Total Risk Administrators (TRA) Gap Cover
Overall, Total Risk Administrators (TRA) Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Total Risk Administrators (TRA) Gap Cover Plans start from R99 ZAR. Total Risk Administrators has a trust score of 4.2.
Total Risk Administrators (TRA) Gap Cover has four plans to choose from:
| 🟥 Date Established | 1999 |
| 🟧 Underwriters | Auto & General Insurance Company Limited |
| 🟨 Headquartered | Modderfontein, Johannesburg |
| 🟩 The average number of members | 10,000+ |
| 🟦 Number of Markets | 1 |
| 🟪 Market Share | <5% |
| 🟥 The number of plans offered | 4 |
| 🟧 Mobile App | ✅ Yes |
| 🟨 Waiting Period | 3 – 12 months |
| 🟩 Exclusions | ✅ Yes |
Total Risk Administrators (TRA) Gap Cover – 11 Key Point Quick Overview
- ✅ Total Risk Administrators (TRA) Gap Cover Premiums
- ✅ Total Risk Administrators – Advantages Over Competitors
- ✅ Total Risk Administrators (TRA) Gap Cover Features
- ✅ How to apply for Gap Cover with Total Risk Administrators (TRA)
- ✅ How can I change my Total Risk Administrators (TRA) Gap Cover option?
- ✅ How to Submit a Claim for Gap Cover with Total Risk Administrators (TRA)
- ✅ Total Risk Administrators (TRA) Gap Cover Exclusions and Waiting Periods
- ✅ Total Risk Administrators (TRA) Gap Cover vs Other Notable Providers
- ✅ Total Risk Administrators (TRA) Gap Cover Pros and Cons
- ✅ Our Verdict on Total Risk Administrators (TRA) Gap Cover
- ✅ Total Risk Administrators (TRA) Gap Cover Frequently Asked Questions
Total Risk Administrators (TRA) Gap Cover Premiums
| 🔎 TRA Gap Cover Option | 🥇 Basic Cover 300 | 🥈 Vital Cover Plus | 🥉 Super Cover Plus | 🏅 Absolute Cover Plus |
| 🟥 All members <65 years | N/A | R275 | R300 | R535 |
| 🟧 Premium per individual policy monthly | R99 | N/A | N/A | N/A |
| 🟨 Premium per family policy monthly | R180 | N/A | N/A | N/A |
| 🟩 For families with one or more members 65 years> | R360 | R410 | R435 | R660 |
Total Risk Administrators – Advantages Over Competitors
Choosing TRA Gap Cover includes a wide range of advantages, including:
- ✅ TRA provides comprehensive gap cover to ensure that medical expenses not covered by medical aids are taken care of.
- ✅ Members can access unlimited gap cover benefits with no annual limit, ensuring they are fully protected.
- ✅ TRA offers affordable rates, with monthly premiums starting at as little as R99.
- ✅ TRA offers a range of gap cover plans, ensuring members can find a plan that suits their needs.
- ✅ TRA offers a 10-month condition-specific waiting period, lower than the industry standard of 12 months.
- ✅ TRA offers a 6-month waiting period for pre-existing medical conditions, lower than the industry standard of 12 months.
- ✅ TRA’s claims process is quick and easy, settling claims within 10 business days.
- ✅ TRA has a 24/7 helpline to assist members with any queries or concerns.
- ✅ Guardrisk Life Limited, a reputable and well-established insurer, underwrites TRA.
and much, MUCH more!
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Total Risk Administrators (TRA) Gap Cover Features
TRA Basic Cover
| 🟥 Gap Cover | Up to 300% cover. |
| 🟧 Prescribed Minimum Benefits | Covered but subject to medical aid review. |
| 🟨 Casualty Unit Benefit | Limited to R3,000 per policy per year. |
| 🟩 Dental Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟦 Oncology Gap Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟪 Accidental Death Cover | Limited to R6,000 per insured or spouse.
Limited to R3,000 per dependent. |
| 🟥 Policy Extender | The cover is valid for 12 months. |
| 🟧 TRA Assist | – |
| 🟨 Home Drive | A designated driver service, which can include “Own Vehicle” or “Uber” services.
Limited to 6 trips per year per policy.
The radius is set at 50 kilometers. |
| 🟩 Panic Button | You will have 24-hour access to a crisis manager who will walk you through an emergency. |
| 🟦 Medical Health and Trauma Counselling Line | Access to qualified nurses is unrestricted. 24 hours a day, 7 days a week, for telephonic emergency medical advice, symptom assessment, medical terminology explanation, etc.
Insured persons have access to a COVID-19 care line. |
| 🟪 Claim Submission | Insured members can use the mobile app to submit their claim documents. |
| 🟥 Travel Benefit | Emergency Medical and Related expenses: up to R600,000 with an excess of R500.
COVID-19 Extension covers emergency inpatient or outpatient treatment due to COVID-19 up to R600,000 with an excess of R500.
Medical evacuation, repatriation, or transportation to a medical center: the full cost is covered when arranged by Hepstar Financial Services.
Hospital Cash benefit provides R500 per day (maximum of R3,000) if you are hospitalized.
Inconvenience Cover includes Baggage Cover up to R5,000 for theft, damage, or loss by the travel supplier. |
TRA Vital Cover Plus
| 🟥 Gap Cover | Up to 700% cover. |
| 🟧 Prescribed Minimum Benefits | Covered but subject to medical aid review. |
| 🟨 Casualty Unit Benefit | Limited to R8,000 per policy per year. |
| 🟩 Co-payment Benefit (In the network) | Limited to R12,000 per policy per year. |
| 🟦 Sub-limit benefit – Internal Prostheses | Limited to R5,000 per policy per year. |
| 🟪 Dental Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟥 Oncology Gap Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟧 Oncology Co-payment Benefit (in the network) | Limited to R12,000 per policy per year. |
| 🟨 Accidental Death Cover | Limited to R9,000 per insured or spouse.
Limited to R4,500 per dependent. |
| 🟩 Policy Extender | The cover is valid for 12 months. |
| 🟦 Medical Aid Contribution Waiver | Limited to 6 months.
Limited to a maximum of R4,000 per month. |
| 🟪 TRA Assist | – |
| 🟥 Home Drive | A designated driver service, which may include “Own Vehicle” or “Uber” services.
Limited to 6 trips per year per policy.
The radius is set at 50 kilometers. |
| 🟧 Panic Button | You will have 24-hour access to a crisis manager who will walk you through an emergency. |
| 🟨 Medical Health and Trauma Counselling Line | Access to qualified nurses is unrestricted. 24 hours a day, 7 days a week, for telephonic emergency medical advice, symptom assessment, medical terminology explanation, etc.
Insured persons have access to a COVID-19 care line. |
| 🟩 Claim Submission | Insured members can use the mobile app to submit their claim documents. |
| 🟦 Travel Benefit | Emergency Medical and Related expenses: up to R600,000 with an excess of R500.
COVID-19 Extension covers emergency inpatient or outpatient treatment due to COVID-19 up to R600,000 with an excess of R500.
Medical evacuation, repatriation, or transportation to a medical center: the full cost is covered when arranged by Hepstar Financial Services.
Hospital Cash benefit provides R500 per day (maximum of R3,000) if you are hospitalized.
Inconvenience Cover includes Baggage Cover up to R5,000 for theft, damage, or loss by the travel supplier. |
TRA Super Cover Plus
| 🟥 Gap Cover | Up to 700% cover. |
| 🟧 Prescribed Minimum Benefits | Covered but subject to medical aid review. |
| 🟨 Casualty Unit Benefit | Limited to R12,000 per policy per year. |
| 🟩 Co-payment Benefit (In the network) | Limited to R55,000 per policy per year. |
| 🟦 Co-payment Benefit (Out-of-hospital) for MRIs, CTs, and PET scans | Limited to 1 MRI, CT, or PET scan per policy per year.
Limited to R11,000 per scan. |
| 🟪 Sub-limit Benefit – Internal Prostheses | Limited to R10,000 per policy per year. |
| 🟥 Sub-limit Benefits for MRI, CT, and PET scans | Limited to 1 MRI, CT, or PET scan per policy per year.
Limited to R3,300 per scan. |
| 🟧 Sub-limit Benefits for Colonoscopies and Gastroscopies | Limited to R12,000 per policy per year and R3,300 per event. |
| 🟨 Dental Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟩 Global Fee Benefit | Limited to R11,000 per policy per year. |
| 🟦 Oncology Gap Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟪 Oncology Co-payment Benefit (in the network) | Limited to R55,000 per policy per year. |
| 🟥 Oncology Extender Benefit | Limited to R33,000 per policy per year. |
| 🟧 Oncology “New-Tech” Benefit | Limited to R7,500 per policy per year. |
| 🟨 Oncology Gap Benefit for Breast Reconstruction Surgery | Limited to R16,500 per beneficiary per life of the policy. |
| 🟩 Accidental Death Cover | Limited to R18,000 per insured or spouse.
Limited to R6,000 per dependent. |
| 🟦 Policy Extender | The cover is valid for 12 months. |
| 🟪 Medical Aid Contribution Waiver | Limited to 6 months.
Limited to a maximum of R5,000 per month. |
| 🟥 TRA Assist | – |
| 🟧 Home Drive | A designated driver service, which may include “Own Vehicle” or “Uber” services.
Limited to 6 trips per year per policy.
The radius is set at 50 kilometers. |
| 🟨 Panic Button | You will have 24-hour access to a crisis manager who will walk you through an emergency. |
| 🟩 Medical Health and Trauma Counselling Line | Access to qualified nurses is unrestricted. 24 hours a day, 7 days a week, for telephonic emergency medical advice, symptom assessment, medical terminology explanation, etc.
Insured persons have access to a COVID-19 care line. |
| 🟦 Claim Submission | Insured members can use the mobile app to submit their claim documents. |
| 🟪 Travel Benefit | Emergency Medical and Related expenses: up to R600,000 with an excess of R500.
COVID-19 Extension covers emergency inpatient or outpatient treatment due to COVID-19 up to R600,000 with an excess of R500.
Medical evacuation, repatriation, or transportation to a medical center: the full cost is covered when arranged by Hepstar Financial Services.
Hospital Cash benefit provides R500 per day (maximum of R3,000) if you are hospitalized.
Inconvenience Cover includes Baggage Cover up to R5,000 for theft, damage, or loss by the travel supplier. |
TRA Absolute Cover Plus
| 🟥 Gap Cover | Up to 700% cover. |
| 🟧 Prescribed Minimum Benefits | Covered but subject to medical aid review. |
| 🟨 Casualty Unit Benefit | Limited to R20,000 per policy per year. |
| 🟩 Co-payment Benefit (In the network) | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟦 Co-payment Benefit (Out of the network) | Limited to 2 payments per policy per year up to a combined limit of R15,000. |
| 🟪 Co-payment Benefit (Out-of-hospital) for MRIs, CTs, and PET scans | Limited to 2 scans per policy per year.
Unlimited cover subject to the aggregate annual limit insured person per year. |
| 🟥 Sub-limit Benefit – Internal Prostheses | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year.
Limited to R30,000 per event. |
| 🟧 Sub-limit Benefits for MRI, CT, and PET scans | Limited to 2 MRI, CT, or PET scans per policy per year.
Limited to R5,500 per scan. |
| 🟨 Sub-limit Benefits for Colonoscopies and Gastroscopies | Limited to R20,000 per policy per year and R5,500 per event. |
| 🟩 Dental Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟦 Global Fee Benefit | Limited to R22,000 per policy per year. |
| 🟪 Oncology Gap Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟥 Oncology Co-payment Benefit (in the network) | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟧 Oncology Co-payment Benefit (out of the network) | Limited to two co-payments per policy per year and a combined limit of R15,000. |
| 🟨 Oncology Extender Benefit | Unlimited cover provided.
Subject to the aggregate annual limit per insured person per year. |
| 🟩 Oncology “New-Tech” Benefit | Limited to R15,000 per policy per year. |
| 🟦 Oncology Gap Benefit for Breast Reconstruction Surgery | Limited to R33,000 per beneficiary per life of the policy. |
| 🟪 Maternity Private Ward Benefit | Limited to R1,000 per day for three consecutive days. |
| 🟥 Accidental Death Cover | Limited to R30,000 per insured or spouse.
Limited to R9,000 per dependent. |
| 🟧 Policy Extender | The cover is valid for 12 months. |
| 🟨 Medical Aid Contribution Waiver | Limited to 6 months.
Limited to a maximum of R6,000 per month. |
| 🟩 TRA Assist | – |
| 🟦 Home Drive | A designated driver service, which may include “Own Vehicle” or “Uber” services.
Limited to 6 trips per year per policy.
The radius is set at 50 kilometers. |
| 🟪 Panic Button | You will have 24-hour access to a crisis manager who will walk you through an emergency. |
| 🟥 Medical Health and Trauma Counselling Line | Access to qualified nurses is unrestricted. 24 hours a day, 7 days a week, for telephonic emergency medical advice, symptom assessment, medical terminology explanation, etc.
Insured persons have access to a COVID-19 care line. |
| 🟧 Claim Submission | Insured members can use the mobile app to submit their claim documents. |
| 🟨 Travel Benefit | Emergency Medical and Related expenses: up to R600,000 with an excess of R500.
COVID-19 Extension covers emergency inpatient or outpatient treatment due to COVID-19 up to R600,000 with an excess of R500.
Medical evacuation, repatriation, or transportation to a medical center: the full cost is covered when arranged by Hepstar Financial Services.
Hospital Cash benefit provides R500 per day (maximum of R3,000) if you are hospitalized.
Inconvenience Cover includes Baggage Cover up to R5,000 for theft, damage, or loss by the travel supplier. |
How to apply for Gap Cover with Total Risk Administrators (TRA)
To apply for Gap Cover with Total Risk Administrators (TRA), follow these steps:
- ✅ Visit the TRA website.
- ✅ Choose the gap cover plan that best suits your needs and budget.
- ✅ Click the “Get a Quote” button and fill in the information in the online quote form. This will include personal details, medical aid information, and any pre-existing medical conditions.
- ✅ Once you have submitted the form, you will receive a quote that outlines the monthly premium payable for your chosen gap cover plan.
- ✅ You can complete the online application form if you are satisfied with the quote.
- ✅ The application form will require you to provide personal details, medical aid information, and any pre-existing medical conditions. You will also need to provide your banking details for premium payments.
- ✅ After you have completed the application form, you will be required to sign a debit order mandate authorizing TRA to deduct the monthly premium from your bank account.
- ✅ Once your application has been processed and approved, you will receive a confirmation email with your policy number and cover details.
You can use your gap cover benefits immediately, subject to applicable waiting periods.
POLL: 10 Things to Consider Before you Abandon your Medical
How can I change my Total Risk Administrators (TRA) Gap Cover option?
To change your Total Risk Administrators (TRA) Gap Cover option, follow these steps:
- ✅ Contact TRA’s customer service department through their website.
- ✅ Inform the customer service representative that you would like to change your gap cover plan and provide details of the new plan you would like to switch to.
- ✅ The customer service representative will advise you on any changes to the premium that may result from switching plans and any applicable waiting periods that may apply to the new plan.
- ✅ If you are happy with the new plan and the premium changes, the customer service representative will guide you through switching plans. This may include completing a new application form and signing a new debit order mandate.
- ✅ If you have already made premium payments for the current month or period, the customer service representative will advise you on any refunds or adjustments that may be required.
Once the switch has been processed and approved, you will receive a confirmation email with the details of your new gap cover plan and any changes to your premium payments. Then, you can start using your new gap cover benefits immediately, subject to any applicable waiting periods.
How to Submit a Claim for Gap Cover with Total Risk Administrators (TRA)
To submit a claim for Gap Cover with Total Risk Administrators (TRA), follow these steps:
- ✅ Obtain all necessary medical invoices and documentation related to the treatment you claim.
- ✅ Log in to the TRA member portal on the TRA website
- ✅ Navigate to the “Claims” section of the member portal and select “Submit a Claim.”
- ✅ Complete the online claim form, providing all the necessary details and attaching the supporting documentation. Ensure that you provide accurate and complete information, as incomplete or inaccurate information may result in delays or rejection of your claim.
- ✅ Once you have submitted the claim, you will receive an email confirming that TRA has received the claim.
- ✅ TRA’s claims team will review the claim and may request additional information or documentation if required.
- ✅ If the claim is approved, TRA will settle the claim by paying the approved amount directly into your bank account within 10 business days.
- ✅ If the claim is rejected, TRA will provide you with the reasons for the rejection and any options for disputing the decision.
You can track the progress of your claim by logging into the member portal and checking the status of your claim.
Total Risk Administrators (TRA) Gap Cover Exclusions and Waiting Periods
Total Risk Administrators (TRA) Gap Cover Exclusions
TRA Gap Cover may have exclusions and limitations depending on the specific plan and the individual’s circumstances. Therefore, it is recommended that members carefully review their policy documents to understand any exclusions or limitations that may apply.
Total Risk Administrators (TRA) Gap Cover Waiting Periods
The following Waiting Periods apply with Total Risk Administrators (TRA):
- ✅ There is no general waiting period of three months for Gap Cover policies.
- ✅ The waiting periods for specific conditions begin from the Join Date of the Gap Cover Policy.
The 10-month condition-specific waiting period applies to the following conditions:
- ✅ Head, neck, and spinal procedures
- ✅ All types of hernia procedures
- ✅ Endoscopic procedures
- ✅ Pregnancy and childbirth
- ✅ Joint replacement (excluding accidental trauma)
- ✅ Inability to walk/move without pain
- ✅ Renal, liver, kidney, and bladder conditions
- ✅ Cardiac conditions
- ✅ Dentistry (excluding accidental trauma or oncology)
- ✅ Cataracts and eye laser surgery (including all eye and lens procedures)
- ✅ Neurological conditions and procedures
- ✅ Organ transplants
and many more. A full list of waiting periods will be provided.
- ✅ All claims for the above conditions received within the waiting period will be reviewed by medical management to identify pre-existing conditions.
- ✅ If a Policyholder is diagnosed with cancer before membership, all related claims will be subject to a nine-month waiting period.
- ✅ If a Policyholder has previously been diagnosed with cancer and is currently in remission, the Policyholder needs to advise the insurer with medical evidence that the remission period has been for two or more consecutive years.
- ✅ No claims relating to pre-existing condition/s that may lead to hospitalization (excluding cancer) will be covered within the first six months of membership.
The insurer reserves the right to request any clinical information from a Policyholder’s doctor should a claim indicate or relate to a pre-existing condition in this period.
Total Risk Administrators (TRA) Gap Cover vs Other Notable Providers
| 🔎 Gap Cover Provider | 🥇 Total Risk Administrators (TRA) | 🥈 Stratum Benefits | 🥉 Discovery Health |
| 🟥 Number of Plans | 4 | 11 | 2 |
| 🟧 Average Price | R99 | R155 | R130 |
| 🟨 Waiting Periods | 3 – 12 months | 3 months | 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 | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Scopes and Scans | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟩 Co-payment Cover | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟦 Emergency Room | ✅ Yes | ✅ Yes | None |
| 🟪 Accidental Cover | ✅ Yes | ✅ Yes | None |
| 🟥 Trauma Counseling | ✅ Yes | ✅ Yes | None |
| 🟧 Premium Waiver | ✅ Yes | ✅ Yes | None |
| 🟨 Non-DSP Co-Payment | ✅ Yes | ✅ Yes | None |
| 🟩 Prostheses | ✅ Yes | ✅ Yes | None |
| 🟦 Accidental Death/ Permanent Disability | ✅ Yes | ✅ Yes | None |
| 🟪 Travel Cover Extender | ✅ Yes | None | ✅ Yes |
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Total Risk Administrators (TRA) Gap Cover Pros and Cons
| ✅ Pros | ❎ Cons |
| Comprehensive gap cover with no annual limit | Only available to individuals who have a medical aid |
| Affordable premiums starting at R99 per month | Some waiting periods may apply, although these are generally lower than the industry standard |
Our Verdict on Total Risk Administrators (TRA) Gap Cover
Total Risk Administrators (TRA) is a reputable provider offering members comprehensive, affordable gap cover plans. TRA’s plans provide unlimited gap cover benefits with no annual limit. In addition, their premiums start at R99 per month, making their plans accessible to many individuals.
TRA also offers a range of value-added benefits, including a wellness program, trauma counseling, and access to an online health platform. In addition, TRA’s claims process is quick and easy, with claims settled within 10 business days.
Total Risk Administrators (TRA) Gap Cover Frequently Asked Questions
What is TRA Gap Cover?
TRA Gap Cover is a type of insurance policy that provides financial protection to individuals who have medical aid by covering the shortfall between the medical aid rates and the actual costs of medical treatment.
What is Total Risk Administrators (TRA)?
Total Risk Administrators (TRA) is a company that specializes in providing gap cover plans to individuals who have medical aid to help them cover the costs of medical treatment not covered by their medical aid.
What gap cover plans does TRA offer?
TRA offers a range of gap cover plans, each designed to meet its members’ specific needs and budgets. These plans include different levels of coverage and different benefits.
What is the TRA claims process?
The TRA claims process involves submitting a claim online and providing all necessary medical invoices and documentation related to the treatment you claim. Claims are reviewed by TRA’s claims team and settled within 10 business days.
What are the waiting periods for TRA Gap Cover?
TRA Gap Cover has waiting periods for certain conditions, including pre-existing conditions and cancer-related claims. However, the waiting periods for TRA Gap Cover are generally lower than the industry standard.
How much do TRA premiums cost?
TRA premiums start at R99 per month, with different levels of coverage available at varying premium rates depending on the member’s needs.
What value-added benefits does TRA offer?
TRA offers a range of value-added benefits, including a wellness program, trauma counseling, and an online health platform to help members maintain their health and well-being.
What is the TRA customer service like?
TRA provides an emergency helpline 24/7 to assist members with queries or concerns. They also have an online contact form and email address for non-urgent inquiries.
Who is the underwriter for TRA Gap Cover?
TRA Gap Cover is underwritten by Guardrisk Life Limited, a reputable insurer with over 25 years of experience in the industry.
What are the exclusions and limitations of TRA Gap Cover?
TRA Gap Cover may have exclusions and limitations depending on the specific plan and the individual’s circumstances. Therefore, it is recommended that members carefully review their policy documents to understand any exclusions or limitations that may apply.
