Gap Cover & Co-Pay

Irrespective of Medical Aid or Hospital Plan
Gap and Co-Pay Cover has become a necessity

Sirago Gap & Co-Pay

Underwritten by GENRIC Insurance, an authorised Financial Services Provider and registered Short-term Insurer. Our core business revolves around the provision of critical benefits to policyholders who are faced with unforeseen medical expense shortfalls which are not fully covered by their medical scheme.

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Under 65yrs

ULTIMATE GAP: R498, Family: R566

PLUS GAP: R395, Family: R452

GAP ASSIST: R342, Family: R371

GAP LITE: R249, Family: R269

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Even if you have medical aid, you could be faced with huge medical bills to pay in over and above what your medical aid will cover. For these cases, gap cover can help alleviate the financial strain – especially for large medical expenses in the case of a serious illness or accident.

APPLICATION FORM

Under 60yrs

COMPREHENSIVE GAP COVER

Individual: R246 per month

Family: R429 per month

Core Option Available

DISCOUNT for Fedhealth & Bonitas Members

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Discovery Gap Cover is a non-life insurance policy, underwritten by Discovery Insure. The product is designed to cover shortfalls on approved in-hospital specialist claims, specific out-of-hospital costs related to an approved hospital admission, and co-payments on approved cancer-related claims.

APPLICATION FORM

CORE GAP Under 55yr

Classic Plans: R130 Single, R225 Family

Essential Plans: R265 Single, R621 Family

COMPREHENSIVE GAP Under 55yr

Classic Plans: R206 Single, R348 Family

Essential Plans: R388 Single, R885 Family

2023 BROCHURE

Liberty/Zestlife, Underwritten by Guardrisk Insurance, an authorised Financial Services Provider and registered Short-term Insurer. Cover you can trust. People you can depend on. Protect yourself against unexpected medical expense shortfalls when you get charged more than what your medical aid pays.

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ESSENTIAL GAP

Single Under 55yrs: R351

Single 55yrs-64yrs: R439, 65yrs Plus: R520

Family Under 65yrs: R439, Any Over 65yrs: R520

UNIVERSAL GAP

Single Under 55yrs: R478

Single 55yrs-64yrs: R606, 65yrs Plus: R710

Family Under 65yrs: R606, Any Over 65yrs: R710

OPTIMAL GAP

Under 35yrs Only: R225pm

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What is Gap Cover

Gap cover is a short-term insurance product designed to provide extra protection for those who already have medical aid or a hospital plan. It covers the deficit between your medical scheme’s tariff (MST) and the actual rates charged by private healthcare professionals. Medical aid schemes in South Africa currently reimburse doctors and specialists at 100%, 200%, or 300% of the scheme rate. In reality, however, professional medical providers may and often charge up to five times the base tariff, known as the medical aid rate.

By subscribing to Gap Cover you protect yourself and your family against this financial disparity, potentially avoiding significant out-of-pocket medical expenses. Gap cover can help alleviate financial strain. Even if you have medical aid or a hospital plan, you could be faced with huge medical bills above what your medical aid will cover.

Gap cover works by covering the difference or shortfall between what your Doctor charges and what your medical aid pays from the Risk or hospital benefit. ... Depending on the option you select, you can also have cover for Medical aid Co-payments, Sub-limits and cancer treatment shortfalls.

What does gap insurance not cover? Most importantly, if it is not authorised by the medical aid or hospital plan - gap will not pay. Your cover is subject to the health plan you on and gap product taken.

Does gap insurance work? Is gap insurance worth it? The simple answer is YES - irrespective of the company you are with or the plan you are on - we always recommend having gap cover! Get Gap Now with OneNet - you won't pay more, just know more! We do not charge a broker fee on our Gap Plans.

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