Total Risk Administrators has four different product options with differing levels of cover. Vital Cover Plus is the ‘second level’ of Gap Cover provided by TRA. This option is sufficient in providing for Gap Cover, Casualty cover and Oncology Gap Cover.
Vital Cover Plus covers up to 700% above the medical aid scheme tariff. This means that if your service provider charges anything up to 7 times what your medical aid will cover, TRA will provide for this gap, subject to the annual limit.
The Basic Cover, Casualty and Oncology Gap benefits are subject to the aggregate Gap Cover annual limit of R158 000 per insured person per annum. (This limit may change due to regulatory amendment).
Some of the benefits which Vital Cover Plus offer are:
Casualty
Your medical aid does not always cover the total casualty costs in full. Whether payment comes from your medical scheme savings account or day-to-day benefit, the gap may be covered. This benefit will cover you for up to R5000 per policy per annum (subject to the annual limit*) EVEN IF YOUR MEDICAL AID COVERS NOTHING. NB: This benefit is only covered for EMERGENCY TREATMENT, specifically for ACCIDENTAL TRAUMA.
Oncology Gap
Up to an aggregate of R158 000 per insured person per annum covered. This if for the shortfall that arises after your medical aid has processed your account and is due to service providers charging above scheme tariff for medical aid approved oncology treatment plans. (NB: Subject to the Gap Cover percentage; and medical aid approved treatment plan being covered up to scheme tariff and within the annual scheme oncology limit).
Accidental Death
Accidents happen! Unfortunately, some severe accidents may even result in death. The situation is made worse if that person was the main breadwinner. Costs can run into the thousands and often funds are tied up to an estate. This benefit will provide an amount of R4 000 in the event of death of the insured and / or spouse, and R2 000 in the event of the death of a dependant.
Policy Extender
We often hear of cases where one of our policyholders passes away, leaving their loved ones to pick up the pieces. They are left with the challenge to make sure that the Gap Cover they were used to is funded for a period of time. This benefit will provide for your Gap Cover premiums for a period of 6 months after the death of the original policyholder.
You can find out more about Vital cover Plus by contacting your intermediary or by going here.
