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Overall, Admed Supreme Senior Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Admed Supreme Senior Gap Cover Plan starts from R656 ZAR. Admed has a trust score of 4.1.
π Provider | π₯ Admed Supreme Senior Gap |
π₯ Years in Operation | N/A |
π§ Underwriters | Guardrisk Insurance Company Limited |
π¨ Market Share in South Africa | <1% |
π© Gap Cover Waiting Period | 3 β 12 months |
π¦ Do Exclusions Apply | β Yes |
πͺ Average Monthly Premium | R656 |
π₯ Oncology Benefit | β Yes |
π§ In-Hospital Benefit | β Yes |
π¨ Out-of-Hospital Cover | β Yes |
The Admed Supreme Senior Gap is one of four plans that starts from R656 per month. The Admed Supreme Senior Gap plan has benefits for gynecology, general surgery, obstetrics, radiology, cardio care, ENT, and several in-hospital and additional benefits.
Admed offers 24/7 medical emergency assistance.
Admed Gap Cover has six options to choose from:
π Supreme Senior Gap | From R656 |
π° Medical Expense Shortfall Benefit In-hospital | Admed covers the difference between what a specialist charges and what the insured memberβs medical scheme pays up to 300%. Only PMBs are covered under this benefit. |
πͺ Medical Expense Shortfall Out-of-Hospital | Admed covers specific medical procedures performed in day clinics or doctorsβ rooms for up to 300% of the amount paid by the medical aid. PMBs are covered under this benefit. |
π΄ Medical Expense Shortfalls for Allied Professional | Admed covers the shortfall between what allied professionals charge and what the medical aid pays for in-hospital care after an in-hospital procedure. Covers up to 300%. Limited to R2,500 per policy yearly. |
π΅ Co-Payment Benefit | Admed covers co-payments on radiology scans and specialist procedures according to the medical aid option. |
πΆ Non-DSP Co-Payment Benefit | When insured persons use a non-network hospital and face an additional co-payment, Admed covers this up to R5,500 per policy annually. |
π· Oncology Co-payment benefit | Depending on the medical aid, when the oncology treatment benefit limit has been reached, Admed covers the first 20% of the co-payment of every treatment paid by the insured person. |
π³ Oncology Extender Benefit | When the oncology benefit limit has been reached, and the insured person has no further benefits available, Admed will cover 20% of the cost of every treatment paid. |
π° Internal Prostheses Shortfall | Limited to R30,000 per family yearly. Stents and pacemakers are limited to R8,000 per claim, subject to an R35,000 annual limit. |
πͺ Sub-limit benefit | Limited to R12,000 per policy annually for MRI and CT scans. |
π΄ Casualty Benefit | Limited to R22,000 for casualty visits. Limited to 5 casualty visits per family yearly. Three of the five can be for an emergency. Children <6 are covered up to R3,500 per policy yearly. Subject to the R22,000 overall annual limit. |
π΅ Robotic Procedure Shortfall Benefit | Covers up to 300% of the amount covered by the medical aid. |
πΆ Robotic Procedure Co-Payment Benefit | Limited to R12,000 per policy annually. |
β€οΈ Cancer Assist | Members diagnosed with stage II local or malignant cancers receive R5,000. Those diagnosed with stage II regional or malignant cancer receive R20,000. There is an additional R15,000 for eligible members. |
𧑠Breast Reconstruction Benefit for the non-affected breast | Insured members diagnosed with breast cancer and who require breast reconstruction for the non-affected breast because of a mastectomy are eligible for R15,000 per policy per year. |
π Accident Assist Benefit | Limited to R55,000 if an insured member dies or becomes permanently disabled because of an accident while covered by Admed. |
π Violent Crime Benefit | If accidental death or disability is because of a violent crime, Admed will double the Accident Assist Benefit. |
π Premium Waiver Benefit | If the policyholder becomes disabled or dies because of an accident, Admed will cover up to R36,000 upfront for the dependentsβ medical aid contributions and gap cover premiums. |
π Trauma and Bereavement Counselling | If an insured member is a witness to, or a victim of, a traumatic accident, or an immediate family member dies, they are eligible to R800 towards counseling sessions up to a maximum of R30,000 per family per year. |
π€ Baby Bump Benefit | Admed covers up to R2,000 for pregnancy diagnosis and any unexpected pregnancy costs. |
π Category | π₯ Procedures Covered by Admed |
π©Έ Cardiovascular | Coronary Angioplasty Angiogram |
π©Ί Dermatologic | Skin Grafts |
𧬠Ear, Nose, Throat | Adenoidectomy Direct Laryngoscopy Grommets Myringotomy Sinus Surgery Tonsillectomy |
π©Ή Gastrointestinal | Closure of colostomy Colonoscopy Endoscopy Gastroscopy Laparoscopy Esophagoscope Hemorrhoidectomy |
π©ββοΈ General Surgery | Hernia Repairs Biopsies |
π¨ββοΈ Gynecology | Cervical Laser Ablation Dilatation and Curettage Hysteroscopy Tubal Litigation |
β οΈ Obstetrics | Childbirth in a non-hospital setting |
βοΈ Oncology | Chemotherapy Radiotherapy |
π§ͺ Ophthalmology | Cataract Removal Pterygium Removal Trabeculectomy |
π Orthopaedic | Arthroscopy Bunionectomy Carpal Tunnel Release Ganglion Surgery |
π Radiology | CAT scan MRI scan PET scan Nuclear Radiology Varicose Vein Removal |
π Renal | Kidney dialysis |
π Respiratory | Bronchoscopy |
βͺοΈ Urology | Circumcision (due to medical necessity) Cystoscopy Orchidopexy Prostate Biopsy Vasectomy |
Admed covers the following Allied Professionals:
and many more. A full list will be supplied by Admed.
Some of Admedβs Exclusions include, but are not limited to, the following:
Investigative procedures, and more.
Admed applies the following waiting periods:
Medical events related to cancer, birth, or pregnancy will have a waiting period of twelve months.
π Provider | π₯ Admed Supreme Senior Gap | π₯ Ambledown Gap Supreme | π₯ Cura Administrators Gap Ultimate Plus |
π₯ Years in Operation | N/A | 19 years | 26 years |
π§ Underwriters | Guardrisk Insurance Company Limited | Guardrisk Insurance Company Limited | GENRIC Insurance Company Limited |
π¨ Market Share in South Africa | <1% | 20% | <5% |
π© Gap Cover Waiting Period | 3 β 12 months | 3 β 12 months | 3 β 12 months |
π¦ Do Exclusions Apply | β Yes | β Yes | β Yes |
πͺ Average Monthly Premium | R656 | R613 | R623 |
π₯ Oncology Benefit | β Yes | β Yes | β Yes |
π§ In-Hospital Benefit | β Yes | β Yes | β Yes |
π¨ Out-of-Hospital Cover | β Yes | β Yes | β Yes |
π© Maternity Benefit | β Yes | None | β Yes |
π¦ Scopes and Scans | β Yes | β Yes | β Yes |
πͺ Co-payment Cover | β Yes | β Yes | β Yes |
π₯ Emergency Room | β Yes | β Yes | β Yes |
π§ Accidental Cover | β Yes | β Yes | β Yes |
π¨ Trauma Counseling | β Yes | None | β Yes |
π© Premium Waiver | β Yes | β Yes | β Yes |
π¦ Non-DSP Co-Payment | β Yes | β Yes | β Yes |
πͺ Prostheses | β Yes | None | β Yes |
π₯ Travel Cover Extender | None | None | β Yes |
π§ Accidental Death/ Permanent Disability | β Yes | None | β Yes |
According to our findings, The Supreme Senior Gap is a comprehensive plan tailored specifically for senior citizens, offering extensive cover for medical expense shortfalls and a range of assistance benefits.
It provides financial protection for both in-hospital and out-of-hospital treatments, including oncology care, co-payments, and various procedures. The plan also includes benefits such as premium waivers and trauma counseling, catering to senior individualsβ unique needs and concerns.
However, the plan has certain waiting periods and exclusions that could affect immediate access to certain benefits. But overall, we can conclude that the Admed Supreme Senior Gap plan offers several features, and it holds its ground against formidable competitors in the market.
Β
Yes, Supreme Senior Gap covers many out-of-hospital procedures, including dermatologic treatments such as skin grafts.
Supreme Senior Gap covers the shortfall between what allied professionals charge and what the medical aid pays for in-hospital care after a procedure, up to 300%.
Supreme Senior Gap provides cover for co-payments on radiology scans and specialist procedures based on the specific medical aid option.
Yes, like other gap cover plans, Supreme Senior Gap has waiting periods ranging from 3 to 12 months.
Depending on the medical aid, when the oncology treatment benefit limit is reached, Supreme Senior Gap covers the first 20% of the co-payment for each treatment paid by the insured person.
We work with leading medical aid companies in South Africa.
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