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The Best Hospital Plans
Overall, Agility Combined 400 Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Agility Combined 400 Gap Cover Plans start from R288 ZAR. Agility has a trust score of 4.1.
π Provider | π₯ Agility Combined 400 |
π₯ Years in Operation | 18 years |
π§ Underwriters | GENRIC Insurance Company Ltd |
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 | R288 |
π₯ Oncology Benefit | β Yes |
π§ In-Hospital Benefit | β Yes |
π¨ Out-of-Hospital Cover | β Yes |
The Agility Combined 400 is one of six plans that starts from R288 per month. The Agility Combined 400 plan has benefits for trauma counseling, maternity, hospital boosters, oncology shortfall and diagnosis, in-hospital shortfall, and more.
Agility offers 24/7 medical emergency assistance.
Agility GAP Cover has six plans to choose from:
π Agility Plan | π₯ Agility Combined 400 |
π °οΈ Individual | R288 |
π ±οΈ Family | R307 |
π Agility Plan | π₯ Agility Combined 400 |
π °οΈ Individual | R421 |
π ±οΈ Family | R505 |
π΄ Gap Cover % | Up to four times the Medical Aid Tariff (400%). |
π΅ Overall Annual Limit | Limited to R191,000 per beneficiary per year. |
π₯ Co-Payment Cover for Procedures, MRI, and CT scan co-payments in and out-of-hospital | Unlimited cover but subject to the OAL. There is no limit per event. |
π§ Penalty Co-Payment Cover for voluntarily using a non-DSP hospital for treatment | Limited to R8,000 per claim.Β Limited to 2 claims per year |
π¨ PMB Cover β In-Hospital Treatment | Limited to R28,000 per policy |
π© Hospital Booster benefits | Limited to R22,000 per policy. Limited to 3 claims per year. |
π¦ Sub-limit cover | Limited to R22,000 per policy |
πͺ Robotic Surgery | Limited to R20,000 per policy |
π₯ Private Room Upgrades | Limited to R2,000 per policy |
π§ In-Hospital Shortfall cover, including consumables | Limited to R6,500 per policy |
π¨ Oncology Diagnosis | Limited to R11,000 per policy |
π© Oncology Shortfall Cover | Limited to R7,500 per policy |
π₯ Emergency Room Benefits for Trauma, Accidents, and Illness | Limited to R11,500 per policy per year. |
π§ Out-patient Procedure Cover procedures performed in the doctorβs rooms | Limited to R5,000 per event and R18,500 per policy per year. |
π¨ Out-patient Consultation Shortfalls include GP, Specialists, Dentists, Physiotherapists, and Psychology | Limited to R1,700 per policy |
π© Maternity Lump-sum Benefit for the first trimester | Limited to R3,300 per policy |
π¦ Maternity Scan Benefit for 2D, 3D, and 4D scans in and out-of-hospital | Limited to R2,200 per policy |
π₯ Gap Premium Waiver if the Policyholder dies or is permanently disabled | Limited to R6,600 per month for up to 12 months. |
π§ Medical Scheme Contribution Waiver if the main policyholder/member dies or is permanently disabled | Limited to R11,000 per policy |
π¨ Trauma Counselling | Limited to R5,500 per policy and R1,200 per event. |
Agility Gap Cover exclusions include, but are not limited to, the following:
and many more! A full list of Exclusions will be made available by Agility.
Agility Gap Cover does not explicitly outline its waiting periods within the policy documentation. However, similar to other providers of gap cover, the following waiting periods may be applicable:
Finally, a Maternity Waiting Period. For maternity-related claims, a waiting period of 10 months may apply. This means you must be a policyholder for at least 10 months before submitting a claim for maternity-related care.
π Provider | π₯ Agility Combined 400 | π₯ Universal Health Gap Plus Cover | π₯ Stratum Benefits Compact300 |
π₯ Years in Operation | 18 years | 16 years | 24 years |
π§ Underwriters | GENRIC Insurance Company Ltd | Compass Insurance Co Ltd | Guardrisk Insurance Company Limited (FSP 75) |
π¨ Market Share in South Africa | <1% | <10% | >5% |
π© Gap Cover Waiting Period | 3 β 12 months | 12 months for maternity and 30 days for other benefits | 3 Months |
π¦ Do Exclusions Apply | β Yes | β Yes | β Yes |
πͺ Average Monthly Premium | R288 | R291.89 | R276 |
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 | None | β Yes |
πͺ Co-payment Cover | β Yes | β Yes | β Yes |
π₯ Emergency Room | β Yes | β Yes | β Yes |
π§ Accidental Cover | None | None | β Yes |
π¨ Trauma Counseling | β Yes | β Yes | β Yes |
π© Premium Waiver | β Yes | β Yes | None |
π¦ Non-DSP Co-Payment | β Yes | β Yes | None |
πͺ Prostheses | β Yes | β Yes | β Yes |
π₯ Travel Cover Extender | None | None | β Yes |
π§ Accidental Death/ Permanent Disability | β Yes | None | β Yes |
According to our research, the Agility Combined 400 plan is a comprehensive insurance product that offers a wide range of benefits designed to fill gaps in healthcare coverage. In addition, it provides a high level of cover for in-hospital professional fee shortfalls, which can significantly reduce out-of-pocket expenses.
In our experience, including a Hospital Booster Benefit adds additional value and can help cover costs associated with sub-limits, robotic-assisted shortfalls, and private room upgrades.Β However, there are some limitations to consider.
The overall annual limit is R191 000 per beneficiary.
Yes, the plan offers 400% coverage for in-hospital professional fee shortfalls.
The Hospital Booster Benefit covers In-Hospital Sub-Limits, Robotic-Assisted Shortfalls, and Private Room Upgrades.
Yes, the plan provides benefits for oncology diagnosis and treatment.
Yes, the plan includes out-of-hospital cover, such as emergency room benefits, outpatient procedure cover, and outpatient consultation shortfalls.
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