Sirago Underwriting Managers

Our Gap Cover Product Information

Our competitive and affordable products are unparalleled in the market place and are the ideal complement to your overall healthcare portfolio. With a range of insurance solutions, Sirago provides comprehensive effective cover to suit every individual.

Disclaimer:
Gap cover is not a substitute for a medical scheme membership and the cover is not the same as that of a medical scheme. This is a Short-term Insurance Accident and Health policy in terms of the Short-term Insurance Act 53 of 1998. The policy wording supersedes any marketing documentation and all benefits will be payable against the policy wording terms and conditions only.

Ultimate Gap Cover

Our most comprehensive option with an extensive range of benefits.

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Plus Gap Cover

Affordable cover that’s right for you.

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Sirago gap assist cover

Gap Assist Cover

A great start to your gap cover.

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Gap Core Cover

Affordable cover for the family.

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Sirao gap lite cover

Gap-Lite Cover

For the younger generation.

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sirago exact hero

Exact Cover

Cover for specific procedures that your medical scheme excludes.

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Exact with Gap and Co-pay Cover

Cover for specific procedures that your medical scheme excludes, with additional gap and co-payment cover.

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Gov Gap

A tailor-made solution for government employees.

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Gap Cover Comparison

in-hospital gap benefits

In-hospital Benefit Comparison

The Gap products below have an Overall Annual Limit (OAL) of R183 000 per beneficiary​

Ultimate Gap

from R532
Per Month

Benefits

  • R201 000 OAL Annual Limit Per Beneficiary Per Annum
  • 500% Gap Cover Additional 500%, BMI 0018 &0019.
  • Robotic Surgery R35 000
  • Co-payments Subject to OAL.
  • Co-payments charged as a percentage Subject to OAL.
  • Penalty Fee cover R16 000 per claim, max 2 claims per policy.
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL.
  • PMB Cover Subject to OAL.
  • Hospital Account Shortfall R7 000 per policy, R1 500 per claim. Private ward R2 000 sub-limit
  • Sub-Limit Enhancer R35 000 per claim. For MRI Scans, CT Scans, Intraocular Lenses and Internal Prostheses only.
  • Step Down R11 000 per policy.
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Plus Gap

from R395
Per Month

Benefits

  • R201 000 OAL Annual Limit Per Beneficiary Per Annum
  • 500% Gap Cover Up to 500%, max 600%
  • Robotic Surgery R15 000
  • Co-payments Subject to OAL.
  • Co-payments charged as a percentage Subject to OAL.
  • Penalty Fee cover R11 650 per claim, max 1 claim per policy.
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL.
  • PMB Cover Subject to OAL
  • Hospital Account Shortfall R4 500 per policy, R950 per claim. Private Ward R1 000 sub-limit.
  • Sub-limit Enhancer R30 000 per policy, R12 000 per claim. MRI Scans and CT Scans.
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Gap Assist

from R366
Per Month

Benefits

  • R201 000 OAL Annual Limit Per Beneficiary Per Annum
  • 500% Gap Cover Additional 500%, max 600%
  • Co-payments R12 000 p/c
  • Penalty Fee cover R6 500 per claim, max 1 claim per policy.
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL.
  • PMB Cover Subject to OAL.
  • Hospital Account Shortfall R3 000 per policy, R500 per claim. Private Room R1 000 sub-limit.
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Gap Core

from R360
Per Month

Benefits

  • R201 000 OAL Annual Limit Per Beneficiary Per Annum
  • 350% Gap Cover Up to 350%, max 400%
  • Robotic Surgery R18 000
  • Co-payments Subject to OAL.
  • Co-payments charged as a percentage Subject to OAL.
  • Penalty Fee cover R11 500 per claim, max 1 claims per policy.
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL.
  • PMB Cover Subject to OAL.
  • Hospital Account Shortfall R4 500 per policy, R950 per claim. Private ward R1 000 sub-limit
  • Sub-Limit Enhancer R26 000 - R13 000 per claim. MRI & CT scans, internal prostheses, and Transcatheter Aortic Valve Implantation (TAVI) procedure valves only..
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Gap Lite

from R289
Per Month

Benefits

  • R201 000 OAL Annual Limit Per Beneficiary Per Annum
  • 250% Gap Cover Additional 250%, max 350%
  • Co-payments R25 000 - R7 500 p/c
  • Penalty Fee cover R5 000 per claim, max 1 claim perp policy.
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL.
  • PMB Cover Subject to OAL.
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Gap Only

from R140
Per Month

Benefits

  • R201 000 OAL Annual Limit Per Beneficiary Per Annum
  • 200% Gap Cover Additional 200%, max 300%
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL.
  • PMB Cover Subject to OAL.
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out-of-hospital gap benefits

Out-of-Hospital Benefit Comparison

Ultimate Gap

from R532
Per Month

Benefits

  • Primary Care Consultation Benefit Max R5 000. R800 per claim. (Consultation only)
  • Emergency Room Cover Sub-limit of R15 000. Accident &Trauma - stated benefit. Illness 9 years and older - R2 500 stated benefit. Emergency Illness - children 8 years and younger - stated benefit.
  • Day-to-day Specialist Consultation Fee R6 500, R1 500 per claim.
  • Preventative Care Cover R8 500 sub-limit per policy, R1 350 per claim.
  • Appliance Benefit R7 500 per policy.
  • Trauma Counselling R10 000 per policy. Cover first 6 months after incident.
  • Accidental Dental Benefit R10 000 per policy, R2 500 per tooth.
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Plus Gap

from R395
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R10 000. Accident - stated benefit. Illness 9 years and older - R1 500 stated benefit. Emergency Illness - children 8 years and younger - stated benefit.
  • Day-to-day Specialist Consultation Fee R5 000, R1 000 per claim.
  • Preventative Care Cover R4 500 sub-limit per policy, R900 per claim, 2 claims per policy.
  • Appliance Benefit R5 500 per policy.
  • Trauma Counselling R6 000 per policy. R800 per claim. Cover first 6 months after incident.
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Gap Assist

from R366
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R6 500. Accident & Trauma - stated benefit. Illness - children 8 years and younger - stated benefit.
  • Appliance Benefit R4 000 per policy, R1 300 per claim
  • Trauma Benefit R4 000 per policy, Cover first 6 months after incident.
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Gap Core

from R360
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R2 000. Accident &Trauma.
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Gap Lite

from R289
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R4 500. Accident & Trauma - stated benefit. Illness - children 8 years and younger - stated benefit.
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Gap Only

from R140
Per Month

No Benefits

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Cancer Benefits

Ultimate Gap

from R532
Per Month

Benefits

  • Cancer Co-payment Benefit Subject to OAL.
  • Cancer Benefit - Boost Subject to OAL.
  • Cancer Benefit - Breast Reconstruction 500% for the reconstruction of the affected breast, R40 000 for the unaffected breast.
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Plus Gap

from R395
Per Month

Benefits

  • Cancer Co-payment Benefit Subject to OAL.
  • Cancer Benefit - Boost Subject to OAL.
  • Cancer Benefit - Breast Reconstruction 500% for the reconstruction of affected breast, R25 000 for unaffected breast.
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Gap Assist

from R366
Per Month

Benefits

  • Cancer Co-payment Benefit R20 000 per claim.
  • Cancer Benefit - Boost R50 000 per beneficiary.
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Gap Core

from R360
Per Month

Benefits

  • Cancer Co-payment Benefit Subject to OAL.
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Gap Lite

from R289
Per Month

No Benefits

Gap Only

from R140
Per Month

No Benefits

Value Added Benefits

Ultimate Gap

from R532
Per Month

Benefits

  • Gap Cover Premium Waiver 6-month period.
  • Medical Scheme Premium Waiver R5 500 p/m for a 6-month period.
  • Accidental Death Principle Policyholder - R16 000, Adult - R11 000, Child - R6 000.
  • Cancer Cover (Initial Diagnosis) Lump sum of R30 000 per beneficiary.
  • Sira-Go' Baby R2 500 per newborn child.
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R9 000.
GET GAP COVER

Plus Gap

from R395
Per Month

Benefits

  • Gap Cover Premium Waiver 6-month period
  • Medical Scheme Premium Waiver R4 000 p/m for a 6-month period
  • Accidental Death Principle Policyholder - R8 500, Adult - R5 500, Child - R3 000.
  • Cancer Cover (Initial Diagnosis) Lump sum of R18 000 per beneficiary.
  • Sira-Go' Baby R2 000 per newborn child.
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R9 000.
GET GAP COVER

Gap Assist

from R366
Per Month

Benefits

  • Gap Cover Premium Waiver 6-month period
  • Sira-Go' Baby R2 000 per newborn child.
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R9 000.
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Gap Core

from R360
Per Month

Benefits

  • Sira-Go' Baby R1 500 per newborn child.
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R9 000.
GET GAP COVER

Gap Lite

from R289
Per Month

Benefits

  • Sira-Go' Baby R1 500 per newborn child.
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R9 000.
get gap cover

Gap Only

from R140
Per Month

No Benefits

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