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Total Risk Administrators Super Cover Plus

Overall, Total Risk Administrators Super Cover Plus is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Total Risk Administrators Super Cover Plus Plan starts from R300 ZAR. Total Risk Administrators has a trust score of 4.2.

🔎 Provider	🥇 Total Risk Administrators Super Cover Plus
🟥 Years in Operation	24 years
🟧 Underwriters	Auto & General Insurance Company Limited
🟨 Market Share in South Africa	<5%
🟩 Gap Cover Waiting Period	3 – 12 months
🟦 Do Exclusions Apply	✅ Yes
🟪 Average Monthly Premium	R300
🟥 Oncology Benefit	✅ Yes
🟧 In-Hospital Benefit	✅ Yes
🟨 Out-of-Hospital Cover	✅ Yes

Total Risk Administrators Super Cover Plus – 7 Key Point Quick Overview

Total Risk Administrators Super Cover Plus Overview

The Total Risk Administrators Super Cover Plus is one of four plans that starts from R300 per month. Total Risk Administrators’ 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:

Total Risk Administrators Super Cover Plus Premiums

🅰️ Policyholder/Family Criteria	🅱️ Super Cover Plus
🟧 All members <65 years	R300
🟨 Premium per individual policy monthly	N/A
🟩 Premium per family policy monthly	N/A
🟦 For families with one or more members 65 years>	R435

Total Risk Administrators Super Cover Plus Benefits and Cover Breakdown

🟥 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 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.

Total Risk Administrators Super Cover Plus Exclusions and Waiting Periods

Super 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.

Gap cover excludes consultations before or after in-hospital treatment, medicine and disposable items, crutches, and wheelchairs unless specified in the policy.

Super 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.

Any policyholder diagnosed with cancer before membership:

✅ Related claims have a 9-month waiting period.

Policyholder previously diagnosed with cancer and in remission:

✅ Must provide medical evidence of 2+ consecutive years of 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.

Total Risk Administrators Super Cover Plus vs Other Gap Cover Plans

🔎 Provider	🥇 Total Risk Administrators Super Cover Plus	🥈 Elixi Gap Single	🥉 Auto & General Comprehensive Gap Cover
🟥 Years in Operation	24 years	6 years	38 years
🟧 Underwriters	Auto & General Insurance Company Limited	Unity Health	1Life Insurance Limited
🟨 Market Share in South Africa	<5%	<5%	<5%
🟩 Gap Cover Waiting Period	3 – 12 months	3 – 12 months	10 months
🟦 Do Exclusions Apply	✅ Yes	✅ Yes	✅ Yes
🟪 Average Monthly Premium	R300	R242	R280
🟥 Oncology Benefit	✅ Yes	None	✅ Yes
🟧 In-Hospital Benefit	✅ Yes	✅ Yes	✅ Yes
🟨 Out-of-Hospital Cover	✅ Yes	None	✅ Yes
🟩 Maternity Benefit	None	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

Our Verdict on Total Risk Administrators Super Cover Plus

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.

Total Risk Administrators Super Cover Plus Frequently Asked Questions

What is the cover limit for in-hospital procedures under the Super Cover Plus plan?

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.

What is the premium for TRA Vital Cover Plus in 2023?

TRA Vital Cover Plus premium starts from R275 per month for all members under 65 years.

What benefits does TRA Vital Cover Plus offer?

TRA Vital Cover Plus provides benefits such as gap cover, in-hospital and out-of-hospital cover, trauma counseling, emergency room cover, and more.

How does TRA Vital Cover Plus compare to other gap cover plans?

TRA Vital 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.

What are the waiting periods for TRA Vital Cover Plus?

TRA Vital 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.

Are there any exclusions with TRA Vital Cover Plus?

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 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.