Gap Cover in South Africa

Gap cover in South Africa is relatively new and can be misunderstood.

Those who are members of a medical scheme think it is unimportant because they already have medical coverage.

It is only when faced with an astronomical hospital bill that they find out they were mistaken.

The problem is that most people do not understand how a medical aid works. Medical aids have preset tariffs that they use to determine how much they will pay. What most people do not realise is that these do not always cover the cost of specialist treatment in hospital.

The doctors and specialists do not have to charge rates according to to the pre-set tariffs.

Protect Yourself Now

The shortfall can be quite substantial. You might be charged as much as 300% or 400% of what the medical aid will pay out. You will then be expected to pay the rest.

If you do not want to have to scrounge around for thousands of Rands in an emergency, you need gap cover in South Africa.

Gap Cover in South Africa

Gap cover in South Africa is available to medical aid members only. If you belong to a medical scheme, just complete and send the form to get a quote

There are plenty of options out there so do your homework and see which works best for you. Start doing your research right away.



Sanlam Gap Cover

Perhaps you would prefer to stick to a trusted name in South African insurance – Sanlam. Sanlam is a household brand that has been in business since 1918.

Sanlam asks for your information and then recommends a suitable plan. You don’t have to do the running around.

The cover will also extend to your immediate family members as well.



Will You Be Able to Apply?

Most people will; there are no medical checks and just a simple form to complete. The main criteria are:

  • Only people 59 or under can apply
  • You must already be a member of a registered medical aid
  • If you have pre-existing conditions, you may still apply, but there will be a waiting period imposed.


The Cost of Not Being Covered

Imagine getting home after being in the hospital and finding out that the medical aid has only paid a third or quarter of the total bill. Most specialists do not charge medical aid rates. This gives the medical aid licence to pay only a portion of the bill.

Now, when it comes to a GP visit or medication not covered, it is not a lot to pay. When it comes to hospital stays, however, it can be many thousands of Rands.



The Cost of Gap Cover in South Africa

Sanlam offers two plans – the Comprehensive Cover and the Standard Cover.

The former will cost you R152 on a monthly basis. The latter comes in at R125 on a monthly basis but the cover offered is less extensive.

You can choose the option that makes the most sense to you in terms of budget and your needs. Coverage starts after a general waiting period of three months. (There are exceptions when it comes to cover for pregnancy or pre-existing conditions.)

To get your complimentary gap cover quote, please complete and send the form


All info was correct at time of publishing