Kaelo Gap Core (🇿🇦 2024)

Overall, Kaelo Gap Core is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Kaelo Gap Core Plan starts from R255 ZAR. Kaelo has a trust score of 4.1.      

Kaelo Gap Core - 7 Key Point Quick Overview

1. ✅ Kaelo Gap Core Overview
2. ✅ Kaelo Gap Core Premiums
3. ✅ Kaelo Gap Core Benefits and Cover Breakdown
4. ✅ Kaelo Gap Core Exclusions and Waiting Periods
5. ✅ Kaelo Gap Core vs Other Gap Cover Plans
6. ✅ Our Verdict on Kaelo Gap Core
7. ✅ Kaelo Gap Core Frequently Asked Questions

Kaelo Gap Core Overview

The Kaelo Gap Core is one of two plans that starts from R255 per month. The Kaelo Gap Core Plan has benefits for sub-limit shortfalls, dental reconstruction, family protection, contribution waivers, hospital booster, and more.   Kaelo Gap Cover has two plans to choose from:

• • Kaelo Gap
  • Kaelo Gap Core

Kaelo Gap Core Premiums

   

Kaelo Gap Core Benefits and Cover Breakdown

Kaelo Gap Core Cover Benefits

 

Kaelo Gap Core Benefit Extenders

   

Kaelo Gap Core Exclusions and Waiting Periods

Kaelo Gap Core Exclusions

  💙The Kaelo Gap Cover has certain exclusions, including:

• ✅ The Gap Cover Policy does not cover claims not paid by the policyholder's medical aid.
• ✅ Claims that the medical aid paid on an ex-gratia basis are not included.
• ✅ Charges by healthcare providers for Split Billing are not covered, but Balance Billing is.
• ✅ The policy does not cover infertility treatment.
• ✅ Treatments that occur outside the period of an Insured Event are not covered.
• ✅ The policy does not cover external prostheses, appliances, and convalescing equipment.
• ✅ The policy does not cover the harvesting or preserving of human tissues such as stem cells.
• ✅ Procedures like breast augmentation, gastroplasty, lipectomy, and gender reversal are not covered.
• ✅ Therapeutic massage therapists are not included on the cover.
• ✅ The policy does not cover rehabilitation, frail care, and hospice services.
• ✅ Step-down facilities are not included in the cover.
• ✅ Medicines to take-out (TTO) are not covered.

  Specialized dental procedures such as crowns, bridges, and implants are not included.    

Kaelo Gap Core Waiting Periods

  💙Kaelo applies the following waiting periods to its policies:

• ✅ Exclusions specific to certain conditions will apply for 12 months.
• ✅ Concessions on waiting periods are arranged with Kaelo by your broker.
• ✅ Your broker will notify you when a concession period has been set.

  These concessions apply only to employer groups.    

Kaelo Gap Core vs Other Gap Cover Plans

   

Our Verdict on Kaelo Gap Core

The Kaelo Gap Core plan offers a broad range of benefits that can provide valuable financial protection against medical shortfalls. It is important to note the limitations of the Gap Core plan. For example, we found that the policy does not cover non-DSP payment benefits, trauma counseling, scopes, and scans, or maternity and oncology benefits. Kaelo Gap Core plan is a comprehensive policy that offers a wide range of benefits designed to supplement your medical aid cover and protect against shortfalls. One of its key strengths is its flexibility.  

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Kaelo Gap Core Frequently Asked Questions

What is the Kaelo Gap Core plan?

The Kaelo Gap Core plan is designed to supplement your medical aid coverage and protect against shortfalls, such as when your healthcare provider charges higher rates than your medical aid will pay.  

What are the main benefits of the Kaelo Gap Core plan?

The plan offers cover for tariff shortfalls, shortfalls from sub-limits, out-of-hospital tariff shortfalls, and dental reconstruction.  

What are the limits of the Kaelo Gap Core plan?

The plan has an Overall Annual Limit of R185 837 per Insured Party Per Annum, with specific limits for each benefit, such as shortfalls from sub-limits, dental reconstruction, hospital booster, family protector, and medical scheme contribution waiver.  

Does the Kaelo Gap Core plan offer any lifestyle benefits?

Yes, as part of Kaelo Lifestyle, the plan offers counseling, coaching, legal, and financial advice.  

How does the claim process work for the Kaelo Gap Core plan?

You have 6 months from the end of the insured event to submit your claim, and once all required documents have been received, your claim will be processed and paid within 7 to 14 working days.