Exact Gap Cover
About this plan
Procedure-specific cover for treatments excluded by your medical scheme, helping pay approved hospital and specialist costs for defined procedures.
Monthly premium
From
R227
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
Exact Cover
Sirago Exact Cover (2024*)
Overall, Sirago Exact Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Sirago Exact Cover Plan starts from R195 ZAR. Sirago has a trust score of 4.4.| 🔎 Provider | 🥇 Sirago Exact Cover |
| 🟥 Years in Operation | 30 years |
| 🟧 Underwriters | GENRIC Insurance Company Limited (FSP: 43638) |
| 🟨 Market Share in South Africa | >10% |
| 🟩 Gap Cover Waiting Period | From 3 months (up to 12) |
| 🟦 Do Exclusions Apply | ✅ Yes |
| 🟪 Average Monthly Premium | R195 |
| 🟥 Oncology Benefit | None |
| 🟧 In-Hospital Benefit | ✅ Yes |
| 🟨 Out-of-Hospital Cover | None |
Sirago Exact Cover - 7 Key Point Quick Overview
- ✅ Sirago Exact Cover Overview
- ✅ Sirago Exact Cover Premiums
- ✅ Sirago Exact Cover Benefits and Cover Breakdown
- ✅ Sirago Exact Cover Exclusions and Waiting Periods
- ✅ Sirago Exact Cover vs Other Gap Cover Plans
- ✅ Our Verdict on Sirago’s Exact Cover
- ✅ Sirago Exact Cover Frequently Asked Questions
Sirago Exact Cover Overview
The Sirago Exact Cover is one of eight plans that starts from R195 per month. Sirago’s Exact Cover has benefits for procedures and surgeries excluded from medical aid cover. Furthermore, Sirago negotiates with service providers and pays claims directly according to a predefined rate. Sirago Gap Cover has eight plans to choose from:
Sirago Exact Cover Premiums
| 🟥 Age Limit | 🟥 Monthly Contribution |
| 🟧 Overall Annual Limit per Beneficiary | 🟧 R140,000 |
| 🟨 Price per Individual who is between 0 – 64 years old | 🟨 R195 |
| 🟩 Price per Family with beneficiaries from 0 – 64 years old | 🟩 R225 |
| 🟦 Price per Individual who is >65 years old | 🟦 R412 |
| 🟪 Price per Family with a beneficiary of >65 years old | 🟪 R508 |
Sirago Exact Cover Benefits and Cover Breakdown
If your selected health insurance policy explicitly omits a particular service, Sirago Exact Cover will continue to provide cover if the service is part of a pre-established list of covered services. Sirago will handle all discussions with service providers and settle your claim up to the outlined amounts below. Moreover, the expenses covered encompass the cost charged by the hospital and all other service providers. Members are advised to be aware that the following restrictions apply to Exact Cover:| 🟥 Procedure | 🟧 Cover Limit | 🟨 Procedure | 🟩 Cover Limit |
| 🟧 Arthroscopic Surgery | R75,000 | Joint Replacement Surgery | R50,000 |
| 🟨 Back and Neck Surgery | R75,000 | Oesophageal reflux and hiatus hernia surgery | R60,000 |
| 🟩 Bunion Surgery | R20,000 | Varicose vein surgery | R22,500 |
| 🟦 A cochlear implant, auditory brain implant, and internal nerve Stimulator surgery, including the device and processor | R85,000 | Knee and shoulder surgery | R20,000 |
| 🟪 Dental procedures for reconstructive plastic surgery due to an accident | R80,000 | MRI and CT scans due to an accident | R10,000 |
| 🟥 Dental procedures for impacted wisdom teeth for children under 18 years old | R15,000 | Emergency casualty benefit: Accident & Trauma, Children under 8 years old (max R4 000) | R6,000 |
| 🟧 Functional Nasal Surgery | R25,000 | Skin disorders, including benign growths and lymphoma | R20,000 |
| 🟨 Non-cancerous breast conditions | R20,000 | Endoscopic Procedures | R5,000 |
Sirago Exact Cover Exclusions and Waiting Periods
Exact Cover Exclusions
The following are excluded from the cover by Sirago on the Exact Cover:- ✅ Sirago does not enumerate any medical procedures your health insurance plan specifically excludes.
Exact Cover Waiting Periods
Sirago Gap Cover applies the following waiting periods on Exact Cover:- ✅ In addition, a 10-month duration exists when claims for the specified procedures or surgeries cannot be lodged.
Sirago Exact Cover vs Other Gap Cover Plans
| 🔎 Provider | 🥇 Sirago Exact Cover | 🥈 Cura Administrators Gap Standard | 🥉 Kaelo Gap Core |
| 🟥 Years in Operation | 30 years | 26 years | 19 years |
| 🟧 Underwriters | GENRIC Insurance Company Limited (FSP: 43638) | GENRIC Insurance Company Limited | Centriq Insurance Company Limited |
| 🟨 Market Share in South Africa | >10% | <5% | <1% |
| 🟩 Gap Cover Waiting Period | From 3 months (up to 12) | 3 – 12 months | 12 months |
| 🟦 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Average Monthly Premium | R195 | R281 | R255 |
| 🟥 Oncology Benefit | None | None | None |
| 🟧 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Out-of-Hospital Cover | None | None | None |
| 🟩 Maternity Benefit | None | None | None |
| 🟦 Scopes and Scans | ✅ Yes | ✅ Yes | None |
| 🟪 Co-payment Cover | None | ✅ Yes | None |
| 🟥 Emergency Room | ✅ Yes | ✅ Yes | None |
| 🟧 Accidental Cover | ✅ Yes | None | ✅ Yes |
| 🟨 Trauma Counseling | None | None | None |
| 🟩 Premium Waiver | None | None | ✅ Yes |
| 🟦 Non-DSP Co-Payment | None | None | None |
| 🟪 Prostheses | ✅ Yes | None | None |
| 🟥 Travel Cover Extender | None | None | None |
| 🟧 Accidental Death/ Permanent Disability | None | None | ✅ Yes |
