Gap cover helps cover the shortfall between what your medical aid will pay and the actual cost of the medical treatments you underwent.
This article delves into the offerings of two leading gap cover providers: Total Risk Administrators (TRA) and Old Mutual.
Let’s unpack their coverage options, premiums, and benefits.
Understanding Gap Cover
Gap cover is supplementary insurance that fills the financial gaps left by medical aid schemes.
It’s crucial to have coverage for unexpected medical expenses that may occur both in and out of hospital. Gap coverage works in conjunction with a medical aid, meaning you must be covered with a medical aid to qualify for gap cover.
Sign up for gap cover so you don’t have to worry about out-of-pocket costs during critical health situations.
TRA Gap Cover: Overview and Features
For more detailed information, visit the official websites of both service providers.
Company Background:
Total Risk Administrators (TRA) is a top-rated, reputable provider of comprehensive gap cover. They provide a range of custom plans to cater to various medical and financial needs.
Coverage and Benefits:
- Coverage Above Tariff: TRA provides up to 700% coverage above the medical aid tariff, making it ideal for extensive medical expenses.
- Co-payments and Sub-limits: TRA offers benefits for co-payments and sub-limits associated with hospital admissions and specific procedures.
- Maternity Gap Cover: This includes coverage for private ward rates during maternity leave.
- Oncology Cover: High levels of coverage for oncology treatments on higher plans.
- Travel Benefits: Provides additional coverage for medical expenses incurred while travelling outside South Africa.
- TRA Assist Mobile App: Facilitates easy access to benefits and quick claim settlements.
- No Maximum Entry or Expiry Age: This plan offers coverage without age restrictions, making it accessible to a broader demographic.
TRA 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
Old Mutual Gap Cover: Overview and Features
Company Background:
Old Mutual, a well-established financial services provider, offers Gap Cover and its other services.
Coverage and Benefits:
- Coverage for Medical Expense Shortfalls: Old Mutual Gap Cover pays up to 500% of the medical aid rate for most medical expenses.
- Family Coverage: The policy covers the principal member, spouse/life partner, and children (up to 26 years of age) under a single policy.
- Affordable Pricing: At just R270 per family per month, Old Mutual’s total benefit per policy is R204 500 per family member per annum.
- Comprehensive Family Protection: This policy covers up to six immediate family members under a single premium. Old Mutal’s Gap Cover applies to you, your spouse/life partner and children (up to 26 years of age and registered as dependants on your medical aid).
- Single Gap Cover Policy Available: a single gap cover policy is available for a principal member and spouse on different medical aids.
Old Mutual Premiums:
- From R270 per family per month.
- The policy premium is from R290 if a family member is 40 – 59 years of age, and from R355 if a family member is 60 years or older.
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.
- Old Mutual: Provides up to 500% coverage, with specific provisions for certain surgeries and non-designated service provider cases.
Cost-to-Value Ratio:
- TRA: Offers a range of plans starting at R99, with comprehensive benefits with family plans available.
- Old Mutual: Provides affordable family coverage at R270 per month, with a range of benefits included.
Customer Service and Additional Benefits:
- TRA: Known for excellent customer service and the convenience of the TRA Assist mobile app.
- Old Mutual: Offers hassle-free enrollment and a simple, straightforward policy for family coverage.
Plan Flexibility and Customisation:
- Both TRA and Old Mutual offer a variety of plans that can be tailored to meet specific medical needs and financial situations.
TRA’s Take
When choosing a gap service provider, consider your specific medical needs, age, and budget.
Review the benefits and coverage details carefully to ensure you select the provider that best meets your requirements.
Get a quote from TRA today!
For more detailed information, it is recommended to review the official websites of both service providers.
