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What is Gap Cover and What Does it Cover?

What Is Gap Cover?

Gap cover is a short-term insurance product designed to cover the financial shortfall between what your medical aid pays and the actual costs charged by private healthcare providers. In South Africa, medical aid schemes often reimburse healthcare services at a predetermined rate, known as the medical scheme tariff (MST). However, specialists and hospitals may charge significantly more than these medical scheme rates, leaving patients responsible for the difference. Total Risk

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Can't afford Comprehensive Medical Aid? Pair a hospital pan with gap cover

What If You Can’t Afford (Comprehensive) Medical Aid?

Most people picture one thing when they hear “medical aid”: a comprehensive plan with all the bells and whistles you hardly use. However, what people don’t often realise is that an entry-level hospital plan can still be a type of medical aid, registered and regulated under the same Medical Schemes Act just as any comprehensive option. And that means, this sort of entry-level plan opens the door to supplementary cover

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what is the annual aggregate limit

What Is The Annual Aggregate Limit & Why Has It Increased?

Are you aware of the annual aggregate limit for your medical aid or gap cover provider and how it can affect you and your family? Terms used in insurance can often be complicated and overwhelming. However, medical aid members need to understand what these terms mean and how they affect their medical scheme and short-term insurance products. What is the annual aggregate limit? The annual aggregate limit refers to the

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What is Gap Cover and What Does it Cover?

What Is Gap Cover?

Gap cover is a short-term insurance product designed to cover the financial shortfall between what your medical aid pays and the actual costs charged by private healthcare providers. In South

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FREQUENTLY ASKED QUESTIONS

How Does Gap Cover Work?

Gap cover insurance is essential for covering shortfalls after medical treatments like surgeries or hospital stays where the specialist’s fees are higher than what your medical aid covers. Once your medical aid has processed and paid their portion of the bill, you can claim the remaining amount from your gap cover provider, according to the terms of your policy. 

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16 September 2026Gap Cover, News, TRA News

What Is Gap Cover?

Gap cover is a short-term insurance product designed to cover the financial shortfall between what your medical aid pays and

16 September 2026Gap Cover, Health Insurance, News, TRA News

What If You Can’t Afford (Comprehensive) Medical Aid?

Most people picture one thing when they hear "medical aid": a comprehensive plan with all the bells and whistles you

Read More
4 September 2026Gap Cover, Health Insurance, News, TRA News

What Is The Annual Aggregate Limit & Why Has It Increased?

Are you aware of the annual aggregate limit for your medical aid or gap cover provider and how it can

Read More
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