What is Dis-Chem Gap Summit?

Dis-Chem Gap Summit is a gap cover plan by Dis-Chem, offering benefits such as oncology tariff shortfalls and out-of-hospital cover from R180 per month.

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Dis-Chem Gap Summit (🇿🇦 2025)

Overall, Dis-Chem Gap Summit is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Dis-Chem Gap Summit Plan starts from R204 ZAR. Dis-Chem has a trust score of 4.1.

🔎 Provider	🥇 Dis-Chem Gap Summit
🟥 Years in Operation	36 years
🟧 Underwriters	Old Mutual Insure
🟨 Market Share in South Africa	<1%
🟩 Gap Cover Waiting Period	3 – 12 months
🟦 Do Exclusions Apply	✅ Yes
🟪 Average Monthly Premium	R204
🟥 Oncology Benefit	✅ Yes
🟧 In-Hospital Benefit	✅ Yes
🟨 Out-of-Hospital Cover	✅ Yes

Dis-Chem Gap Summit – 7 Key Point Quick Overview

Dis-Chem Gap Summit Overview

The Dis-Chem Gap Summit is one of two plans that starts from R204 per month. Dis-Chem Gap Summit offers benefits for oncology tariff shortfalls, penalty co-payments, sub-limit shortfalls, dental reconstruction, child casualty illness, and more.

Dis-Chem Gap Cover has two plans to choose from:

- ➡️ Dis-Chem Gap Summit
- ➡️ Dis-Chem Gap Base

Dis-Chem Gap Summit Premiums

🔎 Age Bracket	👤 Main Member	👥 Adult Premiums	🍼 Child Premiums
🟥 <18	N/A	N/A	R33
🟧 18 – 39	R204	R114	R44 for children up to 26
🟨 40 – 49	R256	R146	N/A
🟩 50 – 59	R314	R187	N/A
🟦 60>	R418	R279	N/A

Dis-Chem Gap Summit Benefits and Cover Comprehensive Breakdown

Dis-Chem Gap Summit Cover Benefits

🟥 Overall Annual Limit	There is an overall annual limit of R210,580 per insured per year.
🟧 Tariff Shortfalls	This Benefit provides additional cover of up to 600% of the medical aid rate for services provided during a Hospital Episode, covering shortfalls for healthcare service providers such as surgeons, radiologists, pathologists and physiotherapists. It also includes cover for Prescribed Minimum Benefits (PMBs).
🟨 Co-Payments and Deductibles	Covers diagnostic and medical procedure cover during hospitalization.
🟩 Shortfalls from Sub-limits	Limited to R68 370.
🟦 Oncology Tariff Shortfalls	The Oncology Shortfall Benefit covers up to 500% of the Medical Schemes rate to cover oncology treatment shortfalls.
🟪 Oncology Sub-Limits	Benefits are payable for oncology and related Treatment approved by the Insured Party’s Medical Scheme for treating cancer (malignant neoplasm) during an Insured Event. The Benefit payable is equal to the charged amount less the amount paid by the Medical Scheme of the Insured Party.
🟥 Oncology Co-Payments	The Oncology Co-payment Benefit pays the 20% Oncology-Related Co-Payment imposed by the Medical Scheme.
🟧 Out-of-Hospital Tariff Shortfalls	Limited to an additional 600% of the medical scheme tariff.
🟨 Penalty Co-payment	Limited to per Family per year, with a maximum of R19,660 per event. Cover for penalty Co-payments or Deductibles that do not exceed 30% for the voluntary use of a non-Network Hospital by an Insured Party.
🟩 Innovative Oncology Medicines	As it relates to Innovative Oncology Medicines, a value equal to the lesser of 25% of the total drug cost, or R14 600, is covered. Cover for shortfalls in Innovative Oncology Medicines as defined by the Medical Scheme of the Insured Party.
🟦 Dental Reconstruction Benefit	Limited to two events per family per year. Limited to R49,900 per year.

Dis-Chem Gap Summit Benefit Extenders

🟥 Family Booster	Limited to R15,900.
🟧 Child Casualty Illness	Paid in respect of Emergency out-patient services that are provided within a casualty ward of a Hospital. The benefit is only payable in the event of afterhours treatment in an emergency. After-hours are Mondays to Fridays between 18:00pm and 08:00am and all-day Saturdays, Sundays and South African public holidays. Subject to a maximum of Two such events per annum and R3 200. Limited to children under age 12.
🟨 Accidental Casualty	Limited to R19 550 per event.
🟩 Hospital Booster	Day 1 – 13: R480 Day 14 – 20: R860 Day 21 – 30: R1 700 Maximum Benefit of R29 300 per Insured Party Per Annum.
🟦 Family Protector	Children below six years: R20 000. All other Insured Parties: R30 000.
🟪 Medical Scheme Contribution Waiver	Contributions will be covered for six months, up to R35,500. This benefit is only available once during the policy’s lifetime.
🟥 Gap Cover Premium Waiver	The Dis-Chem Health Gap Cover premium will be waived six months after the event. This benefit is only available once during the policy’s lifetime.
🟧 Road Accident Fund Claims	Covered by the policy.

Dis-Chem Gap Summit Exclusions and Waiting Periods

Dis-Chem Gap Summit Exclusions

The following will not be covered under Dis-Chem’s Gap Cover Policies:

✅ Excluded or rejected claims by the insured’s medical aid will not be covered.
✅ Claims not included in the registered benefits of the insured’s medical aid but paid on an ex-gratia basis will not be covered.
✅ Split billing fees charged by medical practitioners, hospitals, or healthcare providers (excluding balance billing) will not be covered.
✅ Treatment or medical procedures for infertility outside the period of cover and external prosthesis will not be covered.
✅ Appliances such as wheelchairs, beds, or convalescing equipment, specialized dental procedures, harvesting or preserving of human tissues, and breast augmentation are excluded.

Gender reversal procedures, gastroplasty, lipectomy, otoplasty, therapeutic massage therapists, rehabilitation, frail care, hospice services, step-down facilities, and TTO medicines are excluded.

Dis-Chem Gap Summit Waiting Periods

The following are the Dis-Chem Gap Cover waiting periods:

✅ In addition, a 12-month Condition-Specific Waiting Period is in place, where benefits cannot be claimed for a condition that received medical advice, diagnosis, care, or treatment within 12 months before the Inception Date of the cover.

If a newborn or Spouse is added to the policy within 90 days of their birth or marriage date, they will not be subject to waiting periods.

Dis-Chem Gap Summit vs Other Gap Cover Plans

🔎 Provider	🥇 Dis-Chem Gap Summit	🥈 Linksave Gap 500 Plus	🥉 Liberty Optimal Gap Cover
🟥 Years in Operation	36 years	9 years	66 years
🟧 Underwriters	Old Mutual Insure	Renasa Insurance Company Limited	Guardrisk Life Limited (FSP 76)
🟨 Market Share in South Africa	<1%	<1%	>25%
🟩 Gap Cover Waiting Period	3 – 12 months	3 – 12 months	12 months
🟦 Do Exclusions Apply	✅ Yes	✅ Yes	✅ Yes
🟪 Monthly Premium	R204	R422	R253
🟥 Oncology Benefit	✅ Yes	None	None
🟧 In-Hospital Benefit	✅ Yes	None	✅ Yes
🟨 Out-of-Hospital Cover	✅ Yes	None	✅ Yes
🟩 Maternity Benefit	None	None	None
🟦 Scopes and Scans	✅ Yes	✅ Yes	✅ Yes
🟪 Co-payment Cover	✅ Yes	✅ Yes	✅ Yes
🟥 Emergency Room	✅ Yes	✅ Yes	None
🟧 Accidental Cover	✅ Yes	✅ Yes	✅ Yes
🟨 Trauma Counseling	✅ Yes	None	✅ Yes
🟩 Premium Waiver	✅ Yes	✅ Yes	✅ Yes
🟦 Non-DSP Co-Payment	✅ Yes	✅ Yes	✅ Yes
🟪 Prostheses	✅ Yes	None	✅ Yes
🟥 Travel Cover Extender	✅ Yes	None	None
🟧 Accidental Death/ Permanent Disability	✅ Yes	✅ Yes	✅ Yes

Our Verdict on the Dis-Chem Gap Summit

👉🏾 According to our research, Dis-Chem Gap Summit provides substantial cover, including oncology tariff shortfalls, penalty co-payments, and dental reconstruction, backed by reliable 24/7 medical emergency assistance.

👉🏾 We discovered that the plan competes favorably with other gap cover plans, boasting advantageous offerings such as in-hospital, out-of-hospital cover, and oncology benefits, although it lacks maternity benefits.

Frequently Asked Questions

What is the Dis-Chem Gap Summit?

Dis-Chem Gap Summit is a gap cover plan by Dis-Chem that offers benefits such as oncology tariff shortfalls and out-of-hospital cover from R204 per month.

What benefits does the Dis-Chem Gap Summit offer?

Dis-Chem Gap Summit provides various benefits, including hospitalization co-payments and deductibles cover, oncology tariff shortfalls, and penalty co-payment, among others.

What are the premiums for the Dis-Chem Gap Summit based on age brackets?

Premiums for Dis-Chem Gap Summit are tiered based on age brackets, with rates starting as low as R204 for main members and children under 18 from R33.

Are there any exclusions on the Dis-Chem Gap Summit’s cover?

Dis-Chem Gap Summit’s cover includes exclusions such as rejected claims by the insured’s medical aid, split billing fees, and treatments for infertility outside the coverage period.

What are the waiting periods for the Dis-Chem Gap Summit?

Dis-Chem Gap Summit imposes a 12-month condition-specific waiting period where benefits cannot be claimed for a previously diagnosed or treated condition.

Adriaan Schoeman

Adriaan holds an MBA and specializes in medical aid research. With his commitment to perfection, he ensures the accuracy of all data presented on medicalaid.com every three months. When he is not conducting research, Adriaan can be found indulging in his passion for trout fishing amidst nature.