Vital Cover Plus
About this plan
Enhanced gap cover providing up to 700% medical scheme tariff cover for specialist shortfalls, approved co-payments, sub-limit cover, oncology benefits, and medical aid contribution waiver.
Monthly premium
From
R394
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
Vital Cover Plus
Total Risk Administrators Vital Cover Plus (🇿🇦 2025)
Overall, Total Risk Administrators Vital Cover Plus is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Total Risk Administrators Vital Cover Plus Plan starts from R360 ZAR. Total Risk Administrators has a trust score of 4.2.| 🔎 Provider | 🥇 Total Risk Administrators Vital Cover Plus |
| 🟥 Years in Operation | 25 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 | R360 |
| 🟥 Oncology Benefit | ✅ Yes |
| 🟧 In-Hospital Benefit | ✅ Yes |
| 🟨 Out-of-Hospital Cover | ✅ Yes |
Total Risk Administrators Vital Cover Plus - 7 Key Point Quick Overview
- ✅ Total Risk Administrators Vital Cover Plus Overview
- ✅ Total Risk Administrators Vital Cover Plus Premiums
- ✅ Total Risk Administrators Vital Cover Plus Benefits and Cover Breakdown
- ✅ Total Risk Administrators Vital Cover Plus Exclusions and Waiting Periods
- ✅ Total Risk Administrators Vital Cover Plus vs Other Gap Cover Plans
- ✅ Our Verdict on Total Risk Administrators Vital Cover Plus
- ✅ Total Risk Administrators Vital Cover Plus Frequently Asked Questions
Total Risk Administrators Vital Cover Plus Overview
The Total Risk Administrators Vital Cover Plus is one of four plans that starts from R360 per month. Total Risk Administrators’ Vital Cover Plus has benefits for TRA Assist, medical aid contribution waiver, accidental death, travel, oncology co-payments, and more. Total Risk Administrators (TRA) Gap Cover has four plans to choose from:
Total Risk Administrators Vital Cover Plus Premiums
| 🟥 Policyholder/Family Criteria | Vital Cover Plus |
| 🟧 All members <65 years | R360 |
| 🟨 Premium per individual policy monthly | N/A |
| 🟩 Premium per family policy monthly | N/A |
| 🟦 For families with one or more members 65 years> | R540 |
Total Risk Administrators Vital Cover Plus Benefits and Cover Breakdown
| 🟥 Gap Cover | Up to 700% cover. |
| ⬛ Tariff Shortfalls for Theatre and Ward Fees, Consumables, Laparoscopic/Endoscopic Equipment | R1 000 per policy per annum |
| 🟧 Prescribed Minimum Benefits | Covered but subject to medical aid review. |
| 🟫 Shortfalls on Specialist Consultations | 2 consults per policy per annum |
| 🟨 Casualty Unit Benefit | Limited to R9 240 per policy per year. |
| 🟩 Co-payment Benefit (In the network) | Limited to R13,650 per policy per year. |
| 🟦 Sub-limit benefit – Internal Prostheses | Limited to R5,775 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 R13,650 per policy per year. |
| 🟨 Accidental Death Cover | Limited to R10,500 per insured or spouse. Limited to R5,775 per dependent. |
| 🟩 Policy Extender | The cover is valid for 12 months. |
| 🟦 Medical Aid Contribution Waiver | Limited to 6 months. Limited to a maximum of R4,620 per month. |
| 🟪 TRA Assist | Included |
| 🟥 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 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 Vital Cover Plus Exclusions and Waiting Periods
Vital 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.
- ✅ 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.
Vital 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.
Total Risk Administrators Vital Cover Plus vs Other Gap Cover Plans
| 🔎 Provider | 🥇 Total Risk Administrators Vital 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 | R360 | R282 | R295 |
| 🟥 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 | None | ✅ 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 | None | None | ✅ Yes |
| 🟪 Prostheses | ✅ Yes | None | ✅ Yes |
| 🟥 Travel Cover Extender | ✅ Yes | None | None |
| 🟧 Accidental Death/ Permanent Disability | ✅ Yes | None | None |
