Sanlam Medical Shortfall Cover

When choosing a short-term insurance policy, many South Africans always turn to a name they can rely on. Sanlam medical shortfall cover is reliable and affordable.

For under R200 a month families can buy themselves peace of mind when it comes down to those unforeseen medical costs not covered by their medical aid schemes.

Sanlam medical Shortfall cover For the Family

Sanlam imposes a maximum joining age limit of 60 years but allows its clients to add their parents as beneficiaries. Also covered is the principal holder’s spouse or life partner and children.

What is Sanlam medical Shortfall cover?

Sanlam medical shortfall coverIt is a form of short-term insurance that covers the cost between medical scheme tariffs and charges imposed by the medical profession for hospital treatments.

Why do you need Gap Cover?

Medical schemes operate according to a set schedule of tariffs. Most times these amounts are way below what medical practitioners charge for their services.

In fact, it is not uncommon for medical practitioners to impose costs five times higher than what a medical scheme is prepared to pay.This leaves the medical aid member out of pocket and facing exorbitant bills that often cannot be met by the financial constraints on family budgets.

Who qualifies for Sanlam Medical Shortfall Cover?

All members of a registered South African medical scheme qualify for Gap Cover.

What does Sanlam offer?

Sanlam medical shortfall cover provides two plans. These have been tailored to meet individual lifestyles and financial budgets.

Standard Plan

  • R144 monthly premium
  • Benefits during hospitalisation
  • R13 000 per incident in sub-limits
  • Pays up to 500% of tariff shortfalls
  • Outpatient benefits
  • Up to R5 000 per incident in emergency benefits (accidental only)
  • R9 000 for premature births (34th week or earlier)

Comprehensive Plan

  • R174 monthly premium
  • Benefits during hospitalisation
  • R36 000 per incident in sub-limits
  • Pays up to 500% of tariff shortfalls
  • Unlimited Co-Payments for specified procedures, including MRI and CT scans
  • Unlimited cover for deductibles
  • Outpatient benefits
  • R300 000 for oncology treatments for each beneficiary
  • Up to R8 000 per incident in emergency benefits
  • R12 000 for premature births (34th week or earlier)

We do not cover the following –

As with most Gap Cover providers, Sanlam does not offer insurance for the following:

  • Specialised dental procedures
  • Cosmetic surgery, obesity or breast reconstruction after mastectomies
  • Penalties or Co-Payment limits imposed by a medical scheme for non-compliance of benefit rules
  • Claims that are older than six months


Sanlam’s Gap Cover goes a long way to meeting most needs, but consumers are nevertheless advised to study the fine print of their short term insurance policies before committing pen to paper.Obtaining the advice of a broker is another method to ensure that the Gap Cover selected is the best to suit individual needs.

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All info was correct at time of publishing