GAP COVER / TOP UP

What is Gap Cover and why do I need this cover?

The rising cost of private hospitalization and specialist costs had a dramatic effect on the rising of medical inflation, increase in medical scheme premiums and the decrease in benefit offerings on medical schemes. The decrease in non-life threatening benefits offerings such as dental-, optometry-, pathology-, radiology, and auxiliary necessitated medical schemes to manage some of these expenses to the member as an out-of-pocket expense. The rising cost of private hospitalization also necessitated medical schemes to implement procedure related in-hospital co-payments / deductibles that are out-of-pocket expenses to the member. Medical schemes will pay for in-hospital costs at 100-300% medical scheme tariff, therefore resulting in a shortfall and out-of-pocket expense to the member.

GAP COVER is a short-term product that will cover the above-mentioned expenses for the member by refunding these shortfalls up to 500% of scheme tariff and also refund procedure related deductibles. Thus, providing you the Peace of Mind that you will be covered for these in-hospital expenses and will be in the same financial position as before your procedure.

Certain waiting periods or underwriting will be applicable ( see product brochures in download folder)

The following Gap Cover products are available to you e.g. Stratum, Turnberry, Complimed, Admed, and Sirago.