Overall, Total Risk Administrators Super Cover Plus is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Total Risk Administrators Super Cover Plus Plan starts from R380 ZAR. Total Risk Administrators has a trust score of 4.2.
π Provider | π₯ Total Risk Administrators Super Cover Plus |
π₯ Years in Operation | 25 years |
π§ Underwriters | Auto & General Insurance Company Limited |
π¨ Market Share in South Africa | <5% |
π© Gap Cover Waiting Period | 0-10 months |
π¦ Do Exclusions Apply | β Yes |
πͺ Average Monthly Premium | R380 |
π₯ Oncology Benefit | β Yes |
π§ In-Hospital Benefit | β Yes |
π¨ Out-of-Hospital Cover | β Yes |
The Total Risk Administrators Super Cover Plus is one of four plans that starts from R380 per month. Total Risk Administratorsβ Super Cover Plus 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:
π °οΈ Policyholder/Family Criteria | π ±οΈ Super Cover Plus |
π§ All members <65 years | R380 |
π¨ Premium per individual policy monthly | N/A |
π© Premium per family policy monthly | N/A |
π¦ For families with one or more members 65 years> | R570 |
π₯ Gap Cover | Up to 700% cover. |
π« Tariff Shortfalls for Theatre and Ward Fees, Consumables, Laparoscopic/Endoscopic Equipment | R1 000 per policy per annum |
π§ Prescribed Minimum Benefits | Covered but subject to medical aid review. |
β¬ Shortfalls on Specialist Consultations | 3 consults per policy per annum |
π© Casualty Unit Benefit | Limited to R13 650 per policy per year. |
π¦ Co-payment Benefit (In the network) | Limited to R63,000 per policy per year. |
πͺ Co-Payment Benefit Out of Network | 1 co-payment per policy per annum Up to R5 250 |
π¨ 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 R12,600 per scan. |
πͺ Sub-limit Benefit β Internal Prostheses | Limited to R11,550 per policy per year. |
π₯ Sub-limit Benefits for MRI, CT, and PET scans | Limited to 1 MRI, CT, or PET scan per policy per year. Limited to R3,780 per scan. |
π§ Sub-limit Benefits for Colonoscopies and Gastroscopies | Limited to R13,650 per policy per year and R3,780 per event. |
π© Dental Benefit | Unlimited cover provided. Subject to the aggregate annual limit per insured person per year. |
π¦ Global Fee Benefit | Limited to R12,600 per policy per year. |
π¨ Oncology Gap Benefit | Unlimited cover provided. Subject to the aggregate annual limit per insured person per year. |
πͺ Oncology Co-payment Benefit (in the network) | Limited to R63,000 per policy per year. |
β¬ Oncology Co-Payment Benefit: Out of Network | 1 co-payment per policy per annum. Up to R5 250 |
π₯ Oncology Extender Benefit | Limited to R36,750 per policy per year. |
π§ Oncology βNew-Techβ Benefit | Limited to R8,610 per policy per year. |
π© Oncology Gap Benefit for Breast Reconstruction Surgery | Limited to R18,900 per beneficiary per life of the policy. |
π¦ Accidental Death Cover | Limited to R21,000 per insured or spouse. Limited to R8,400 per dependent. |
π¨ Policy Extender | The cover is valid for 12 months. |
πͺ Medical Aid Contribution Waiver | Limited to 6 months. Limited to a maximum of R5,775 per month. |
π₯ TRA Assist | – |
π§ Home Drive | 6 trips per policy per annum. Limited to a 50km radius. |
π© Panic Button | You will have 24-hour access to a crisis manager who will walk you through an emergency. |
π¦ 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. |
π¨ Claim Submission | Insured members can use the mobile app to submit their claim documents. |
πͺ 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 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.
Gap cover excludes consultations before or after in-hospital treatment, medicine and disposable items, crutches, and wheelchairs unless specified in the policy.
There is no general three (3) month waiting period. Instead, the waiting periods commence from the Join Date of the Gap Cover Policy.Β 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:
Any policyholder diagnosed with cancer before membership:
Policyholder previously diagnosed with cancer and in remission:
There will not be any coverage for pre-existing conditions (excluding cancer) leading to hospitalization for the first 6 months of membership. Furthermore, TRA reserves the right to request clinical information if a claim in this period indicates a pre-existing condition.
π Provider | π₯ Total Risk Administrators Super Cover Plus | π₯ Elixi Gap Single | π₯ Auto & General Comprehensive Gap Cover |
π₯ Years in Operation | 25 years | 6 years | 38 years |
π§ Underwriters | Auto & General Insurance Company Limited | Unity Health | 1Life Insurance Limited |
π¨ Market Share in South Africa | <5% | <5% | <5% |
π© Gap Cover Waiting Period | 0-10 months | 3 β 12 months | 10 months |
π¦ Do Exclusions Apply | β Yes | β Yes | β Yes |
πͺ Average Monthly Premium | R380 | R282 | R295 |
π₯ Oncology Benefit | β Yes | None | β Yes |
π§ In-Hospital Benefit | β Yes | β Yes | β Yes |
π¨ Out-of-Hospital Cover | β Yes | None | β Yes |
π© Maternity Benefit | β Yes | None | None |
π¦ Scopes and Scans | β Yes | β Yes | β Yes |
πͺ Co-payment Cover | β Yes | None | β Yes |
π₯ Emergency Room | β Yes | β Yes | β Yes |
π§ Accidental Cover | None | None | β Yes |
π¨ Trauma Counseling | β Yes | None | None |
π© Premium Waiver | β Yes | None | β Yes |
π¦ Non-DSP Co-Payment | β Yes | None | β Yes |
πͺ Prostheses | β Yes | None | β Yes |
π₯ Travel Cover Extender | β Yes | None | None |
π§ Accidental Death/ Permanent Disability | β Yes | None | None |
According to our research, the Super Cover Plus plan offers substantial coverage for various medical needs, including in-hospital procedures, casualty unit benefits, and oncology extender benefits.
However, it lacks cover in some areas, such as out-of-network co-payments and maternity private ward benefits.
The Super Cover Plus plan covers the shortfall after your medical aid has processed your account due to service providers charging the above scheme tariff for authorized in-hospital procedures. The cover is limited to 700% of the original scheme tariff.
TRA Super Cover Plus premium starts from R380 per month for all members under 65 years.
TRA Super Cover Plus offers competitive benefits compared to other gap cover plans, including oncology benefits, in-hospital benefits, co-payment cover, and cover for accidental death and permanent disability.
TRA Super Cover Plus has waiting periods that vary depending on the condition or procedure. It is best to refer to the comprehensive list provided by TRA for specific waiting period details.
While TRA does not mention exclusions in its policy documents, general exclusions could apply to gap cover in South Africa. Therefore, it is recommended to contact TRA to verify exclusions before applying.
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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