Gap service providers are crucial in bridging the financial shortfalls that medical aid may not fully cover.
This article will examine two leading gap service providers, Total Risk Administrators (TRA) and Stratum Gap Cover, highlighting their monthly premiums, coverage, and key benefits.
Gap Cover
Gap Cover services are supplementary medical insurance plans that cover the difference between what your medical aid pays and the actual cost of the medical expense.
Gap services are essential for avoiding unexpected out-of-pocket costs and ensuring comprehensive financial protection during medical emergencies and certain out-of-hospital treatments.
Side By Side: Gap Cover Providers
For more detailed information, visit the official websites of both service providers.
Stratum Benefits: Overview and Features
Company Background:
Stratum Benefits is a well-established provider known for offering a variety of gap cover options tailored to meet the needs of individuals and families. You can expect the most often experienced in- and out-of-hospital medical expense shortfalls from Stratum Benefits.
Monthly Premium:
- Base 500: From R275 p/m for individuals (No longer an active product of the supplier as of January 2024)
- Compact 300: From R301 p/m for individuals
- Meridian 400: From R228 p/m for individuals
- Elite 500: From R438 p/m for individuals
- Access Optimiser: From R179 p/m for families
- Access Co-Pay Plus 300: From R368 p/m for families
Coverage Above Tariff
- Up to 500%.
Key Benefits
- Co-payment Coverage for both in-network and out-of-network provider co-payments
- Dental and Maternity Coverage
- Radiology and Sub-limits: Covers advanced diagnostic procedures like MRI, CT, and PET scans, with additional top-up options available under higher-tier plans.
- Cover cancer treatment shortfalls, top-ups for advanced treatments, and support for breast reconstruction surgery.
- Specialist Consultations and Rehabilitation
- Includes trauma counselling, preventative care advice, and lifestyle benefits to support overall well-being.
- Casualty and Emergency Benefits
- Payout benefits for accidental death, disability, and first-time cancer diagnosis, along with waiver benefits for medical aid contributions during critical times.
TRA: Overview and Features
Company Background
- Total Risk Administrators (TRA) is a well-known gap service provider with a strong reputation for offering comprehensive coverage options.
Monthly Premium
- 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
Coverage Above Tariff
- Up to 700%.
Key Benefits
- Casualty
- Co-payment benefit
- Sub-limits
- Certain dental procedures
- Global fee benefit
- Maternity private ward rate shortfalls
- Travel benefits
- Add-on options for female cancer cover
- TRA Assist Mobile App
- No maximum entry or expiry age
- Automatic adult dependent cover
- No general waiting period at the start date of cover
- High levels of cover for in-hospital and over 50 out-of-hospital procedures
- Co-payment cover for hospital admissions and scans
- High levels of oncology cover
- Cover while travelling outside of South Africa
- Fast and efficient claim settlement.
Get To Know Your Gap Cover
Coverage for Medical Expense Shortfalls:
- TRA: Offers up to 700% coverage above the tariff and is ideal for those seeking extensive coverage for a wide range of medical expenses, including casualty and co-payments.
- Stratum Benefits: Provides up to 500% coverage above the tariff, with various options tailored to different levels of in- and out-of-hospital expense shortfalls.
Cost-to-Value Ratio:
- TRA: More affordable with premiums starting at R99, offering extensive benefits.
- Stratum Benefits: Offers a range of options with premiums starting from R301 for individuals, providing tailored benefits for specific medical needs and financial situations.
Overall Customer Service:
- TRA: Known for excellent customer service and a comprehensive support system, including TRA Assist. TRA is often praised for its broader coverage options, being rated the top gap cover provider on Hellopeter.
- Stratum Benefits: Positive reviews on customer support, particularly appreciated for handling specific medical procedures and comprehensive in-hospital coverage.
Plan Flexibility and Customisation:
- TRA: Offers a wide range of benefits and plans that can cater to various medical needs, making it simple to tailor the plan based on your budget and the coverage you desire.
- Stratum Benefits: Plan options for families are also tiered, allowing for customisation in the plan when it comes to families.
Additional Perks:
- TRA teams up with Hepstar to provide gap-cover clients with travel benefits options. This is a notable perk, along with access to the TRA Assist mobile app, which offers benefits like Uber trips.
- Stratum Benefits offers a lifestyle benefit that includes a travel benefit for their higher-tiered products and access to free high school learning support.
For more detailed information, visit the official websites of both service providers.
Let’s Sum It Up
TRA offers extensive coverage and a wide range of benefits at a lower starting premium, making it a cost-effective option for comprehensive gap coverage.
TRA is best suited for individuals and families seeking extensive coverage across various medical scenarios at a competitive price. Start now, we have no general waiting period for your convenience.
TRA’s Take
Review the benefits and coverage details carefully to ensure you select the provider that best meets your requirements.
Get a quote from TRA.
For more detailed information, visit the official websites of both service providers.