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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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 R472
Per Month

Benefits

  • R183 000 OAL
  • 500% Gap Cover Additional 500%, BMI 0018 &0019, R15 000
  • Co-payments Subject to OAL
  • Co-payments charged as a percentage R17 500 per claim
  • Penalty fee cover R13 000 per claim, max 3 claims per person
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL
  • PMB Cover Subject to OAL
  • Hospital Account Shortfall R6 000, R1 300 per claim, 3 claims per beneficiary. Private ward R2 000 sub-limit
  • Sub-limit Enhancer R100 000, R25 000 per claim. 4 claims per policy. For MRI Scans, CT Scans, Intraocular Lenses and Internal Prostheses only.
  • Step Down R11 000 per policy
GET GAP COVER

Plus Gap

from R370
Per Month

Benefits

  • R183 000 OAL
  • 500% Gap Cover Additional 500%, max 600%
  • Co-payments Subject to OA
  • Co-payments charged as a percentage R13 000 per claim
  • Penalty fee cover R9 100 per claim, max 1 claims per person
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL
  • PMB Cover Subject to OAL
  • Hospital Account Shortfall R850 per claim, 3 claims per beneficiary. Private Ward R1 000 sub-limit.
  • Sub-limit Enhancer MRI Scans and CT Scans. R30 000, R11 500 per claim. 2 claims per beneficiary, 3 claims per policy.
GET GAP COVER

Gap Assist

from R322
Per Month

Benefits

  • R183 000 OAL
  • 500% Gap Cover Additional 500%, max 600%
  • Co-payments R42 000, R11 000 per claim
  • Penalty Fee R6 000 per claim, 1 claim
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL
  • PMB Cover R30 000 per claim
  • Hospital Account Shortfall R2 000 per person per annum, R500 per claim, 3 claims per beneficiary
get gap cover

Gap Lite

from R234
Per Month

Benefits

  • R183 000 OAL
  • 250% Gap Cover Additional 350%
  • Co-payments R25 000, R5 500 per claim
  • Penalty fee cover R3 000 per claim, max 2 claims
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL
  • PMB Cover R50 000 per person, max of R20 000 per claim
get gap cover

Gap Only

from R124
Per Month

Benefits

  • R183 000 OAL
  • 200% Gap Cover 200% Gap Cover, max 300%
  • Day Hospital/Clinic/In-room Surgical Procedures Subject to OAL
  • PMB Cover R30 000 per person, max of R12 000 per claim
get gap cover
out-of-hospital gap benefits

Out-of-Hospital Benefit Comparison

Ultimate Gap

from R472
Per Month

Benefits

  • Primary Care Consultation Benefit Sub-limit of R5 000. R400 per claim.
  • Emergency Room Cover Sub-limit of R12 000. Accident &Trauma - stated benefit. Illness 9 years and older - R2 000 stated benefit. Emergency Illness - children 8 years and younger - stated benefit.
  • Day-to-day Specialist Consultation Fee R6 500, R1 350 per claim, 4 claims per beneficiary
  • Preventative Care Cover R8 000 sub-limit per policy, R1 000 per claim, 4 claims per beneficiary
  • Appliance Benefit R7 000 per policy.
  • Trauma Counselling R8 000, 3 claims per beneficiary. R950 per claim children 13 years and younger. R750 per claim for those 14 years and older.
GET GAP COVER

Plus Gap

from R370
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R9 000. Accident - stated benefit. Illness 9 years and older - R1 000 stated benefit. Emergency Illness - children 8 years and younger - stated benefit.
  • Day-to-day Specialist Consultation Fee R4 500, R950 per claim, 3 claims per beneficiary.
  • Preventative Care Cover R4 000 sub-limit per policy, R800 per claim, 3 claims per beneficiary.
  • Trauma Counselling R4 000, 3 claims per beneficiary. R800 per claim children 13 years and younger. R600 per claim for those 14 years and older.
GET GAP COVER

Gap Assist

from R322
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R6 000. Accident - stated benefit. Illness - gap portion only.
  • Appliance Benefit R3 600 per policy, R1 200 per claim
get gap cover

Gap Lite

from R234
Per Month

Benefits

  • Emergency Room Cover Sub-limit of R4 000. Accident - stated benefit. Illness - gap portion only.
get gap cover

Gap Only

from R124
Per Month

No Benefits

get gap cover

Cancer Benefits

Ultimate Gap

from R472
Per Month

Benefits

  • Cancer Co-payment Benefit Subject to OAL
  • Cancer Benefit - Boost Subject to OAL
  • Cancer Benefit - Breast Reconstruction 300% for the reconstruction of the affected breast, R25 000 for the unaffected breast
GET GAP COVER

Plus Gap

from R370
Per Month

Benefits

  • Cancer Co-payment Benefit Subject to OAL
  • Cancer Benefit - Boost Subject to OAL
  • Cancer Benefit - Breast Reconstruction 200% for the reconstruction of affected breast, R18 000 for unaffected breast
GET GAP COVER

Gap Assist

from R322
Per Month

Benefits

  • Cancer Co-payment Benefit Subject to OAL, R18 000 per claim
  • Cancer Benefit - Boost R50 000 per beneficiary
get gap cover

Gap Lite

from R234
Per Month

Benefits

  • Cancer Benefit - Boost R25 000

Gap Only

from R124
Per Month

No Benefits

Value Added Benefits

Ultimate Gap

from R472
Per Month

Benefits

  • Gap Cover Premium Waiver 12-month period
  • Medical Scheme Premium Waiver R5 000 p/m for a 6-month period
  • Accidental Death Principle policyholder R15 000, Adult R10 000, Child R5 000
  • Cancer Cover (Initial Diagnosis) Lump sum of R25 000
  • Sira-Go' Baby R2 500 per newborn child
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R12 000.
GET GAP COVER

Plus Gap

from R370
Per Month

Benefits

  • Gap Cover Premium Waiver 12-month period
  • Medical Scheme Premium Waiver R3 750 p/m for a 6-month period
  • Accidental Death Principle policyholder R8 000, Adult R5 000, Child R3 000
  • Cancer Cover (Initial Diagnosis) Lump sum of R16 000
  • Sira-Go' Baby R2 000 per newborn child
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R12 000
GET GAP COVER

Gap Assist

from R322
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 R12 000
get gap cover

Gap Lite

from R234
Per Month

Benefits

  • Sira-Go' Baby R2 000 per newborn child
  • Sirago MedCare (Free Medical scheme ADR) Claims exceeding R12 000
get gap cover

Gap Only

from R124
Per Month

No Benefits

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