GAP COVER
COMPARISON
With our Gap Cover Comparison Tool,
we eliminate the headache of
selecting the perfect Gap Cover
solution for your needs.
BENEFITS
Costs
Individual |
Family |
R223 000 Overall Annual Limited Per Beneficiary Per Annum (from 1 April 2026)
In-hospital Benefits
Gap Cover |
Robotic Surgery |
Co-payments & co-payments charged as a percentage |
Penalty Fee Co-payments |
Day Hospital/Clinic and/or In-Room Surgical Procedures Cover |
PMB Cover |
Hospital Account Shortfalls |
Sub-limit Enhancer |
MRI/CT Scan |
Step-down (includes accident, strokes and Cancer Treatment) |
Out-of-hospital Benefits
Primary Care |
Specialist Consultation Fee |
Casualty Benefit – After Hours (18:00 pm – 07:00 am) and all Saturday, Sundays, and all Public Holidays |
Preventative Care Cover |
Appliance Benefit |
Trauma Counselling |
Accidental Dental |
Cancer Benefits
Cancer Co-payment Benefit |
Cancer Benefit – Boost |
Cancer Benefit – Breast Reconstruction |
The following benefits do not form part of the aggregated OAL.
Value-added Benefits
Gap Cover Premium Waiver |
Medical Scheme Premium Waiver |
Accidental Death |
Cancer Cover (Initial Diagnosis) |
Sira’Go Baby |
MedCare cover |
* pc – Per claim | pb – Per beneficiary | pm – Per month. All benefit categories are per policy. Refer to Policy Wording for full details and explanations. This document is for basic information purposes only. Premiums are reviewed and may be adjusted annually.