💙 Overall, Turnberry Optimal Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Turnberry Optimal Gap Cover Plans start from R510 ZAR. Turnberry has a trust score of 4.3.
| 🔎 Provider | 🥇 Turnberry Optimal |
| 🟥 Years in Operation | 22 years |
| 🟧 Underwriters | Lombard Insurance Company |
| 🟨 Market Share in South Africa | <5% |
| 🟩 Gap Cover Waiting Period | 3 – 12 months |
| 🟦 Do Exclusions Apply | ✅ Yes |
| 🟪 Average Monthly Premium | R510 |
| 🟥 Oncology Benefit | ✅ Yes |
| 🟧 In-Hospital Benefit | ✅ Yes |
| 🟨 Out-of-Hospital Cover | ✅ Yes |
💙 The Turnberry Optimal is one of five plans that starts from R510 per month. The Turnberry Optimal Plan has benefits for in-hospital dental procedures, illness, oncology, innovative cancer drugs, trauma care, critical illness, travel, and more.
👉 Turnberry Gap Cover has five plans to choose from
| 🅰️ Families under 65 years | 🅱️ Families that have members 65 years> |
| R510 | R736 |
| 🟥 Medical Expense Shortfall Cover | Increases medical aid by 500%. Covers costs associated with GPs, Specialists, Anaesthetists, Radiology, Pathology, and Consumables. Subject to the Overall Annual Limit. |
| 🟧 Co-payment cover | Subject to the Overall Annual Limit. |
| 🟨 Non-DSP Hospital Penalty Cover | Limited to R13,500 per admission. Limited to 1 family claim per year. Subject to the Overall Annual Limit. |
| 🟩 Sub-Limit Cover | Limited to R33,000 per admission per insured. Limited to R72,000 per family per year. Subject to the Overall Annual Limit. |
| 🟥 Medical Expense Shortfall Cover | Increases medical aid by 500% for impacted wisdom teeth, orthognathic surgery, reconstructive maxillofacial surgery after an accident, and oral cancer diagnosed while on the policy. Subject to the Overall Annual Limit. |
| 🟧 Basic Dental Medical Expense Shortfall Cover for Children | Increases Medical Aid by 500% for basic dentistry for children under 12. Limited to R4,000 per family per year. |
| 🟨 Co-payment Cover | Subject to the Overall Annual Limit. |
| 🟩 Sub-limit and Co-payment Cover Dental Implants | Covers oral cancer and reconstructive maxillofacial surgery dental implants (diagnosed while on the policy). Limited to R24,000 per admission, R50,000 per family per year. Subject to the Overall Annual Limit. |
| 🟦 Sub-limit Cover | Limited to R24,000 per admission and R50,000 per family per year for impacted wisdom teeth, orthognathic surgery, reconstructive maxillofacial surgery due to an accident while on the policy, and oral cancer (diagnosed while on the policy). Subject to the Overall Annual Limit. |
| 🟥 Co-payments for MRI, CT, and PET scans | Subject to AOL |
| 🟧 Co-payments for scopes | Limited to R6,000 per event. Limited to 2 claims per insured yearly. Subject to the Overall Annual Limit. |
| 🟨 Sub-limit cover for MRI, CT, and PET scans | Limited to R33,000 per event per insured. Limited to R72,000 per family per year. Subject to the Overall Annual Limit. |
| 🟩 Casualty Benefits for Accidents | Limited to R12,000 per event per insured. Subject to the Overall Annual Limit. |
| 🟦 Casualty Benefit for Illness | Limited to R5,000 per event. Limited to 2 claims per family yearly. Subject to the Overall Annual Limit. Treatment is limited to 6 pm – 6 am, Mondays–Fridays, Saturdays–Sundays, and Public Holidays |
| 🟥 Traditional Cancer Cover | Traditional cancer treatment co-payments are limited to 20% per admission. Subject to the Overall Annual Limit. |
| 🟧 Biological Cancer Drug Cover | Covers Biological Cancer Drugs when the Medical Scheme has a sub-limit. Subject to the formulary and the Annual Maximum |
| 🟨 Innovative Cancer Drug Cover | Cover for new and innovative cancer drugs. Each claim is limited to R12,000. Subject to the Overall Annual Limit. |
| 🟩 MRI and CT Scan Cover | Covers MRI and CT scans without Medical Scheme cover. R7,000 per event and 1 claim per family per year. |
| 🟦 Trauma Care Cover | Covers trauma counseling with a registered healthcare provider after a member is diagnosed with a critical illness, is a victim of a violent crime, or loses an immediate family member. Limited to R3,000 per insured and R7,000 per family annually. Subject to the Overall Annual Limit |
| 🟪 Breast Cancer Prevention Cover | Increases the Medical Aid rate for a Prophylactic Mastectomy by up to 500%. Subject to clinical entry criteria and the Annual Maximum. |
| 🟥 Breast Cancer Reconstruction Cover | Increases the Medical Aid rate for breast reconstruction after a mastectomy due to cancer for the affected breast by up to 500%. When there is no benefit on the insured person’s Medical Scheme, reconstruction of the unaffected breast for symmetry is limited to R22,000 per insured person per lifetime. Subject to the Overall Annual Limit. |
| 🟥 Medical Scheme Contribution Waiver | Limited to R7,500 per month for six months if the Medical Scheme Contribution Payer dies or becomes permanently disabled in an accident. |
| 🟧 Gap Premium Waiver | Pays your Optimal Policy premium for 12 months if the Contribution Payer dies or becomes permanently disabled in an accident. |
| 🟨 Personal Accident Benefit | Limited to R19,500 per insured registered on the policy if there is accidental death or permanent total disability. |
| 🟩 Critical Illness Benefit | The policy is limited to R9,500 per insured if death or critical illness occurs (excluding cancer). |
| 🟦 International Travel Cover | R5 million per insured, but a 48-hour travel notice is required. |
💙 Turnberry Optimal excludes Hospitalization, bodily injury, sickness, or disease caused by:
💙 There is a general waiting period of three months for all benefits except accidents on the policy and a waiting period of 10 months for pregnancy/childbirth. Furthermore, there is a waiting period of 12 months for the following treatments:
💙 A full overview of Optimal Waiting Periods will be provided by Turnberry.
| 🔎 Provider | 🥇 Turnberry Optimal | 🥈 Sirago Exact Cover with Gap and Co-Pay | 🥉 Netcare Plus Gap Cover |
| 🟥 Years in Operation | 23 years | 31 years | 28 years |
| 🟧 Underwriters | Lombard Insurance Company | GENRIC Insurance Company Limited (FSP: 43638) | The Hollard Insurance Company Limited |
| 🟨 Market Share in South Africa | <5% | >10% | <5% |
| 🟩 Gap Cover Waiting Period | 3 – 12 months | From 3 months (up to 12) | 3 – 12 months |
| 🟦 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Monthly Premium from. | R510 | R413 | R315 |
| 🟥 Oncology Benefit | ✅ Yes | None | ✅ Yes |
| 🟧 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Out-of-Hospital Cover | ✅ Yes | None | ✅ Yes |
| 🟩 Maternity Benefit | None | None | ✅ Yes |
| 🟦 Scopes and Scans | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟪 Co-payment Cover | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟥 Emergency Room | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟧 Accidental Cover | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟨 Trauma Counseling | ✅ Yes | None | ✅ Yes |
| 🟩 Premium Waiver | ✅ Yes | ✅ Yes | ✅ Yes |
| 🟦 Non-DSP Co-Payment | ✅ Yes | None | ✅ Yes |
| 🟪 Prostheses | None | ✅ Yes | ✅ Yes |
| 🟥 Travel Cover Extender | ✅ Yes | None | None |
| 🟧 Accidental Death/ Permanent Disability | ✅ Yes | ✅ Yes | ✅ Yes |
💙 Our research shows the Turnberry Optimal plan offers comprehensive benefits to supplement your existing medical aid coverage. Optimal can easily enhance medical aid by providing additional benefits and increasing the medical aid rate up to 500% for various medical expenses.
💙It covers various medical expenses, including in-hospital treatments, specialized procedures, and out-of-hospital services like cancer treatments and diagnostic scans.
Turnberry Optimal is a comprehensive gap cover plan that enhances medical aid coverage. It benefits medical expense shortfalls, co-payments, in-hospital dental procedures, cancer treatments, diagnostic scans, trauma care, and more.
The Medical Expense Shortfall Cover increases the medical aid rate to 500% for various medical services, such as consultations with specialists, radiology, pathology, and consumables. It helps bridge the gap between the actual medical costs and what your medical scheme covers.
The overall annual limits refer to the maximum amount Turnberry Optimal will pay for various benefits within a year. These limits ensure that the cover remains within a certain financial threshold and may vary depending on the benefit or procedure.
Yes, Turnberry Optimal provides cover for cancer treatments. It includes co-payment cover for traditional cancer treatments, cover for biological cancer drugs when there are sub-limits on your medical scheme, and cover for new innovative cancer drugs up to a certain limit per claim.
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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