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Medical Aid Shortfall

Medical Aid Is Not Enough: Why You Were Left With A R20,000+ Medical Aid Shortfall

It’s a scenario playing out across South Africa every day: You’re diligent with your medical aid payments. You go in for a necessary procedure. Everything gets approved. Then comes the gut punch: a bill for R20,000 that your medical aid won’t cover.  That begs the question: How is this possible with comprehensive medical aid? Well, the truth is that comprehensive plans leave significant gaps between what they pay and what

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Corporate gap cover explained

Corporate Gap Cover: Protection for SA Employer Groups

Medical aids and medical schemes in South Africa don’t cover the full cost of healthcare. The gap between what medical aid pays and what healthcare providers charge creates significant financial risk for employees. Corporate gap cover bridges this gap, protecting your workforce from unexpected medical costs and debt. What Is Corporate Gap Cover? Corporate gap cover is a group insurance policy that covers the difference between medical scheme tariff rates

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BrandMapp provides insights to the Gap Cover market in South Afric

TRA’s Consumer Research: Understanding The Gap Cover Market in South Africa

Copyright: Consumer research conducted by BrandMapp on behalf of Total Risk Administrators (TRA), 2025. “With only 19% of medically insured South Africans currently having gap cover, there are literally millions of families who could benefit from this protection but haven’t yet recognised the need.” When you’re lying in a hospital bed recovering from surgery, the last thing you want to worry about is a massive medical bill that your medical

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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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