Gap-Lite Cover

Your whole policy has an Overall Annual Limit (OAL) of R164 000 per beneficiary to utilise.

INDIVIDUAL, UNDER 54
R203 / mon
INDIVIDUAL, 65+
R285/ mon
FAMILY, UNDER 54
R218 / mon
FAMILY, 65+
R325/ mon

Benefits

Image

In-hospital Benefits

Gap Cover

Will settle claims at an additional 200% above medical scheme rate or at the stated benefit value.

Co-payments

The excesses imposed by your medical scheme payable to a maximum rand limit for specified procedures or tests. Cover for co-payments imposed by medical schemes for hospital admissions, scans and surgical procedures. Co-payment benefits are subject to a sub-limit of R25 000 per policy per annum, limited to R5 500 per claim.

Penalty Fee Cover

Subject to a sub-limit of R3 000 per claim, a maximum of 2 claims per policy per annum for the voluntary use of a nondesignated service provider/network hospital. This includes the use of a partial cover network hospital as determined by your medical scheme.

Room Surgical Procedures Cover

Will settle the Gap portion of claims.

PMB Cover

This benefit will cover your Gap portion for the voluntary use of a non-designated service provider for planned procedures, except in the event of an emergency. R50 000 sub-limit per policy per annum.

Ou-of-hospital Benefits

Emergency Room Cover

A sub-limit of R4 000 is applicable. This benefit covers an emergency at any registered emergency facility when you require immediate medical treatment due to an accident or illness. The following benefits collectively accumulate to the sub-limit: Accident benefit: all costs related to the accidental event will be covered and paid to a maximum value of the sublimit available, whether you are liable to pay the costs related to the emergency event out of your own pocket or if your medical scheme pays from your savings account. Illness benefit: when you visit an emergency room in a medical emergency as a result of illness, we will cover the Gap portion only if the medical scheme has paid a portion. We will cover a GP’s emergency facility where no hospital emergency is available within a 30km radius within the above-stated benefit limits.

Value Added Benefits

Image
Sira-Go’ Baby

A branded Sirago welcome gift will be posted (or delivered to your contracted broker) to your physical address as per your application form upon receipt of the instruction to add the new-born child. The instruction must be submitted within 31 days of the birth of the child to the policy. Subject to availability. Please allow 6 weeks for delivery.

asset-2.png

Sirago Underwriting Managers (Pty) Ltd is an Authorised Financial Services Provider (FSP:4710).
Underwriting Agency for GENRIC Insurance Company Limited (FSP:43638).
GENRIC is an Authorised Financial Services Provider and Registered Short-term Insurer.

asset-4.png

Contact

Tel: 010 599 1163

Fax: 086 508 2292

Email: info@sirago.co.za

Address: Midrand Business Park, Building 3, 563 Old Pretoria Main Road, Midrand, 1685

Follow Us

Copyright © 2020 Sirago Underwriters.

Search

+880 322448500 Beverly Boulevard Los Angeles