Why Gap Cover is So Essential For Existing Medical Aid Members

Why Gap Cover is Vital for Medical Scheme Members

It is a known fact that the cost of medical treatment is steadily on the rise. As such it is imperative to consider taking a gap policy. A gap is very significant since it will save you from paying extra expensive medical bills.


These additional expensive medical bills can also have a significantly great effect on your budget and savings.

If you are an active member of a medical scheme, you might be led to believe you have full cover for any medical emergency treatment.

However, you could be wrong, and you could find yourself paying for extra bills.

What is more, you might find yourself exceeding your health cover set limits more quickly than you anticipated.

Although you are entitled to certain minimum benefits by the law, you do not have any assurance doctors will not charge you more than the set medical limits.

As such, a medical gap cover is vital.

gap cover is vital

Gap Cover is Vital for the Shortfall

Here is where medical shortfalls draw their importance since it will foot the bill that is not paid by your health cover.

Which Company to choose?


Zestlife, our favourite, has announced enhanced benefits in 2019, including:

  • Overall regulatory maximum for medical expense shortfall cover increased from R150 000 to R160 000.
  • Cancer lump sum increased from R25 000 to R30 000.
  • Casualty benefit increased from R10 000 to R20 000. Casualty visit must be within 48 hours of the accident.
  • Medical Aid and Gap Cover Premium Waiver maximum increased from R6 500 toR7 300.
  • Medical Aid and Gap Cover Premium Waiver limited to accidental only, but the payment period increased from 3 to 12 months. This change was due to legal requirements.
  • Accidental dentistry maximum increased from R15 750 to R19 250 and amount per tooth increased from R2 250 to R2 750.
  • Non-Designated Service Provider co-payment increased from R8 600 to R9 300.
  • Oncology co-payment maximum increased from 20% to 25%.
  • Cover for robotic procedures up to R30 000.
  • Cover for procedures in day clinics.
  • New Oncology Benefit to cover 20% of treatment cost when oncology limit is exceeded.
  • Varicose veins have been added as an out-of-hospital procedure that is covered.

Zestlife Premiums in 2019:








To request a Zestlife gap cover quote, simply enter your details into the form provided and click the GET A QUOTE button!

All info was correct at time of publishing