Gap Cover

The current environment within the private healthcare industry allows specialists to charge above the medical scheme tariffs.

All medical scheme members are at risk and current trends suggest that the consumers will have to fund the difference in fees.

Gap Cover is a short-term insurance product in addition to your medical aid scheme that offers up to 500% of scheme tariff when you are hospitalised. This option is not only suggested to ensure you are completely covered but it also provides a peace of mind that not many other products can offer.

Below is an example of the shortfalls a medical aid member may experience:


Amount charged by practitioner

Potential Shortfall Incurred (Practitioner cost minus medical scheme payout)

Gap Cover Benefit (paid directly to you)*

Natural child birth

R8 308

R5 359

R5 359

Caesarean section

R15 343

R9 548

R9 548


R19 156

R14 367

R14 367


R7 528

R5 648

R5 648

Coronary Bypass

R43 112

R29 153

R29 153

There are certain Medical Schemes that could require a co–payment for certain procedures in hospital. These hidden costs are addressed by Gap cover to ensure you are fully covered for any procedure you might have to go under.

Before signing up for a Gap Cover plan there are a few important aspects to take note of:

  • One premium covers your whole family
  • You cannot apply for Gap cover if you are not on a medical scheme
  • Gap cover pays up to 500% of the scheme rate directly to you
  • Group schemes are available


Get completely covered and sign up for Gap cover today, just download and fill in our application form

If you need any further information please feel free to contact us.

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