Medical Aid Gap Cover

Does your medical aid leave you with a shortfall?  If so you need GAP Cover.  GAP Cover will cover the difference between what your medical aid pays and what the doctors charge, up to 500% of medical aid rates.
          It also covers:
  • Co –payments which are often imposed by your medical aid for certain procedures, i.e. MRI/CT Scans.
  • Cover for Sub Limits (e.g, limits in respect of a prosthesis).
  • Additional cover for cancer treatment once your oncology treatment limit has been reached.
These shortfalls are covered by the GAP Select Package.  This covers the whole family and costs R234.00pm (including administration fee).  Certain procedures are covered on an out-patient basis, such as cataract removal, tonsillectomy, sinus surgery and childbirth in a non-hospital setting.

Should you and your spouse be on two different medical aids, you will qualify for one GAP Cover Policy.  Should any of your children over the age of 21 be on your medical aid policy they can remain on your GAP Cover Policy until age 25 provided they are full time students.  A full list of out-patient procedures as well as policy documents outlining waiting periods and exclusions is available on request.
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