Medical Gap insurance can often be overlooked during financial planning, yet it can provide extensive cover for medical expenses when coupled with a medical aid. Private healthcare can be costly in South Africa, and medical aid schemes often don’t pay the full rate charged by specialists and private hospitals. By adding gap cover to your medical aid to cover potential rate shortfalls, you will ensure added coverage and benefits for you and your family to give you peace of mind.

What to consider when choosing medical aid Gap cover

  • Maximum rate

One of the first things to consider when choosing Gap cover for you and your family is the maximum rate. This percentage indicates the shortfall that your Gap insurance provider will be prepared to cover should your medical scheme not cover all medical expenses. Gap cover plans offer various maximum rates, which increase with higher monthly premiums for added coverage. Higher maximum rates also usually provide more coverage benefits.

  • Value-added benefits

High-end Gap insurance policies will often offer value-added benefits in addition to coverage for in-hospital procedures and co-payments. Value-added benefits usually include premium waivers and coverage in the event of non-network co-payments. These benefits ensure that your family’s monthly premiums will continue to be covered by your Gap provider in the event of death or disability of the policy’s main member.

  • Waiting periods

It is usually ideal to have Gap cover with the shortest waiting period, which will mean that you and your family will have coverage and protection as soon as possible. Prescribed time limits are often stipulated on Gap policies that will only have your Gap coverage kick in after the waiting period. If you have pre-existing conditions, be sure to pay close attention to waiting periods when choosing your Gap cover policy.

Total Risk Administrators offers four different Gap Cover packages to choose from according to your requirements:

  • Basic Cover 300, starting at R99 p/m
  • Vital Cover Plus, starting at R235 p/m 
  • Super Cover Plus, starting at R265 p/m
  • Absolute Cover Plus, starting at R480 p/m

Should you require more information on our Gap coverage, you can have a look at our TRA Gap Cover brochure. For any other queries, contact Total Risk Administrators to speak to one of our specialists today:

Note: All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being. The information and opinions expressed here are believed to be accurate, based on the best judgment available to the authors, and readers who fail to consult with appropriate health authorities assume the risk of any injuries. Errors and Omissions Excepted. Terms and Conditions Apply.