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!

All info was correct at time of publishing