Dis-Chem Gap Cover
Overall, Dis-Chem offers 2 Gap Cover plans, starting from R141 per month. Dis-Chem Gap Base and Dis-Chem Base Summit. Dis-Chem offers mobile apps for both Android and IOS.
Dis-Chem Gap Cover Summary
- ✅ Dis-Chem at a Glance
- ✅ Dis-Chem Gap Cover vs Other Notable Providers
- ✅ Dis-Chem Gap Cover Features
- Dis-Chem Gap Cover Premiums
- Dis-Chem Gap Cover Exclusions
- Dis-Chem Gap Cover Waiting Periods
- Dis-Chem Recent User Reviews
- Advantages of Using Dis-Chem Gap Cover – Unique Selling Points
- How to apply for Gap Cover with Dis-Chem
- How can I change my Dis-Chem Gap Cover option?
- How to Submit a Claim for Gap Cover with Dis-Chem
- Dis-Chem Regulation
- Dis-Chem Contact Details
- Our Verdict on Dis-Chem Gap Cover
- Dis-Chem Gap Cover Pros and Cons
- Dis-Chem Gap Cover FAQ
Dis-Chem at a Glance
| 📅 Date Established | 1978 (Dis-Chem) |
| 🖊️ Underwriters | Old Mutual Insure |
| 🏢 Headquartered | Midrand, Gauteng |
| 💻 Number of Markets | 1 |
| 📈 Market Share | <1% |
| 📊 Number of plans offered? | 2 |
| 📱 Is a Mobile App offered? | Yes |
| 💰 Social Media Platforms and Links | • Facebook • YouTube |
| 📞 Customer Support Operating Hours | Monday to Friday – 8 am to 5 pm |
| 💻 Waiting Period | 3 – 12 months |
| ❌ Exclusions | Yes |
Dis-Chem Gap Cover vs Other Notable Providers
| Gap Cover Provider | 1️⃣ Dis-Chem | 2️⃣ Auto & General | 3️⃣ Turnberry |
| Underwriters | Kaelo Risk (Pty) Ltd | 1Life Insurance Limited | Lombard Insurance Company |
| Number of Plans | 2 | 3 | 5 |
| Price | R141 | R99 | R155 |
| Waiting Periods | 3 – 12 months | 3 – 12 months | 3 – 12 months |
| Exclusions | Yes | Yes | Yes |
| Oncology Benefit | Yes | Yes | Yes |
| In-Hospital Benefit | Yes | Yes | Yes |
| Out-of-Hospital Cover | Yes | Yes | Yes |
| Maternity Benefit | Yes | Yes | Yes |
| Scopes and Scans | No | Yes | Yes |
| Co-payment Cover | Yes | No | Yes |
| Emergency Room | Yes | No | Yes |
| Accidental Cover | Yes | No | Yes |
| Trauma Counseling | Yes | No | Yes |
| Premium Waiver | Yes | No | Yes |
| Non-DSP Co-Payment | Yes | No | Yes |
| Prostheses | Yes | No | Yes |
| Accidental Death/ Permanent Disability | Yes | Yes | No |
| Travel Cover Extender | No | No | Yes |
Dis-Chem Gap Cover Features
Dis-Chem Gap Base
Cover Benefits
| Overall Annual Limit | • There is an overall annual limit of R185,537 per insured per year. |
| Tariff Shortfalls | • Subject to the overall annual limit of R185,537 per insured per year. |
| Shortfalls from Sub-limits | • Limited to R30,700. |
| Out-of-Hospital Tariff Shortfalls | • Limited to an additional 500% of the medical scheme tariff. |
| Dental Reconstruction Benefit | • Limited to two events per family per year. • Limited to R45,700 per year. |
Dis-Chem Gap Summit
Cover Benefits
| 🟧 Overall Annual Limit | • There is an overall annual limit of R185,537 per insured per year. |
| 🟦 Tariff Shortfalls | • Subject to the overall annual limit of R185,537 per insured per year. |
| 🟪 Shortfalls from Sub-limits | • Limited to R58,300. |
| 🟩 Out-of-Hospital Tariff Shortfalls | • The Oncology Shortfall Benefit provides additional cover of up to 500% of the Medical Scheme rate to cover oncology treatment shortfalls. |
| 🟥 Dental Reconstruction Benefit | • Benefits are payable for oncology and related Treatment approved by the Insured Party's Medical Scheme for treating cancer (malignant neoplasm) during an Insured Event. • The Benefit payable is equal to the charged amount less the amount paid by the Medical Scheme of the Insured Party. |
Dis-Chem Gap Cover Premiums
Dis-Chem Base Premiums
| 👤 Age Bracket | 💊 Main Member | 💵 Adult Premiums | 👶 Child Premiums |
| <18 | - | - | R20 |
| 18 – 39 | R141 | R72 | R29 for children up to 25 |
| 40 – 49 | R176 | R96 | - |
| 50 – 59 | R229 | R125 | - |
| 60> | R272 | R177 | - |
Dis-Chem Summit Premiums
| 👤 Age Bracket | 💊 Main Member | 💵 Adult Premiums | 👶 Child Premiums |
| <18 | - | - | R29 |
| 18 – 39 | R189 | R106 | R39 for children up to 25 |
| 40 – 49 | R237 | R135 | - |
| 50 – 59 | R285 | R170 | - |
| 60> | R370 | R246 | - |
Dis-Chem Gap Cover Exclusions
👉 The following are exclusions to Cura Administrators Gap Cover claims:
➡️ The insured’s medical aid will not cover claims excluded or rejected.
➡️ Claims not included in the registered benefits of the insured’s medical aid but paid on an ex-gratia basis will not be covered.
➡️ Any fee charged by a medical practitioner, hospital, or healthcare provider that constitutes split billing as defined in the policy will not be covered except for balance billing.
➡️ Treatment or medical procedures for infertility outside the period of cover and external prosthesis will not be covered.
➡️ Appliances, including wheelchairs, beds, or convalescing equipment, specialised dental procedures, harvesting or preserving of human tissues, and breast augmentation are excluded.
➡️ Gender reversal procedures, gastroplasty, lipectomy, otoplasty, therapeutic massage therapists, rehabilitation, frail care, hospice services, step-down facilities, and TTO medicines are excluded.
Dis-Chem Gap Cover Waiting Periods
👉 The following are the Dis-Chem Health Gap waiting periods:
➡️ 12-month Condition-Specific Waiting Period – You cannot claim benefits for a condition for which medical advice, diagnosis, care, or treatment was recommended or received within the 12 months preceding the Inception Date of your cover.
➡️ A newborn or Spouse will not be subject to waiting periods if they are added to your policy within 90 days of birth or marriage date.
Dis-Chem Recent User Reviews
➡️ Brian van der Linde (March 2024) “Recently, I had the opportunity to interact with a consultant from Dis-Chem Gap Cover who proved to be immensely helpful. Her sincerity and profound knowledge made it easier for me to relate to her.”
➡️ Cindy Oosthuizen (January 2024) “I would like to express my utmost admiration for the Dis-Chem Gap Cover department agents. Despite being informed that my husband’s surgery shortfall would not be covered, one of the agents went above and beyond to assist us.”
Advantages of Using Dis-Chem Gap Cover – Unique Selling Points
➡️ Dis-Chem Gap Cover covers medical expenses not covered by medical aids, such as co-payments, deductibles, and shortfalls.
➡️ The cover is available for both in-hospital and out-of-hospital medical procedures.
➡️ Members can choose from three plans to suit their specific needs and budgets.
➡️ The cover includes emergency medical transportation, which can be costly without insurance.
➡️ Dis-Chem Gap Cover provides an additional benefit of up to R50,000 in the event of accidental death or permanent disability.
➡️ Members have access to a 24/7 emergency medical helpline, which can aid in the case of medical emergencies.
➡️ The cover is available to individuals and families, with no age limit on joining.
➡️ The claims process is straightforward and hassle-free, with claims paid directly to the service provider in most cases.
➡️ Old Mutual Insure, a trusted and reputable insurance provider, underwrites Dis-Chem Gap Cover.
➡️ The cover can be purchased online, making it convenient and accessible.
How to apply for Gap Cover with Dis-Chem
👉 To apply for Gap Cover with Dis-Chem, you can follow these steps:
➡️ Visit the Dis-Chem website at www.dischem.co.za and navigate to the Gap Cover page.
➡️ Choose the plan that best suits your needs and budget, and click the “Apply Now” button.
➡️ Complete the application form with your details, including your name, contact information, and medical aid details.
➡️ Review the terms and conditions of the cover and ensure you understand the benefits and limitations.
➡️ Submit the application form and wait for approval from Dis-Chem.
➡️ Once your application is approved, you will receive a confirmation email with your policy documents and details on making payments.
➡️ Your cover will become effective once your first premium payment is received.
How can I change my Dis-Chem Gap Cover option?
👉 You can easily switch from your current Gap cover to Dis-Chem Health Gap. However, it would help if you did not allow a break in your cover to ensure that the waiting periods are applied fairly.
👉 If the cover gap is less than 90 days, the unexpired portion of the waiting periods from the previous policy will be transferred to your Dis-Chem Health Gap policy, and if you have already completed your waiting periods on your previous Gap cover, no waiting periods will apply on Dis-Chem Health Gap.
👉 If you are a Dis-Chem Gap Cover member and would like to change your plan option, you can follow these steps:
➡️ Contact the Dis-Chem Gap Cover call centre on 0860 10 53 40 and inform the consultant that you want to change your plan option.
➡️ The consultant will guide you through the process and explain the options available.
➡️ Once you choose a new plan option, the consultant will provide the necessary forms and documentation to complete the process.
➡️ Complete the forms and return them to Dis-Chem and any other required documentation.
➡️ Your new plan option will become effective from the start of the next calendar month.
How to Submit a Claim for Gap Cover with Dis-Chem
👉 To submit a claim for Gap Cover with Dis-Chem, you can follow these steps:
➡️ Obtain the necessary claim forms from the Dis-Chem Gap Cover website or call centre.
➡️ Complete the claim form fully, ensuring all required information is provided.
➡️ Attach all relevant documentation to support your claims, such as invoices, statements, and medical reports.
➡️ Submit the claim form and supporting documentation to Dis-Chem Gap Cover via email, fax, or post. The contact details for submission can be found on the claim form or the Dis-Chem website.
➡️ Dis-Chem Gap Cover will process your claim and may request additional information or documentation if required.
➡️ Once your claim has been processed, Dis-Chem Gap Cover will inform you of the outcome and any payment due.
Dis-Chem Regulation
👉 The Council for Medical Schemes regulates Dis-Chem Medical Scheme.
👉 The Council governs South Africa’s medical plan business for Medical Schemes (CMS), a regulating body set up under the Medical Schemes Act, No. 131 of 1998 (the Act). The CMS is responsible for a range of tasks related to the oversight of medical insurance plans, such as:
➡️ Responsible for registering medical insurance plans and ensuring they comply with the law and other laws.
➡️ Making sure healthcare plans have the money to pay claims.
➡️ Examining and authorising proposed price hikes for medical plans.
➡️ Accepting and examining member complaints and initiating disciplinary action against medical plans that violate the Act or other applicable rules.
➡️ Helping medical insurance plans follow the law and other laws.
👉 Furthermore, if a medical scheme is found to violate the law, the CMS has the authority to issue administrative fines and penalties.
Dis-Chem Contact Details
| 💻 Live Chat | No |
| 0860 347 243 | |
| 📞 Telephone | • Careline – 0860 347 243 • Switchboard – 010 589 2200 |
| 📅 Social Media | • Facebook • YouTube |
| 🤝 “Get Help” Service on the website | No |
Our Verdict on Dis-Chem Gap Cover
👉 Dis-Chem Gap Cover offers individuals and families a valuable form of insurance to cover medical expenses not fully covered by medical aids, such as co-payments, deductibles, and shortfalls.
👉 Members can access various benefits, including emergency medical transportation, accidental death and disability cover, and a 24/7 medical helpline.
👉 With a choice of three plan options and a straightforward claims process, Dis-Chem Gap Cover is a convenient and accessible way to protect against the high costs of medical care.
👉 Overall, Dis-Chem Gap Cover is a reliable and reputable insurance product that provides its member’s peace of mind and financial protection.
Dis-Chem Gap Cover Pros and Cons
| ✔️ PROS | ❌ CONS |
| Covers medical expenses that are not fully covered by medical aids | Exclusions and waiting periods may apply |
| Access to emergency medical transportation | Some medical procedures may not be covered |
| Accidental death and disability cover | Limited choice of plan options |
| 24/7 medical helpline | |
| Straightforward claims process | |
| Underwritten by a trusted and reputable insurance provider |
Dis-Chem Gap Cover FAQ
What is Dis-Chem Gap Cover?
Dis-Chem Gap Cover is a form of insurance covering medical expenses not fully covered by medical aids, such as co-payments, shortfalls, and deductibles.
What does Dis-Chem Gap Cover include?
Dis-Chem Gap Cover includes in-hospital and out-of-hospital cover, emergency medical transportation, accidental death and disability cover, and a 24/7 medical helpline.
How many plan options are available with Dis-Chem Gap Cover?
Dis-Chem Gap Cover offers two plan options to choose from.
Are there waiting periods or exclusions with Dis-Chem Gap Cover?
Yes, waiting periods or exclusions may apply to certain medical procedures or conditions.
How do I claim with Dis-Chem Gap Cover?
To claim with Dis-Chem Gap Cover, you must complete a claim form and submit it, along with supporting documentation, to Dis-Chem via email, fax, or post.
How long does it take for a claim to be processed with Dis-Chem Gap Cover?
The processing time for a claim with Dis-Chem Gap Cover may vary but typically takes a few days to a few weeks depending on the complexity of the claim.
What are the premiums for Dis-Chem Gap Cover?
The premiums for Dis-Chem Gap Cover may vary depending on the plan option chosen and the individual’s specific circumstances. Premiums with Dis-Chem typically start from R134 per month.
Can I change my plan option with Dis-Chem Gap Cover?
Yes, you can change your plan option with Dis-Chem Gap Cover. Contact the Dis-Chem Gap Cover call centre for assistance with changing your plan option.
Does Dis-Chem Gap Cover cover pre-existing medical conditions?
No, Dis-Chem Gap Cover does not cover pre-existing medical conditions.
How do I apply for Dis-Chem Gap Cover?
You can apply for Dis-Chem Gap Cover online via the Dis-Chem website or by visiting your nearest Dis-Chem pharmacy and speaking to a consultant.
