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The Affordable Medical Aid Option: Hospital Plan and Gap Cover

The Affordable Medical Aid Option: Hospital Plan and Gap Cover

A hospital plan is one of the medical aid options in South Africa, regulated under the Medical Schemes Act, with the catch that it only pays for in-hospital costs. That means you still qualify for gap cover with a hospital plan, exactly as you would with comprehensive medical aid. Pairing the two often costs less per month than full comprehensive cover, while still protecting you against the in-hospital tariff shortfalls

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Medical Gap insurance waiting periods

Yes, you can get gap cover with no waiting period in South Africa, but only if you transfer from another gap cover provider with similar benefits. TRA waives all standard waiting periods under this 90-day transfer rule, provided you apply within 90 days of cancelling your previous policy and submit a membership certificate as proof. New gap cover members starting fresh are subject to the standard waiting periods set out

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Qualifying For Gap Cover: All You Need To Know

Qualifying For Gap Cover: All You Need To Know

You qualify for gap cover in South Africa when you are a registered member of a medical aid scheme. Gap cover sits alongside your medical aid and pays the in-hospital shortfalls that arise when specialists charge more than the scheme’s tariff. You can extend the policy to your spouse and dependants who share your medical aid membership. Now that we’ve covered one of the most frequent questions we receive as

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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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