Absolute Cover Plus
About this plan
Premium gap cover providing up to 700% medical scheme tariff cover for specialist shortfalls, approved co-payments, oncology treatment, emergency medical services, sub-limit cover, and comprehensive hospital-related benefits.
Monthly premium
From
R681
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
Absolute Cover Plus
Total Risk Administrators Absolute Cover Plus (🇿🇦 2025)
Overall, Total Risk Administrators Absolute Cover Plus is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Absolute Cover Plus Plan starts from R620 ZAR. Total Risk Administrators has a trust score of 4.2.| 🔎 Provider | 🥇 Total Risk Administrators Absolute Cover Plus |
| 🟥 Years in Operation | 24 years |
| 🟧 Underwriters | Auto & General Insurance Company Limited |
| 🟨 Market Share in South Africa | <5% |
| 🟩 Gap Cover Waiting Period | 0-10 months |
| 🟦 Do Exclusions Apply | ✅ Yes |
| 🟪 Average Monthly Premium | R620 |
| 🟥 Oncology Benefit | ✅ Yes |
| 🟧 In-Hospital Benefit | ✅ Yes |
| 🟨 Out-of-Hospital Cover | ✅ Yes |
Total Risk Administrators Absolute Cover Plus - 7 Key Point Quick Overview
- ✅ Total Risk Administrators Absolute Cover Plus Overview
- ✅ Total Risk Administrators Absolute Cover Plus Premiums
- ✅ Total Risk Administrators Absolute Cover Plus Benefits and Cover Breakdown
- ✅ Total Risk Administrators Absolute Cover Plus Exclusions and Waiting Periods
- ✅ Total Risk Administrators Absolute Cover Plus vs Other Gap Cover Plans
- ✅ Our Verdict on Total Risk Administrators Absolute Cover Plus
- ✅ Total Risk Administrators Absolute Cover Plus Frequently Asked Questions
Total Risk Administrators Absolute Cover Plus Overview
The Total Risk Administrators Absolute Cover Plus is one of four plans that starts from R620 per month. It has benefits for co-payments for non-DSP scopes and scans, sub-limits for scopes, internal prostheses, cancer boosters, and more. Total Risk Administrators (TRA) Gap Cover has four plans to choose from:
Total Risk Administrators Absolute Cover Plus Premiums
| 🟥 Policyholder/Family Criteria | Absolute Cover Plus |
| 🟧 All members <65 years | R620 |
| 🟨 Premium per individual policy monthly | N/A |
| 🟩 Premium per family policy monthly | N/A |
| 🟦 For families with one or more members 65 years> | R770 |
Total Risk Administrators Absolute Cover Plus Benefits and Cover Breakdown
| 🟥 Gap Cover | Up to 700% cover. |
| 🟫 Tariff Shortfalls for Theatre and Ward Fees, Consumables, Laparoscopic/Endoscopic Equipment | "R5 000 per policy per annum " |
| 🟧 Prescribed Minimum Benefits | "Covered, subject to medical aid review" |
| 🟩Shortfalls on Specialist Consultations | Limited to the following number of consults p.p.p.a (up to a max of R500 per consult). 4 consults per policy per annum |
| 🟨 Casualty Unit Benefit | Up to R23 100 per policy per annum |
| 🟩 Co-payment Benefit (In the network) | Unlimited but subject to the aggregate annual limit per insured person per annum |
| 🟦 Co-payment Benefit (Out of the network) | Limited to 2 payments per policy per year up to a combined limit of R16,800. |
| 🟪 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 but subject to the aggregate annual limit per insured person per annum. Up to R68 250 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 R6,300 per scan. |
| 🟨 Sub-limit Benefits for Colonoscopies and Gastroscopies | Limited to R23,100 per policy per year and R6,300 per event. |
| 🟩 Dental Benefit | Unlimited cover provided. Subject to the aggregate annual limit per insured person per year. |
| 🟦 Global Fee Benefit | Limited to R25,200 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 R16,800. |
| 🟨 Oncology Extender Benefit | Unlimited cover provided. Subject to the aggregate annual limit per insured person per year. |
| 🟩 Oncology “New-Tech” Benefit | Limited to R17,325 per policy per year. |
| 🟦 Oncology Gap Benefit for Breast Reconstruction Surgery | Limited to R36,750 per beneficiary per life of the policy. |
| 🟪 Maternity Private Ward Benefit | Limited to R1,250 per day for three consecutive days. |
| 🟥 Accidental Death Cover | Limited to R31,500 per insured or spouse. Limited to R21,000 per dependent. |
| 🟧 Policy Extender | The cover is valid for 12 months. |
| 🟨 Medical Aid Contribution Waiver | Limited to 6 months. Limited to a maximum of R6,930 per month. |
| 🟩 TRA Assist | - |
| 🟦 Home Drive | A designated driver service may include “Own Vehicle” or “Uber” services. Limited to 6 trips per year per policy. The radius is set at 50 kilometers. |
| 🟪 Panic Button | Included |
| 🟥 Medical Health and Trauma Counselling Line | Included |
| 🟧 Claim Submission | Included |
| 🟨 Travel Benefit | Emergency Medical and Related expenses R1 000 000 Medical Evacuation, Repatriation, or Transportation to a Medical Centre Actual expense covered when arranged by Hepstar Financial Services Personal Accident Cover Death: R25 000 / Permanent Disability: up to R25 000 Theft or Accidental Damage during trip R 5 000 / Single item limit: R 1 500 Theft, Damage or loss by Airline R5 000 / Single item limit: R 1 500 Baggage Delay (more than 4 hours) R500 Baggage Delay (more than 24 hours) R1 000 |
Total Risk Administrators Absolute Cover Plus Exclusions and Waiting Periods
Total Risk Administrators Absolute Cover Plus Exclusions
Total Risk Administrators does not mention exclusions in its policy documents. However, we have found some general exclusions that could apply to gap cover in South Africa. However, we urge potential policyholders to contact TRA to verify exclusions before they apply.- ✅ Certain treatments are generally not covered, including cosmetic surgery, obesity treatment, laser eye surgery, dental implants, and fertility treatment.
- ✅ Treatments for self-inflicted wounds, alcohol or drug addiction, or suicide attempts are not covered unless taken according to a medical practitioner’s prescription, resulting in a bad reaction.
- ✅ Expenses related to psychiatric treatment, depression, emotional or mental illness, or stress-related illness are generally not covered.
- ✅ Gap cover does not pay for medical expenses incurred outside South Africa’s borders unless specified in the policy.
- ✅ Services provided by allied health professionals are generally not included in gap cover, except for in-hospital physiotherapy.
- ✅ Injuries from certain adventure sports like skiing, mountain climbing, or scuba diving are not covered.
Total Risk Administrators Absolute Cover Plus Waiting Periods
There is no general three (3) month waiting period. Instead, the waiting periods commence from the Join Date of the Gap Cover Policy. There is a 10-month condition-specific waiting period. No claims may be submitted within the first 10 months of membership for any Gap Cover policy if they relate to any of the following conditions:- ✅ Head, neck, and spinal procedures (e.g., Laminectomy)
- ✅ All types of hernia procedures
- ✅ Endoscopic procedures (e.g., Colonoscopy, Gastroscopy)
- ✅ Pregnancy and childbirth (including cesarean delivery)
- ✅ Gynecological conditions (e.g., Hysterectomy)
- ✅ Joint replacement (excluding treatment due to accidental trauma)
- ✅ Inability to walk/move without pain, and more.
- ✅ Related claims have a 9-month waiting period.
- ✅ Must provide medical evidence of 2+ consecutive years of remission.
💙Discover more about Precautionary Care
Total Risk Administrators Absolute Cover Plus vs Other Gap Cover Plans
| 🔎 Provider | 🥇 Total Risk Administrators Absolute Cover Plus | 🥈 Elixi Gap Single | 🥉 Auto & General Comprehensive Gap Cover |
| 🟥 Years in Operation | 25 years | 7 years | 39 years |
| 🟧 Underwriters | Auto & General Insurance Company Limited | Unity Health | 1Life Insurance Limited |
| 🟨 Market Share in South Africa | <5% | <5% | <5% |
| 🟩 Gap Cover Waiting Period | 0-10 months | 3 – 12 months | 10 months |
| 🟦 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Average Monthly Premium | R620 | R282 | R295 |
| 🟥 Oncology Benefit | ✅ Yes | None | ✅ Yes |
| 🟧 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Out-of-Hospital Cover | ✅ Yes | None | ✅ Yes |
| 🟩 Maternity Benefit | ✅ Yes | None | None |
| 🟦 Scopes and Scans | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Co-payment Cover | ✅ Yes | None | ✅ Yes |
| 🟥 Emergency Room | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟧 Accidental Cover | None | None | ✅ Yes |
| 🟨 Trauma Counseling | ✅ Yes | None | None |
| 🟩 Premium Waiver | ✅ Yes | None | ✅ Yes |
| 🟦 Non-DSP Co-Payment | ✅ Yes | None | ✅ Yes |
| 🟪 Prostheses | ✅ Yes | None | ✅ Yes |
| 🟥 Travel Cover Extender | ✅ Yes | None | None |
| 🟧 Accidental Death/ Permanent Disability | ✅ Yes | None | None |
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