Why Gap Cover is Vital for Medical Aid Members

Gap cover is vital because costs of medical treatment are steadily rising.

Gap cover will save you from paying extra, unexpected expensive medical bills.

Thus, it is imperative to consider taking a gap policy. Now is the time to make a decision on having a financial backup plan.

Gap Cover is Vital for Medical aid Members

Let’s face it, everything is getting more expensive but specialist and hospital costs are going through the roof. Here is a list of the top Gap cover providers in South Africa that can help control the


You will get a cover for monthly premiums of R274, and a maximum of R521. Zestlife Universal Gap Cover enhanced benefits for 2019 are:

  • 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 to R7 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.


Medical Gap Cover is VitalStratum

The gap cover from Stratum includes

  • costs related to specialist fee
  • Expenses related to co-payments
  • The comprehensive cover includes CT and MRI scans and other procedures in the hospital.


The gap cover from Turnberry will come at affordable rates. Further, the cover is offered up to 500% of the medical insurance rates.

The Elect-A-Care Standard plan covers:

  • Deductibles
  • Scopes
  • Scans
  • Some out-patients scans
  • Costs incurred while at the hospital.

Essential Gap Cover

However, this package does not cover for co-payments and sub-limits

The Cover will pay out the shortfall up to 500% the standard medical tariffs with a total plan of R250, 000 yearly.

The prestige package will cost you R160 per month, covering your immediate family.

Even more options…


This is a premium gap cover that will pay up to 500% of the set medical rates, with an annual cap of R2 million for the whole family.

Expenses incurred while at the hospital are covered.

Cover for outpatient includes chemotherapy and radiotherapy.

They also cover out-patient treatment for renal failure.

Complimed Gap Cover

Another gap cover option.


If you are looking for value for money package, Sirago offers you the perfect option

Further, the cover caters for optometry and dentistry as long as you attend the preferred hospital.


This is just a basic gap cover.


Talksure is one of South Africa’s leaders concerning gap cover.

Why Gap Cover is Vital

Indeed, 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.

By law, health schemes must pay out per the Medical Scheme Tariffs. But doctors often charge way more than these tariffs, which leaves you to pay the shortfall.

Hence, gap cover is vital if you are on a medical aid.

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All info was correct at time of publishing