Overall, Liberty Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Liberty Gap Cover Plans start from R253 ZAR. Liberty has a trust score of 4.1.
Liberty Gap Cover has three plans to choose from:
| 🟥 Date Established | 2008 |
| 🟧 Underwriters | Guardrisk Insurance Company Limited |
| 🟨 Headquartered | Johannesburg, South Africa |
| 🟩 The average number of members | 100,000+ |
| 🟦 Number of Markets | 19 |
| 🟪 Market Share | <5% |
| 🟥 Number of plans offered | 2 |
| 🟧 Is a Mobile App offered | None |
| 🟨 Waiting Period | 3 – 12 months |
| 🟩 Exclusions | ✅ Yes |
| 🟥 Cover for Individuals | 🟥 Premium |
| 🟧 Younger than 55 years | R397 per month |
| 🟨 55 to 64 years old | R499 per month |
| 🟩 65 years and older | R592 per month |
| 🟦 Cover for Families | 🟦 Premium |
| 🟪 Where all members are <65 years | R499 per month |
| 🟥 Where one or more insured lives are 65 years> | R592 per month |
| 🟥 Cover for Individuals | 🟥 Premium |
| 🟧 Younger than 55 years | R537 per month |
| 🟨 55 to 64 years old | R700 per month |
| 🟩 65 years and older | R838 per month |
| 🟦 Cover for Families | 🟦 Premium |
| 🟪 Where all members are <65 years | R700 per month |
| 🟥 Where one or more insured lives are 65 years> | R838 per month |
💙Choosing Liberty Gap Cover comes with a long list of advantages, including:
Allows easy and convenient claims processing through various channels, including a mobile app and online portal.
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Family Coverage applies to primary members and their dependents, as listed by their medical plan. Cover will also extend to spouses with separate medical plan memberships.
| 🟥 In-Hospital Cover | Up to 300% of doctors’ and specialists’ charges are covered (MST). Doctors’ and specialists’ charges (limited to 3 times MST) less the medical scheme’s contribution or MST determine the shortfall cover amount. |
| 🟧 Out-of-Hospital Cover | Limited to 50 outpatient CT, PET, and MRI scans. Doctors’ and specialists’ charges (limited to 3 times MST) less the medical scheme’s contribution or MST determine the shortfall cover amount. |
| 🟨 Medical Scheme Co-payment Cover | Hospital admission, scan, and procedure co-payments are covered. Medical schemes’ penalty co-payments for not getting a general practitioner referral before seeing a specialist, a pre-authorization before a procedure, or a back and neck program assessment before spinal surgery are not covered. |
| 🟩 Emergency Room/Casualty Ward Cover | Limited to R25,400 per year for hospital emergency room treatment within 48 hours of an accident. This benefit does not cover prosthetists, orthotist, crutches, neck braces, knee and ankle guards, post-treatment, and recuperative device fees. |
| 🟦 Robotic Medical Procedure Cover | Limited to R37 600 per policy per year for medical expenses related to robotic machinery used in in-hospital surgical treatment. |
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| 🟥 Accidental Dentistry Cover | Accidental tooth fracture due to an external blow to the mouth covered up to R25,700. This benefit applies to permanent teeth (crowns and implants excluded) where at least 50% of the visible portion is lost and the dental nerve is permanently damaged due to an accident. Regardless of medical scheme cover, this benefit is R3,700 per fractured tooth. |
| 🟧 Accidental Death and Permanent Disability Cover | The policy’s R50,000 accidental death or permanent disability benefit covers unexpected costs. All policyholders lose accidental permanent disability cover at 65. |
| 🟨 Trauma Counselling Cover | After a violent or traumatic event, insured individuals receive R900 per session for counseling. Within six months of the trauma, counseling will be covered up to R30,300. |
| 🟩 Medical Scheme and Gap Policy – Premium Waiver Cover | After an accidental death or permanent disability, the policyholder will receive 12 times their monthly gap policy and medical scheme premiums. Policy limits this benefit to R122,400. Cover ends for members at 65. |
Family Coverage applies to primary members and their dependents, as listed by their medical plan. Cover will also extend to spouses with separate medical plan memberships.
| 🟥 In-Hospital Cover | Up to 500% of doctors’ and specialists’ charges are covered (MST). Doctors’ and specialists’ charges (limited to 3 times MST) less the medical scheme’s contribution or MST determine the shortfall cover amount. |
| 🟧 Out-of-Hospital Cover | Limited to 50 outpatient CT, PET, and MRI scans. Doctors’ and specialists’ charges (limited to 3 times MST) less the medical scheme’s contribution or MST determine the shortfall cover amount. |
| 🟨 Medical Scheme Co-payment Cover | Hospital admission, scan, and procedure co-payments are covered. Medical schemes’ penalty co-payments for not getting a general practitioner referral before seeing a specialist, a pre-authorization before a procedure, or a back and neck program assessment before spinal surgery are not covered. |
| 🟩 Non-network Co-payment Cover | Full medical scheme co-payment cover for non-DSP hospitals and providers. One claim per year is limited to R16,000. |
| 🟦 MRI, PET, and CT scan Sub-cover | After reaching the insured’s medical scheme sub-limit, this benefit covers MRI, PET, and CT scans. The benefit covers MRI, PET, and CT scans for up to R3,000 per person per year. MRI, PET, and CT scans for non-essential cosmetic surgery are excluded. Policy exclusions exclude this benefit. This benefit is incompatible with Medical Scheme Co-Payment Cover. |
| 🟪 Emergency Room/Casualty Ward Cover | Limited to R25,400 per year for hospital emergency room treatment within 48 hours of an accident. This benefit does not cover prosthetists, crutches, neck braces, knee and ankle guards, post-treatment, and recuperative device fees. |
| 🟥 Cancer Treatment Program – Co-payment cover | Covered medical scheme co-payments for exceeding the annual cancer treatment limit. This cover covers general and specialized treatment, biological drugs, and a maximum 25% co-payment. |
| 🟧 Medical Scheme Cancer Cover Limit Extender | Cancer treatment cost limits cover 20% of ongoing treatment costs. This covers general and specialized treatment and biological drugs. |
| 🟨 Enhanced Cancer Cover – Cosmetic Breast Reconstruction | R27,500 cosmetic breast reconstruction cover. If a breast cancer-related single mastectomy occurs, this cover pays for non-affected breast reconstruction. |
| 🟩 Internal Prostheses and Artificial Joint Cover | Medical expenses and internal prosthesis co-payments are covered up to R44,000 per policy per year. Policyholders with major medical benefits and internal prosthesis cover can use this benefit. If the medical scheme does not cover the full cost of the internal prosthesis due to an annual limit or co-payment, this benefit will cover the difference. Stents are covered up to R3,000 per person per year. Intraocular lenses, breast implants, cochlear implants, and pacemakers are excluded from the cover. |
| 🟦 In-Hospital Dentistry Expense Shortfall Cover | Doctor, dentist, and specialist shortfalls up to 500% of the Medical Scheme Tariff are covered (MST). Doctors and specialists’ charges (limited to 5 times MST) less the greater of the medical scheme’s contribution, or MST is the shortfall cover amount. |
| 🟪 Robotic Medical Procedure Cover | Limited to R37,600 per policy per year for medical expenses related to robotic machinery used in in-hospital surgical treatment. |
| 🟥 Enhanced Cancer Cover | The R30,000 Enhanced Cancer Cover benefit covers unexpected costs for first-time stage II and above cancer diagnoses. Stage I prostate cancer with a Gleason score of 8 or higher also benefits. This benefit requires a confirmed cancer diagnosis with an ICD 10 C code and registration on the medical scheme’s oncology treatment program. This cover excludes skin cancer and only covers the first diagnosis after the 12-month waiting period. |
| 🟧 Accidental Dentistry Cover | Accidental tooth fracture due to an external blow to the mouth covered up to R25,700. This benefit applies to permanent teeth (crowns and implants excluded) where at least 50% of the visible portion is lost and the dental nerve is permanently damaged due to an accident. Regardless of medical scheme cover, this benefit is R3,700 per fractured tooth. |
| 🟨 Accidental Death and Permanent Disability Cover | The policy’s R50,000 accidental death or permanent disability benefit covers unexpected costs. All policyholders lose accidental permanent disability cover at 65. |
| 🟩 Trauma Counselling Cover | After a violent or traumatic event, insured individuals receive R900 per session for counseling. Within six months of the trauma, counseling will be covered up to R30,300. |
| 🟦 Medical Scheme and Gap Policy – Premium Waiver Cover | After an accidental death or permanent disability, the policyholder will receive 12 times their monthly gap policy and medical scheme premiums. Policy limits this benefit to R122,400. Cover ends for members at 65. |
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💙To apply for Gap Cover with Liberty, you can follow these steps:
Alternatively, you can apply for Gap Cover with Liberty by calling their customer service hotline or visiting one of their branches.
💙If you want to change your Liberty Gap Cover option, you can follow these steps:
Your new Gap Cover option will become effective on the date agreed upon with Liberty Gap Cover, and any changes in premium will be reflected in your next billing statement.
💙To submit a claim for Gap Cover with Liberty, you can follow these steps:
If your claim is rejected, Liberty Gap Cover will provide a reason for the rejection and any steps you can take to dispute the decision.
Participation in any form of race or speed test involving any mechanically propelled vehicle, vessel, craft, or aircraft
Treatment costs for services rendered by allied health care professionals, such as but not limited to dieticians, podiatrists, audiologists, chiropractors, acupuncturists, and more.
There are no waiting periods that prevent cover after the policy’s commencement date, whether they are general or specific to certain conditions.
However, if the policyholder has received medical advice, diagnosis, care, or treatment for a medical condition within the 12 months before the policy’s start date, they cannot make any claims related to that condition for the first 12 months of cover.
| 🔎 Gap Cover Provider | 🥇 Liberty | 🥈 Universal Health | 🥉 Auto & General |
| 🟥 Underwriters | Guardrisk Insurance Company Limited | Compass Insurance Co Ltd | 1Life Insurance Limited |
| 🟧 Number of Plans | 2 | 2 | 3 |
| 🟨 Average Price | R253 | R244.89 | R99 |
| 🟩 Waiting Periods | 3 – 12 months | 12 months | 3 – 12 months |
| 🟦 Exclusions | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Oncology Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟥 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟧 Out-of-Hospital Cover | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Maternity Benefit | None | ✅ Yes | None |
| 🟩 Scopes and Scans | ✅ Yes | None | ✅ Yes |
| 🟦 Co-payment Cover | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Emergency Room | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟥 Accidental Cover | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟧 Trauma Counseling | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Premium Waiver | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟩 Non-DSP Co-Payment | ✅ Yes | ✅ Yes | None |
| 🟦 Prostheses | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Accidental Death/ Permanent Disability | ✅ Yes | None | ✅ Yes |
| 🟥 Travel Cover Extender | None | ✅ Yes | None |
| ✅ Pros | ❌ Cons |
| Provides additional protection against unexpected medical expenses not covered by medical schemes | Exclusions and waiting periods may apply to the policy, including pre-existing conditions and pregnancy |
| Offers a range of benefits and options to suit different needs and budgets | Changes to the policy may result in changes to benefits, premiums, and waiting periods |
| Covers hospitalization, day-to-day medical expenses, chronic conditions, and international travel for medical emergencies | The loyalty benefit may take time to accumulate |
| Includes additional benefits, such as accidental death cover and a funeral benefit | The policy is an additional expense on top of medical scheme premiums |
| Offers easy and convenient claims processing through various channels, including a mobile app and online portal | Some exclusions apply to specific treatments and procedures |
Liberty Gap Cover provides an additional layer of protection against unexpected medical expenses that are not covered by medical schemes. It offers a range of benefits and options to suit different needs and budgets, including coverage for hospitalization, day-to-day medical expenses, and chronic conditions.
The policy also includes international travel cover for medical emergencies and a range of additional benefits, such as accidental death cover and a funeral benefit.
One of the key advantages of Liberty Gap Cover is its loyalty benefit, which increases the annual limit and reduces the co-payment amount over time.
Liberty Gap Cover is an insurance policy that provides additional protection against unexpected medical expenses not covered by medical schemes.
Liberty Gap Cover supplements your existing medical scheme by providing additional benefits and covering expenses such as co-payments, non-medical expenses, and certain chronic conditions.
Liberty Gap Cover may have exclusions and waiting periods, such as pre-existing conditions and pregnancy, which may affect your cover.
The loyalty benefit is a feature of Liberty Gap Cover that increases your annual limit and reduces your co-payment amount over time as long as you maintain your policy.
You can submit your claim online through the Liberty Gap Cover website, mobile app, email, or fax.
Liberty Gap Cover includes additional benefits, such as accidental death cover and a funeral benefit, that can provide financial security for unexpected events.
Yes, you can change your Liberty Gap Cover option by contacting Liberty Gap Cover’s customer service department and following their process for making changes.
Liberty Gap’s premiums depend on the family structure, the insured person’s age, and the option chosen, with cover starting from R253.
The processing time for a claim with Liberty Gap Cover depends on the claim’s complexity and the supporting documentation’s completeness. Liberty Gap Cover aims to process claims as quickly as possible.
No, Liberty Gap Cover is designed to supplement your existing medical scheme cover and requires that you are a member of a registered medical scheme to be eligible for cover.
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.
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