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Overall, Agility Ultra Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Agility Ultra Gap Cover Plan starts from R546 ZAR. Agility has a trust score of 4.1.
🔎 Provider | 🥇 Agility Ultra Gap Cover |
🟥 Years in Operation | 18 years |
🟧 Underwriters | GENRIC Insurance Company Ltd |
🟨 Market Share in South Africa | <1% |
🟩 Gap Cover Waiting Period | 3 – 12 months |
🟦 Do Exclusions Apply | ✅ Yes |
🟪 Average Monthly Premium | R546 |
🟥 Oncology Benefit | ✅ Yes |
🟧 In-Hospital Benefit | ✅ Yes |
🟨 Out-of-Hospital Cover | ✅ Yes |
The Agility Ultra Gap Cover is one of six plans that starts from R546 per month. The Agility Ultra Gap Cover plan has benefits for premature birth, sub-limits, private room upgrades, outpatient consults, maternity lump-sum, trauma counseling, accidental death/permanent disability, and more.
Agility offers 24/7 medical emergency assistance, and we give it a trust score of 4.3 as there are insufficient reviews for the Trust Index to score the gap cover provider.
Agility GAP Cover has six plans to choose from:
🔎 Agility Plan | 🥇 Agility Ultra Gap Cover |
🅰️ Individual | R546 |
🅱️ Family | R605 |
🔎 Agility Plan | 🥇 Agility Ultra Gap Cover |
🅰️ Individual | R805 |
🅱️ Family | R873 |
🟥 Gap Cover % | Up to five times the Medical Aid Tariff (500%). |
🟧 Overall Annual Limit | Limited to R191,000 per beneficiary per year. |
🟥 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. |
🟧 Penalty Co-Payment Cover for voluntarily using a non-DSP hospital for treatment | Limited to R16,000 per claim. Limited to 6 claims per policy per year. |
🟨 PMB Cover – In-Hospital Treatment | Unlimited cover but subject to the OAL. There is no limit per event. |
🟩 Hospital Booster benefits | Limited to 5 claims per policy |
🟦 Sub-limit cover | Limited to R30,000 per policy |
🟪 Robotic Surgery | Limited to R30,000 per policy |
🟥 Private Room Upgrades | Limited to R7,000 per policy |
🟧 In-Hospital Shortfall cover, including consumables | Limited to R11,000 per policy |
🟨 Oncology Diagnosis | Limited to R27,000 per policy |
🟩 Oncology Shortfall Cover | Unlimited, but subject to the OAL. There are no event limits. |
🟦 Premature Birth Cover up to 6 weeks before the due date | Provides an R6,500 lump sum. Limited to 1 claim per year. |
🟥 Emergency Room Benefits for Trauma, Accidents, and Illness | Limited to R15,000 per policy per year. |
🟧 Out-patient Procedure Cover procedures performed in the doctor’s rooms | Limited to R25,000 per policy |
🟨 Out-patient Consultation Shortfalls include GP, Specialists, Dentists, Physiotherapists, and Psychology | Limited to R9,000 per policy |
🟩 Maternity Lump-sum Benefit for the first trimester | Limited to R5,500 per policy |
🟦 Maternity Scan Benefit for 2D, 3D, and 4D scans in and out-of-hospital | Limited to R4,400 per policy |
🟥 Gap Premium Waiver if the Policyholder dies or is permanently disabled | Limited to R6,600 per month up to 12 months. |
🟧 Medical Scheme Contribution Waiver if the main policyholder/member dies or is permanently disabled | Limited to R13,000 per policy per year for 6 months. |
🟨 Trauma Counselling | Limited to R26,000 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 provided 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.
🔎 Provider | 🥇 Agility Ultra Gap Cover | 🥈 Stratum Benefits Corporate Elite | 🥉 Turnberry Premier |
🟥 Years in Operation | 18 years | 24 years | 22 years |
🟧 Underwriters | GENRIC Insurance Company Ltd | Guardrisk Insurance Company Limited (FSP 75) | Lombard Insurance Company |
🟨 Market Share in South Africa | <1% | >5% | <5% |
🟩 Gap Cover Waiting Period | 3 – 12 months | 3 Months | 3 – 12 months |
🟦 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
🟪 Average Monthly Premium | R546 | N/A | R525 |
🟥 Oncology Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟨 Out-of-Hospital Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟩 Maternity Benefit | ✅ Yes | ✅ Yes | None |
🟦 Scopes and Scans | ✅ Yes | ✅ Yes | ✅ Yes |
🟪 Co-payment Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟥 Emergency Room | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Accidental Cover | None | ✅ Yes | ✅ Yes |
🟨 Trauma Counseling | ✅ Yes | ✅ Yes | ✅ Yes |
🟩 Premium Waiver | ✅ Yes | None | ✅ Yes |
🟦 Non-DSP Co-Payment | ✅ Yes | None | ✅ Yes |
🟪 Prostheses | ✅ Yes | ✅ Yes | None |
🟥 Travel Cover Extender | None | ✅ Yes | ✅ Yes |
🟧 Accidental Death/ Permanent Disability | ✅ Yes | ✅ Yes | ✅ Yes |
According to our research, the Agility Ultra Gap Cover, a well-regarded plan in South Africa, provides comprehensive insurance, including unique benefits like cover for premature birth, trauma counseling, and private room upgrades.
Its pricing starts at R546 per month for individuals and R605 for families under 65 years, making it competitive in the market.
The cover stands out for its extensive benefits, ranging from in-hospital and out-of-hospital cover to ancillary cover, with a beneficial overall annual limit of R191,000 per beneficiary. However, the plan does not offer accidental and travel cover extenders, which some might find limiting.
For individuals who are 65 years and older, the Agility Ultra Gap Cover has a monthly premium of R805. The premium for a family with 65 years or older members is R873 per month.
Yes, the Agility Ultra Gap Cover does offer out-of-hospital procedure cover. It provides up to R25,000 per policy for procedures performed in the doctor’s rooms. This can benefit people who often require medical procedures that don’t necessitate hospital stays.
The Agility Ultra Gap Cover does not cover claims related to pre-existing conditions (for 12–24 months), accidents within the first three months of the policy, routine medical advice, obesity-related treatments, professional or dangerous sports, psychiatric conditions, and certain elective or cosmetic procedures, among others.
The overall annual limit for the Agility Ultra Gap Cover is R191,000 per beneficiary per year. This means each individual covered under the policy has up to R191,000 of benefits that can be used within a year.
Yes, the plan provides maternity benefits. However, a maternity lump-sum benefit is limited to R5,500 per policy for the first trimester. Additionally, maternity scan benefits for 2D, 3D, and 4D scans in and out of the hospital are covered, limited to R4,400 per policy.
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