse or child, under 25 years old, they will qualify as dependents.

> Members and their dependents are only allowed to be on two different medical aids and one Gap Cover Policy if they are legally married, or common law partners who can confirm by means of a verified affidavit that they have been living together for a minimum of 12 months.

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Basic Cover 300, starting at R99 p/m

Vital Cover Plus, starting at R220 p/m

Super Cover Plus, starting at R250 p/m

Absolute Cover Plus, starting at R450 p/m

If you need more information on our Medical Gap Insurance, you can have a look at our TRA Gap Cover brochure. For any other queries, contact our Total Risk Administrators specialists 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 and matter relating to their health and well-being. The information and opinions expressed here are believed to be accurate, based on the best judgement 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.


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