Making a Gap cover Claim from Sanlam

If you have gap cover from Sanlam, you will be required to put in a gap cover claim following a hospital visit.

Going to hospital is not something that we expect to happen.

After all, no one really thinks about disease or injuries resulting from accidents.

And so, only a few of us, are prepared when such an eventuality happens.

However, in the event they do occur, your medical insurance will pay all the bills, won’t they? That is what most people think, however, that is not strictly true.

Gap cover Claim – what Most people Don’t know

Gap cover claim

A number of medical schemes will cover 100% of the standard medical rate, however, a medical specialist may charge 200% or 300% more than the standard rates.

Once your health cover pays out 100% of your claim according to their rates, there will still be the specialists fee for you to pay. It’s a legal fact, and you can do little about it.

Luckily, you can protect yourself without switching to a more expensive insurance cover. Gap cover from Sanlam will, at most, cost you a monthly premium of R152.

However, if you feel that a more basic plan suits you, you can pay a monthly premium of R125.

Do I qualify?

The joining procedure is not that strict. You must be no older than 60 years and an active member of a registered medical aid plan.

Gap Cover claim for the whole Family?

You can only cover your dependents below 27 years on your policy. However, Sanlam considers other individual dependents on a case to case basis.

Wait out the waiting period.

There is a three-month waiting period for the general cover. If you have a pre-existing health condition or pregnancy, you wait for 12 months.

No muss No fuss Cover

To ensure the policy remains as affordable as possible, members can only make a gap cover claim for certain treatments.

  • Sanlam does not cover aesthetic surgery unless prompted by injury or cancer.
  • Dentistry is only covered due to cancer or injury.
  • No cover for weight loss treatment, or gastric band surgery.
  • Sanlam does not cover costs incurred outside hospitals.

To cover, or Not to Cover?

The cost of treatment and a normal GP in South Africa can be expensive, but when you get into consultancy fields, they’re even worse.

The majority of facilities require you to deposit a few thousand Rands before they can admit you.

Thus, focus on your recovery and not how you will settle the bills. Take gap cover, it is a responsible financial choice.

Get a Gap Cover Quote by filling in and submitting the form. It’s FREE!

Published:

Updated:

Latest posts

  • Which are the Top Gap Cover Companies in South Africa?

    There are many companies that offer gap cover, so which are the top gap cover companies in South Africa? Here is a look at four of the best options. Ambledown Ambledown offers 13 options for gap cover. Each option will cover costs at a different level. Gap cover with Ambledown can be purchased from Constantia…

    Read more

  • Zestlife Shortfall Insurance is the SA Leader

    Zestlife Gap Cover Information One of the biggest headaches for health aid members is the shortfall, also known as the gap, which is the difference between what doctors charge and what schemes pay out. Hence, Zestlife shortfall insurance takes steps to cater for the extra costs that arise. The upper limits set by medical aids…

    Read more

  • Medical Gap Cover for Diabetics – Learn More About Gap Cover for Diabetics

    Gap cover and Diabetes – Information for People With Diabetes Diabetes acquired in one’s adult life is lifestyle condition, and it is becoming increasingly common. On the other hand, health covers are paying less for medical expenses frequently. As such you might have questions about medical gap cover and diabetes. Typical diet from the west…

    Read more

Share via
Copy link