Admed Gap Cover (🇿🇦 2025)

Overall, Admed Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Admed Gap Cover Plans start from R248 ZAR. Admed has a trust score of 4.1.   💙Admed Gap Cover has six options to choose from:

• • ✅ Admed Premium Millennium Plan
  • ✅ Admed Supreme Senior Plan
  • ✅ Admed Supreme Millennial Plan
  • ✅ Admed Supreme Plan
  • ✅ Admed Premium Senior Plan
  • ✅ Admed Premium Plan

           

Admed Gap Cover - 12 Key Point Quick Overview

1. ✅ Admed Gap Cover - Advantages over Competitors
2. ✅ Admed Gap Cover Premiums
3. ✅ Admed Primary Offer
4. ✅ Admed Supreme Offer
5. ✅ How to apply for Gap Cover with Admed
6. ✅ How can I change my Admed Gap Cover option?
7. ✅ How to Submit a Claim for Gap Cover with Admed
8. ✅ Admed Gap Cover Exclusions and Waiting Period
9. ✅ Admed Gap Cover vs Other Notable Providers
10. ✅ Admed Gap Cover Pros and Cons
11. ✅ Our Verdict on Admed Gap Cover
12. ✅ Admed Gap Cover Frequently Asked Questions

   

Admed Gap Cover for Medical Aid - Advantages over Competitors

💙Choosing Admed Gap Cover comes with a long list of advantages, including:

• ✅ Admed provides comprehensive and affordable gap cover policies that offer extensive protection against medical expense shortfalls that can occur when medical aid benefits are exhausted.
• ✅ Admed offers a range of gap cover plans, each designed to cater to different budget and medical aid plan requirements, providing members with flexibility and choice.
• ✅ Admed's gap cover policies covering in-hospital procedures, specialized procedures, and out-of-hospital treatments, including medical consultations, tests, and medicines.
• ✅ Admed's policies include cover for co-payments and deductibles, which can save members money and alleviate financial burdens.
• ✅ Admed has no annual limit on claims, so members can make as many claims as required throughout the year without worrying about hitting a cap.
• ✅ Admed provides a streamlined claims process, with claims paid out within three working days of receiving all the required documentation.
• ✅ Admed offers various value-added services, including 24/7 telephonic medical advice, trauma and assault counseling, and emergency medical evacuation services.

  Admed has a reputation for exceptional customer service, with a dedicated team of claims agents available to assist members with queries or concerns.        

Admed Gap Cover Premiums

 

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Admed Primary Offer

• ✅ Primary Gap:  Ideal for you, your spouse, children, and parents registered as independents on your medical aid who are eligible for cover.
• ✅ Premiums start from R422 per month.
• ✅ Primary Millennial Gap: Cover for individuals 29 or younger.
• ✅ Premiums start from R248 per month.
• ✅ Primary Pensioner Gap:  Cover for individuals 65 years and older.
• ✅ Premiums start from R705 per month.

   

Admed Primary Shortfall Benefits

   

Admed Primary Out-of-Hospital Procedures Covered

   

Admed Primary Allied Professionals Covered

💙Admed covers the following Allied Professionals:

• ✅ Chiropractors
• ✅ Clinical Technologist
• ✅ Genetic Counsellors
• ✅ Myotherapists
• ✅ Occupational Therapists
• ✅ Orthoptists
• ✅ Osteopaths
• ✅ Perfusionist
• ✅ Physiotherapists

  and many more.  

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Admed Supreme Offer

• ✅ Supreme Gap is ideal for most individuals and their families, including spouses, children, and parents registered on the policyholder’s medical aid.
• ✅ Monthly contributions start from R511 for those under 65.
• ✅ Supreme Millennial Gap is ideal for individuals younger than 29.
• ✅ The monthly contribution is R302 per month.
• ✅ Supreme Pensioner Gap is ideal for individuals 65 or older on the date of joining.
• ✅ Monthly premiums start from R749 per month.

   

Admed Supreme Shortfall Benefits

 

Admed Supreme Assist Benefits

 

Admed Supreme Out-of-Hospital Procedures Covered

 

Admed Supreme Allied Professionals Covered

💙Admed covers the following Allied Professionals:

• ✅ Chiropractors
• ✅ Clinical Technologist
• ✅ Genetic Counsellors
• ✅ Myotherapists
• ✅ Occupational Therapists
• ✅ Orthoptists
• ✅ Osteopaths
• ✅ Perfusionist

  and many more.  

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How to apply for Gap Cover with Admed

💙To apply for gap insurance with Admed, you can take the following steps:

• ✅ Visit the Admed website or call their customer service department to obtain the required application forms and supporting documentation.
• ✅ Fill out the application form with accurate and complete information, including personal details, medical aid plan information, and any pre-existing medical conditions.
• ✅ Submit the application form and any supporting documentation, such as copies of your medical aid membership certificate, proof of identification, and proof of payment of the gap cover premiums.
• ✅ Admed may require up to 14 business days to process your application. If your application is approved, you will receive a letter of confirmation and a policy schedule outlining your cover.

    Once registered, you can start reaping the benefits of your Admed gap cover policy, such as financial protection against medical expense shortfalls and access to value-added services like telephone medical advice and emergency medical evacuation services.  

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How can I change my Admed Gap Cover option?

💙To modify your Admed gap cover option, you can take the following actions:

• ✅ Contact Admed's customer service to modify your gap cover option.
• ✅ Admed will provide you with the required paperwork to change your option.
• ✅ Fill out the forms for the new gap cover option you wish to switch to and submit them to Admed along with any supporting documentation, such as proof of premium payment, which may be required.
• ✅ Your request will be processed by Admed, which could take up to fourteen business days.
• ✅ Admed will issue a new policy schedule that reflects the changes if your request to change your gap cover option is approved.

    Ensure you are familiar with the terms and conditions of your new gap cover option, including any applicable waiting periods and exclusions.        

How to Submit a Claim for Gap Cover with Admed

  💙To file a claim for gap cover with Admed, you can take the following steps:

• ✅ Obtain a claim form by visiting the Admed website or contacting customer service.
• ✅ Include your personal information, the specifics of the medical procedure or treatment for which you submit a claim, and any supporting documentation, such as medical bills and receipts, on the claim form.
• ✅ Email, fax, or mail the completed claim form and supporting documentation to Admed. Confirming this with Admed's customer service is prudent, as they may require original documentation.
• ✅ Your claim will be processed by Admed, who may request additional information or documentation if necessary.
• ✅ After processing and approving your claim, Admed will deposit the eligible benefits into your designated bank account within three business days.

    Furthermore, insured members must know that Admed may have specific deadlines for submitting claims, exclusions, and waiting periods.      

Admed Gap Cover Exclusions and Waiting Period

 

Admed Gap Cover Exclusions

💙Some of Admed’s Exclusions include, but are not limited to, the following:

• ✅ Shortfalls where medical aid has not covered the initial portion of costs.
• ✅ Pre-admission and out-of-hospital consultations.
• ✅ Materials or medication used during a procedure.
• ✅ External Prosthetics.
• ✅ Home or private nursing.
• ✅ Investigative procedures, and more.

    Hospital and clinic fees such as theatre charges, ward fees, or other hospital or clinic costs will be excluded.  

Admed Gap Cover Waiting Periods

💙Admed applies the following waiting periods:

• ✅ A 3-month general waiting period will apply for individuals, not in a group.
• ✅ A 9-month pre-existing waiting period applies for procedures or surgeries relating to pre-existing conditions.

    A 12-month birth, pregnancy, or cancer-related waiting period applies for cancer, birth, or pregnancy-related medical events.        

Admed Gap Cover vs Other Notable Providers

       

Admed Gap Cover Pros and Cons

       

Our Verdict on Admed Gap Cover

Admed is a reputable gap cover provider offering comprehensive and affordable policies to help individuals and families protect themselves against medical expense shortfalls. The company has various plans designed to cater to different budget and medical aid plan requirements, providing members with flexibility and choice.   Admed's policies cover in-hospital procedures, specialized procedures, and out-of-hospital treatments, including medical consultations, tests, and medicines.  

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Admed Gap Cover Frequently Asked Questions

 

What is Admed Gap Cover, and how does it work?

Admed Gap Cover is a type of insurance that provides cover for medical expenses that exceed the limits of your medical aid plan.  It pays the difference between the amount your medical aid covers and the actual cost of your medical expenses. This means you will not have to pay for unexpected medical expenses out of pocket.  

How much does Admed Gap Cover cost?

The cost of an Admed Gap Cover varies depending on your chosen plan and your needs. However, Admed’s cheapest option starts from R228 per month.  

Is Admed Gap Cover worth the investment?

Admed Gap Cover could be worth the investment to ensure that you and your family are financially protected from unexpected medical expenses.  

What benefits does Admed Gap Cover offer?

Admed Gap Cover offers a range of benefits, including cover for in-hospital and out-of-hospital medical expenses, co-payments, and deductibles.  Additionally, Admed offers extended benefits such as cover for non-medical expenses related to hospitalization, as well as cover for medical procedures that are not covered by medical aids.  

How do I file a claim with Admed Gap Cover?

To file a claim with Admed Gap Cover, you can contact their claims department via phone or email. You will need to provide your personal and policy details, as well as the details of the medical expense for which you are claiming.  Admed will then assess your claim and provide you with feedback on the outcome.  

What are the eligibility requirements for Admed Gap Cover?

To be eligible for Admed Gap Cover, you must have an active medical aid plan with a registered medical scheme in South Africa.  

How does Admed Gap Cover compare to other gap cover options?

Admed Gap Cover is known for offering affordable rates and comprehensive coverage compared to other gap cover options in South Africa.  Admed has a reputation for providing policyholders with excellent customer service and personalized support.