Total Risk Administrators has four different product options with differing levels of cover. The entry-level product option is Basic Cover 300. This option is sufficient in providing for Gap Cover, Casualty cover and Oncology Gap Cover.
Basic Cover 300 covers up to 300% above medical aid scheme tariff. This means that if your service provider charges anything up to 2 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 Basic Cover 300 offer are:
Your medical aid does not always cover the total costs in full. Whether payment comes from your medical scheme savings account or day-to-day benefit, the gap will be covered. This benefit will cover you for up to R2 750 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.
Up to an aggregate of R158 000 per insured person per annum. 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 annual scheme oncology limit).
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.
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 R3 000 in the event of death of the insured and / or spouse, and R1 500 in the event of the death of a dependant.
Find out more about Basic Cover 300 here.