Gap cover
Medical aids unfortunately do not cover everything when it comes to
being hospitalisation. These shortfalls can be claimed back from a Gap cover policy.
Gap Cover
Gap cover serves to cover shortfalls where doctors in hospital charge above the medical aid rate, as a medical aid will only pay up to their specified medical aid rate from the Risk or hospital benefit. Gap cover cannot provide cover where medical aid does not pay towards a procedure or covers the full amount for a procedure. Gap cover can provide cover for this shortfall with options for an additional 250% up to an additional 500% of the medical aid rate cover for in-hospital specialist account shortfalls.
Co-payments
Many medical aids charge upfront co-payments for hospital admission for certain procedures. This can be a huge amount a client has to pay for out of their pockets depending on the medical aid and the procedure.
Other benefits
many of the GAP providers also cover additional benefits such as casualty for accidental emergencies, not covered by your medical aid, Oncology treatment shortfalls, sub-limit benefits for when a limit is reached in hospital for things like Prosthesis limits, MRI/CT scans etc, Premium waiver benefits for medical aid and GAP premiums, etc
We have contracts with the following GAP providers: Ambledown, Sirago GAP, Sanlam GAP and Zestlife GAP.
We have contracts with the following Gap providers:
