The Universal plan offers a range of benefits, including coverage for non-network co-payments, oncology treatments, internal prostheses, casualties, robotic medical procedures, and various other additional advantages.
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
In Hospital Benefits:
Out of Hospital Cover:
Tax Deductible:
Prostheses:
500+
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
In Hospital Benefits:
Out of Hospital Cover:
Tax Deductible:
Prostheses:
Monthly Premium
From R253
Waiting Period
12 months
Optimal
The Optimal plan provides several benefits, including premium waivers, trauma counseling, coverage for accidental death and permanent disability, internal prostheses, artificial joints, and various other additional advantages.
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
In Hospital Benefits:
Out of Hospital Cover:
Tax Deductible:
Prostheses:
500+
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
In Hospital Benefits:
Out of Hospital Cover:
Tax Deductible:
Prostheses:
Monthly Premium
From R397
Waiting Period
12 months
Essential
The Essential plan offers various benefits, including coverage for in-hospital shortfalls, scopes and scans, accidental dentistry, and several other additional advantages.
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
In Hospital Benefits:
Out of Hospital Cover:
Tax Deductible:
Prostheses:
500+
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
The 500+ plan offers a range of benefits, including coverage for sub-limits, hospital birth, day-to-day expenses, prenatal testing, premium waiver, and various other additional advantages.
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.
✅ The cover is available to individuals and families in all South African medical schemes, with no age restrictions.
✅ Individual coverage is for those who do not have any dependents covered by a medical plan.
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.
Liberty Essential Gap Cover Medical Expense Shortfall Cover
🟥 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.
Liberty Essential Gap Cover Health Insurance Benefit
🟥 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.
Liberty Universal Gap Cover
✅ The cover is available to individuals and families in all South African medical schemes, with no age restrictions.
✅ Individual coverage is for those who do not have any dependents covered by a medical plan.
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.
Liberty Universal Gap Cover Medical Expense Shortfall Cover
🟥 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.
Liberty Universal Gap Cover Health Insurance Benefit
🟥 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.
💙To apply for Gap Cover with Liberty, you can follow these steps:
✅ Visit the Liberty Gap Cover webpage and review the available options and benefits.
✅ Click on the “Get a Quote” button and provide your details, such as your name, contact information, and medical scheme information.
✅ Choose the Gap Cover option that best suits your needs and budget.
✅ Complete the online application form with your personal and medical information and select your preferred payment method.
✅ Read and accept the terms and conditions of the policy and submit your application.
✅ Once your application has been received, a Liberty Gap Cover consultant will contact you to confirm your details and discuss the next steps in the process.
✅ Your Gap Cover policy will commence once your application has been accepted and your first premium payment has been received.
Alternatively, you can apply for Gap Cover with Liberty by calling their customer service hotline or visiting one of their branches.
How can I change my Liberty Gap Cover option?
💙If you want to change your Liberty Gap Cover option, you can follow these steps:
✅ Contact Liberty Gap Cover’s customer service department through their hotline or by visiting one of their branches.
✅ Inform the customer service representative that you wish to change your Gap Cover option.
✅ Provide your policy details and any relevant information regarding the change you want.
✅ The customer service representative will guide you through changing your Gap Cover option, including any changes in premium and benefits.
✅ Once you have agreed to the changes, you must sign a new policy agreement reflecting your updated cover.
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.
How to Submit a Claim for Gap Cover with Liberty
💙To submit a claim for Gap Cover with Liberty, you can follow these steps:
✅ Obtain the relevant claim form from the Liberty Gap Cover website, mobile app, or customer service department.
✅ Fill out the claim form with all necessary information, including your details, medical scheme information, and medical expenses incurred.
✅ Attach all supporting documents to the claim form, such as medical invoices, receipts, and medical scheme statements.
✅ Submit the completed claim form and supporting documents to Liberty Gap Cover through their online portal, mobile app, email, or fax.
✅ Liberty Gap Cover will review your claim and notify you of the outcome within the agreed timeframe.
✅ If your claim is approved, Liberty Gap Cover will pay the eligible benefits directly to your nominated bank account or medical service provider, depending on the type of claim.
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.
Liberty Gap Cover Exclusions and Waiting Periods
Liberty Gap Cover General Exclusions
✅ Claims resulting from nuclear weapons or nuclear or ionizing radiation
✅ Suicide, attempted suicide, or intentional self-injury
✅ Taking any drug or narcotic unless prescribed by a registered medical practitioner (other than the insured person)
✅ Any illness or injury caused by the use of alcohol
✅ Illegal behavior, or as a result of breaking the law of the Republic of South Africa
✅ Participation in war, terrorist activity, invasion, rebellion, active military duty, police duty, police reservist duty, civil commotion, labor disturbances, riot, strike, or the activities of locked-out workers
✅ Aviation accidents, except on a commercial flight as a fare-paying passenger.
Participation in any form of race or speed test involving any mechanically propelled vehicle, vessel, craft, or aircraft
Liberty Gap Cover-Specific Exclusions
✅ Cosmetic surgery, unless required due to illness or injury
✅ Penalty co-payments are imposed by medical schemes for not following the rules of the scheme
✅ Pre- and post-hospitalization doctor and specialist charges
✅ Treatment for obesity or treatment that is required as a result of obesity
✅ Elective or routine procedures and physical examinations, including tests, annual check-ups, ECGs, contraception-related treatments, fertility, ART (assisted reproduction therapy), and elective circumcisions
✅ Treatment for depression, mental or stress-related conditions
✅ Claims not covered by the medical scheme
✅ Private and home nursing
Treatment costs for services rendered by allied health care professionals, such as but not limited to dieticians, podiatrists, audiologists, chiropractors, acupuncturists, and more.
Liberty Gap Cover Waiting Periods
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.
Liberty Gap Cover vs Other Notable Providers
🔎 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
Liberty Gap Cover Pros and Cons
✅ 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
Our Verdict on Liberty Gap Cover
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 Frequently Asked Questions
What is Liberty Gap Cover?
Liberty Gap Cover is an insurance policy that provides additional protection against unexpected medical expenses not covered by medical schemes.
How does Liberty Gap Cover work?
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.
What exclusions and waiting periods apply to Liberty Gap Cover?
Liberty Gap Cover may have exclusions and waiting periods, such as pre-existing conditions and pregnancy, which may affect your cover.
What is the loyalty benefit offered by Liberty Gap 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.
How do I file a claim with Liberty Gap Cover?
You can submit your claim online through the Liberty Gap Cover website, mobile app, email, or fax.
What are the additional benefits of Liberty Gap Cover?
Liberty Gap Cover includes additional benefits, such as accidental death cover and a funeral benefit, that can provide financial security for unexpected events.
Can I change my Liberty Gap Cover option?
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.
How much does Liberty Gap Cover cost?
Liberty Gap’s premiums depend on the family structure, the insured person’s age, and the option chosen, with cover starting from R253.
How long does it take for Liberty Gap Cover to process a claim?
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.
Can I purchase a Liberty Gap Cover without an existing medical scheme?
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 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.
