Think of gap cover as a financial safety net that protects you from medical treatment costs exceeding what medical aids cover.
In this article, we discuss the offerings of two leading providers: Total Risk Administrators (TRA) and Liberty Gap Cover. We will explore their coverage options, premiums, and benefits to help you better understand each provider’s offerings.
Understanding Gap Cover
Put simply, gap cover is supplementary health insurance that ensures medical expense shortfall cover. This type of insurance is designed to cover the difference between what your medical scheme pays and the actual cost of medical procedures.
This happens when medical practitioners charge higher rates than what medical aid will cover, known as “above medical aid rates/tariffs”. This insurance becomes necessary for those who want to avoid unexpected expenses, especially during hospital stays, surgeries, and certain out-of-hospital treatments.
TRA Gap Cover: Overview and Features
Company Background:
Total Risk Administrators (TRA) offers comprehensive gap cover solutions tailored to individuals’ and families’ various medical and financial needs.
Coverage and Benefits:
- Coverage Above Tariff: TRA provides up to 700% coverage above the medical aid tariff, ensuring that even extensive medical expenses are covered.
- Co-payment and Sub-limits: Includes benefits for co-payments related to hospital admissions and specific procedures.
- Maternity Private ward cover: On the higher plans, can cover the shortfall between the general and the private ward rate for maternity.
- Oncology benefits: Most of the plans offer extensive coverage for specific oncology treatments, etc.
- Travel Benefits: Provides additional coverage for medical expenses incurred while travelling outside South Africa.
- TRA Assist Mobile App: Facilitates easy access to benefits and expedites claim settlements.
- No Maximum Entry or Expiry Age: Offers coverage without age restrictions, making it more accessible.
Premiums:
- Basic Cover 300: From R99 per month
- Vital Cover Plus: From R300 per month
- Super Cover Plus: From R330 per month
- Absolute Cover Plus: From R590 per month
Liberty Gap Cover: Overview and Features
Company Background:
Liberty Gap Cover offers a range of gap cover options to suit different budgets. Individuals’ age groups determine the plans’ pricing.
Coverage and Benefits:
- Coverage for Medical Expense Shortfalls: Liberty provides up to 500% coverage above the medical aid tariff for in-hospital treatments and a range of outpatient procedures, including CT, PET, and MRI scans.
- Co-payments and Casualty Benefits: Liberty covers co-payments imposed by medical aids for hospital admissions, specified procedures, and emergency treatments in casualty facilities following accidents.
- Internal Prosthesis and Artificial Joints: Covers shortfalls on internal prosthesis costs, including artificial joints, with a limit of up to R41,000 per policy per year.
- Oncology and Cosmetic Benefits: Liberty offers coverage for oncology treatment co-payments and cosmetic breast reconstruction following a mastectomy.
Premiums:
- Universal Gap Cover: R506 per month for individuals under 35; R646 per month for families with all members under 65.
- Essential Gap Cover: R372 per month for individuals under 35; R468 per month for families with all members under 65.
- Optimal Gap Cover: From R239 per month, available only for single individuals under 35.
Let’s Sum It Up
For more detailed information, visit the official websites of both service providers.
Coverage for Medical Expense Shortfalls:
- TRA: Offers up to 700% coverage above the tariff, providing extensive protection across various medical scenarios, with specific out-of-hospital benefits.
- Liberty: Provides up to 500% coverage, with tailored options for different needs, including specialised cover for internal prostheses and oncology.
Cost-to-Value Ratio:
- TRA: Offers a range of plans starting at R99, with comprehensive benefits and family plans available.
- Liberty: Provides various options with premiums starting at R239, ensuring flexibility and affordability, especially for younger individuals.
Customer Service and Additional Benefits:
- TRA: Known for excellent customer service and the convenience of the TRA Assist mobile app on the go.
- Liberty: Offers comprehensive plans with additional benefits like trauma counselling, accidental dentistry, and premium waiver cover.
Plan Flexibility and Customisation:
- TRA and Liberty offer customisable plans to meet specific medical needs and financial situations. TRA provides extensive coverage options, while Liberty offers three distinct plans to cater to different age groups and medical requirements.
TRA’s Take
Both TRA and Liberty offer valuable gap cover solutions, each catering to different needs and preferences.
TRA’s comprehensive coverage for all ages and benefits, such as the TRA assist app and HepStar Travel, make it a trusted provider in South Africa.
For more detailed information, visit the official websites of both service providers.
When choosing a gap cover provider, you can consider your medical needs, financial situation, and the type of coverage you require.
Get a quote from TRA today!
