Sirago Underwriting Managers

Gap Only Cover

Our no frills, gap cover only solution. Smart, simple, value for money.

Key Benefits

OAL per beneficiary per annum:
R100 000

in-hospital gap benefits
In-Hospital Benefits

Gap Cover
Day Hospital/Clinic and/or In Room Surgical Procedures Cover
PMB Cover

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In-hospital Benefits

Gap Cover

We cover up to 200% above your medical scheme rates or at the stated benefit value, to a maximum of 300%.

Day Hospital/Clinic and/or In Room Surgical Procedures Cover

If you choose to have, or your medical scheme pre-authorises treatment that would normally be performed in a hospital, at a day hospital, clinic, or in a doctor’s room, we will pay the gap portion of claims.

PMB Cover

PMB Cover on this policy is for the shortfalls resulting from the use of a non-designated service provider for a planned PMB procedure. This is not applicable in the event of an emergency. Subject to a sub-limit of R30 000 per policy and up to R12 000 per claim.

Prescribed Minimum Benefits as defined in the Medical Schemes Act and Regulations determines that all scheme members have access to certain minimum health benefits, regardless of your medical scheme option. This includes a requirement for medical schemes to pay the full cost of diagnosis and treatment of a list of medical conditions.

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