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Overall, Auto & General Comprehensive Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. TheAuto & General Comprehensive Gap Cover Plan starts from R280 ZAR. Auto & General has a trust score of 4.1.
🔎 Provider | 🥇 Auto & General Comprehensive Gap Cover |
🟥 Years in Operation | 38 years |
🟧 Market Share in South Africa | <5% |
🟨 Gap Cover Waiting Period | 10 months |
🟩 Do Exclusions Apply | ✅ Yes |
🟦 Average Monthly Premium | R280 |
🟪 Oncology Benefit | ✅ Yes |
🟥 In-Hospital Benefit | ✅ Yes |
🟧 Out-of-Hospital Cover | ✅ Yes |
🟨 Maternity Benefit | None |
The Auto & General Comprehensive Gap is one of three plans that starts from R280 per month. Auto & General’s Comprehensive Gap has benefits for the in-hospital shortfall, scope and scan co-payments, sub-limits, non-network hospital co-pays, global fee benefits for robotic surgery, and more.
Auto & General Gap Cover has three plans to choose from:
🟥 Under 65 (based on the oldest beneficiary) premium per policy monthly | R280 |
🟧 Premium per individual per policy monthly | N/A |
🟨 Premium per family per policy monthly | N/A |
🟩 Over 65’s (based on the oldest beneficiary) premium per policy monthly | R470 |
🟥 In-hospital Shortfalls | Covers procedure claim shortfalls up to 500% of medical scheme tariff. |
🟧 Prescribed Minimum Benefits | All medical schemes must cover an emergency, 270, and 27 chronic conditions. Medical aid review is required. |
🟨 Emergency Medical Treatment in a Casualty Unit | A&E will pay for emergency room or casualty unit treatment up to the specified amount if you are in an accident. Limited to R15,000 per policy annually. |
🟩 In Network Hospital Co-payments | A&E will pay your medical aid co-payment/deductible for certain in-hospital and doctor-performed procedures. Limited to R55,000 per policy per year |
🟦 Co-payment Benefit – Out-of-hospital MRI, CT, and PET scans | The co-payment or deductible of your medical aid charges for MRI/CT/PET scans that have been authorized and paid from the in-hospital or Major Medical benefit. Limited to one annual MRI/CT/PET scan per policy up to R11,000. |
🟪 Sub-limit Benefit – Internal Prostheses | A&E will cover the shortfall up to R20,000 per policy per year if you reach your medical aid’s sub-limit for Internal Prostheses authorized and paid for from your In-Hospital or Major Medical benefit. |
🟥 Dental Treatment Benefit | After your medical aid processes your account, A&E will cover the shortfall for authorized in-hospital or doctor’s office dental procedures paid from the in-hospital or major medical benefit only. The unlimited cover is provided but with a per-insured-person annual limit. |
🟧 Global Fee Benefit | A&E will cover any service provider overcharges for a specific procedure like robotic surgery. Limited to R11,000 per policy annually. |
🟨 Oncology Gap Benefit | A&E will cover the difference between the service provider and medical scheme payment. Unlimited, but with a per-insured-person annual limit. |
🟩 Oncology “New Tech” Benefit | Keytruda®, Xalkori®, Tagrisso®, Yervoy®, Zelboraf®, Imbruvica® will be covered by A&E. Limited to R7,500 per policy annually. |
🟦 Enhanced Cancer Cover – Lump Sum Pay-out | A&E will pay a lump sum if your oncologist or pathologist confirms “Stage 2” or higher cancer. First cancer diagnosis pay-out of R20,000. |
🟪 Policy Extender | A&E will cover the gap cover premium if the main policyholder dies accidentally. Limited to 12 months. |
🟥 Medical Aid Contribution Waiver | A&E will cover a policyholder’s medical aid contribution for 6 months after the main policyholder’s accidental death. Limited to R5,000 monthly. |
Auto & General does not include its specific exclusions on its policy document. However, below we provide some typical exclusions that might relate to gap cover:
There is no general three-month waiting period when you register a Gap Cover policy. A 10-month condition-specific waiting period applies. No claims may be submitted within the first 10 months of membership for any Gap Cover policy if they relate to any of the following conditions:
There is a nine-month waiting period if a policyholder is diagnosed with cancer before membership.
🔎 Provider | 🥇 Auto & General Comprehensive Gap Cover | 🥈 Zestlife Universal Gap Cover | 🥉 Cura Administrators Gap Advanced Plus |
🟥 Years in Operation | 38 years | 3 years | 26 years |
🟧 Market Share in South Africa | <5% | >15% | <5% |
🟨 Gap Cover Waiting Period | 10 months | 3 – 12 months | 3 – 12 months |
🟩 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
🟦 Average Monthly Premium | R280 | R478 | R437 |
🟪 Oncology Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟥 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Out-of-Hospital Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟨 Maternity Benefit | None | None | ✅ Yes |
🟩 Scopes and Scans | ✅ Yes | ✅ Yes | ✅ Yes |
🟦 Co-payment Cover | ✅ Yes | None | ✅ Yes |
🟪 Emergency Room | ✅ Yes | ✅ Yes | ✅ Yes |
🟥 Accidental Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Trauma Counseling | None | ✅ Yes | ✅ Yes |
🟨 Premium Waiver | ✅ Yes | ✅ Yes | ✅ Yes |
🟩 Non-DSP Co-Payment | ✅ Yes | ✅ Yes | ✅ Yes |
🟦 Prostheses | ✅ Yes | ✅ Yes | ✅ Yes |
🟪 Travel Cover Extender | None | None | ✅ Yes |
🟥 Accidental Death/ Permanent Disability | None | ✅ Yes | ✅ Yes |
In our experience, Auto & General Comprehensive Gap offers a comprehensive range of benefits, including cover for in-hospital shortfalls, prescribed minimum benefits, out-of-hospital treatments, scopes and scans, emergency room visits, co-payment cover, prostheses, and more.
We also found features like the premium waiver and non-DSP co-payment cover, providing additional financial support to policyholders.
The premium per policy monthly for individuals under 65, based on the oldest beneficiary, is R280.
Auto & General Comprehensive Gap provides cover for emergency room or casualty unit treatment up to R15,000 per policy annually if the treatment is due to an accident.
Yes, Auto & General Comprehensive Gap offers cover for out-of-hospital treatments, ensuring comprehensive healthcare support beyond just in-hospital care.
Auto & General Comprehensive Gap cover procedure claim shortfalls up to 500% of the medical scheme tariff, ensuring extensive cover for in-hospital treatments.
Yes, there is a 10-month waiting period for specific conditions under the Auto & General Comprehensive Gap. During this period, no claims related to those conditions can be submitted.
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