Zestlife Gap Cover

 

Overall, Zestlife Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Zestlife Gap Cover Plans start from R239 ZAR. Zestlife has a trust score of 4.1.

 

Zestlife Gap Cover has three plans to choose from:

• • Zestlife Universal
  • Zestlife Optimal
  • Zestlife Essential

 

🟥 Headquartered	Cape Town, South Africa
🟧 Number of Markets	South Africa
🟨 Market Share	>15%
🟩 The number of plans offered	3
🟦 Mobile App	None

 

 

 

Zestlife Gap Cover – 11 Key Point Quick Overview

 

1. ✅ Zestlife Gap Cover Premiums
2. ✅ Zestlife Gap Cover – Advantages Over Competitors
3. ✅ Zestlife Gap Cover Features
4. ✅ How to apply for Gap Cover with Zestlife
5. ✅ How can I change my Zestlife Gap Cover option
6. ✅ How to Submit a Claim for Gap Cover with Zestlife
7. ✅ Zestlife Gap Cover Exclusions and Waiting Periods
8. ✅ Zestlife Gap Cover vs. Other Notable Providers
9. ✅ Zestlife Gap Cover Pros and Cons
10. ✅ Our Verdict on Zestlife Gap Cover
11. ✅ Zestlife Gap Cover Frequently Asked Questions

 

 

Zestlife Gap Cover Premiums

 

Zestlife Universal Gap Cover

 

🅰️ Cover for Individuals	🅱️ Monthly Contribution
🟨 <55 Years	R506 per month
🟩 55 – 64 Years	R646 per month
🟦 >65 Years	R770 per month
🅰️ Cover for Families	🅱️ Monthly Contribution
🟧 Where all insured are <65 Years	R646 per month
🟨 Where one or more insured are >65 Years	R770 per month

 

Zestlife Essential Gap Cover

 

🅰️ Cover for Individuals	🅱️ Monthly Contribution
🟨 <55 Years	R372 per month
🟩 55 – 64 Years	R468 per month
🟦 >65 Years	R548 per month
🅰️ Cover for Families	🅱️ Monthly Contribution
🟪 Where all insured are <65 Years	R468 per month
🟧 Where one or more insured are >65 Years	R548 per month

 

Zestlife Optimal Gap Cover

 

🅰️ Cover for Individuals	🅱️ Monthly Contribution
<35 Years	R225 per month

 

 

Zestlife Gap Cover – Advantages Over Competitors

 

Choosing Zestlife Gap Cover includes a wide range of Advantages, including:

 

• ✅ Zestlife Gap Cover provides extensive benefits that bridge the gap between the cost of medical procedures and what is covered by medical aid. This means that policyholders are protected from hefty out-of-pocket costs.
• ✅ Zestlife Gap Cover is a cost-effective way to supplement your existing medical insurance coverage.
• ✅ The claims process is straightforward, enabling policyholders to receive their benefits quickly and effectively.
• ✅ Zestlife Gap Cover does not restrict policyholders to a specific network of healthcare providers, allowing them to choose the best medical care for their specific needs.
• ✅ Policyholders are covered regardless of where they receive medical care, making Zestlife Gap Cover a highly portable option for those who travel frequently or reside in multiple locations.
• ✅ Zestlife Gap Cover typically has no waiting periods, so policyholders can immediately begin utilizing their coverage.
• ✅ Zestlife Gap Cover provides additional benefits, such as coverage for dental procedures, psychiatric care, and more, making it a comprehensive solution for policyholders.

 

 

With Zestlife Gap Cover, policyholders can have peace of mind knowing they are protected against unforeseen medical expenses, allowing them to concentrate on their recovery without financial stress.

 

 

Zestlife Gap Cover Features

 

Zestlife Universal Gap Cover

 

Zestlife Universal Gap Cover provides the most extensive medical expense shortfall coverage and extensive financial protection against a vast array of health risks. This option is available as either an individual or family plan.

 

Zestlife Universal Gap Cover Benefits and Cover

 

Section A – Medical Expense Shortfall Cover

 

• ️ In-hospital cover of up to 500% of the medical aid tariff.
• ️ Out-of-Hospital cover of up to 500% of the medical aid tariff.
• ️ General Co-payments imposed by the policyholder’s medical aid for hospital admission, CT, PET, and MRI scans are covered.
• ️ Non-Network Co-Payments charged by the policyholder’s medical aid for treatment with a non-DSP provider are covered up to R11,600 per policy per year.
• ️ MRI, PET, and CT scan over the medical aid sub-limit are covered up to R3,200 for every insured person according to the policy annually.
• ️ Casualty and emergency room treatment are covered up to R22,100 per policy annually.
• ️ Casualty Facility emergency treatment for children under 11 (after-hours treatment) is covered up to R2,500 per policy per year.
• ️ Internal prostheses and Artificial joints are covered if there are any shortfalls or co-payments up to R38,500 per policy annually.
• ️ Robotic Medical Procedures are covered up to R33,000 per policy annually.
• ️ Oncology treatment co-payments are covered when the policyholder’s medical aid requires co-payments where annual cancer limits have been exceeded.
• ️ Oncology treatments where the Medical Aid limit has been exceeded – Zestlife offers continued treatment by covering up to 20% of the insured person’s treatment costs.

 

 

Cosmetic Breast Reduction after a single mastectomy because of breast cancer diagnosed after the policy started is covered up to R24,000 for each insured person.

 

Section B – Health Insurance Benefits

 

• ️ Enhanced cancer covers up to R30,000 to cover any unexpected costs during the initial cancer diagnosis.
• ️ Accidental dentistry is covered up to R22,500 for an accidental tooth fracture, paid at a rate of R3,200 per tooth fractured regardless of the medical aid contribution to treat it.
• ️ Accidental Death and Disability cover is provided up to R50,000 for members <65 years old.
• ️ Trauma Counselling is covered up to R800 per session, and there is an annual limit of R26,500 for treatment started within 6 months of the event, paid up to 6 months of treatment.

 

 

Medical Aid Gap Cover Premium Waiver covers 12 x the combined medical aid. The gap covers premiums up to a combined total of R110,000 for insured persons <65 years.

 

Zestlife Essential Gap Cover

 

Zestlife Essential Gap Cover provides affordable coverage for the most common medical expense shortfalls and additional financial protection against various health risks. This option is available as either an individual or family plan.

 

Zestlife Essential Gap Cover Benefits and Cover

 

Section A – Medical Expense Shortfall Cover

 

• ️ In-hospital cover of up to 300% of the medical aid tariff.
• ️ Out-of-Hospital cover of up to 300% of the medical aid tariff.
• ️ General Co-payments imposed by the policyholder’s medical aid for hospital admission, CT, PET, and MRI scans are covered.
• ️ Casualty and emergency room treatment are covered up to R22,100 per policy annually.
• ️ Casualty Facility emergency treatment for children under 11 (after-hours treatment) is covered up to R2,500 per policy per year.

 

 

Robotic Medical Procedures are covered up to R33,000 per policy annually.

 

Section B – Health Insurance Benefits

 

• ️ Accidental dentistry is covered up to R22,500 for an accidental tooth fracture, paid at a rate of R3,200 per tooth fractured regardless of the medical aid contribution to treat it.
• ️ Accidental Death and Disability cover is provided up to R50,000 for members <65 years old.
• ️ Trauma Counselling is covered up to R800 per session, and there is an annual limit of R26,500 for treatment started within 6 months of the event, paid up to 6 months of treatment.

 

 

Medical Aid Gap Cover Premium Waiver covers 12 x the combined medical aid. The gap covers premiums up to a combined total of R110,000 for insured persons <65 years.

 

Zestlife Optimal Gap Cover

 

Zestlife Optimal Gap Cover provides high coverage at an affordable price for individuals under 35.

 

Zestlife Optimal Gap Cover Benefits and Cover

 

Section A – Medical Expense Shortfall Cover

 

• ️ In-hospital cover of up to 500% of the medical aid tariff.
• ️ Out-of-Hospital cover of up to 500% of the medical aid tariff.
• ️ General Co-payments imposed by the policyholder’s medical aid for hospital admission, CT, PET, and MRI scans are covered.
• ️ Non-Network Co-Payments charged by the policyholder’s medical aid for treatment with a non-DSP provider are covered up to R11,600 per policy per year.
• ️ MRI, PET, and CT scan over the medical aid sub-limit are covered up to R3,200 for every insured person according to the policy annually.
• ️ Casualty and emergency room treatment are covered up to R22,100 per policy annually.
• ️ Internal prostheses and Artificial joints are covered if there are any shortfalls or co-payments up to R38,500 per policy annually.

 

 

Robotic Medical Procedures are covered up to R33,000 per policy annually.

 

Section B – Health Insurance Benefits

 

• ️ Accidental dentistry is covered up to R22,500 for an accidental tooth fracture, paid at a rate of R3,200 per tooth fractured regardless of the medical aid contribution to treat it.
• ️ Accidental Death and Disability cover is provided up to R50,000 for members <65 years old.
• ️ Trauma Counselling is covered up to R800 per session, and there is an annual limit of R26,500 for treatment started within 6 months of the event, paid up to 6 months of treatment.

 

 

Medical Aid Gap Cover Premium Waiver covers 12 x the combined medical aid. The gap covers premiums up to a combined total of R110,000 for insured persons <65 years.

 

 

How to apply for Gap Cover with Zestlife

 

To apply for cover with Zestlife, follow these easy steps:

 

Go to the Zestlife website and click on either of the following options:

 

• ✅ “Learn More” to learn more about Zestlife’s products, services, terms, and conditions.
• ✅ “Call me Back” to have a Zestlife support agent call you to discuss the options and to provide a comprehensive quote.
• ✅ “Apply now” if you have already gathered enough information and decided on a suitable Zestlife plan for your and/or your dependents.

 

If you apply via the site, you can click on “Apply Now,” and you will be redirected to the Zestlife online application, where you can complete these sections:

 

• ✅ Product Selection
• ✅ Personal Details
• ✅ Medical Details
• ✅ Declaration
• ✅ Payment Details

 

 

Once complete, you can finish the application, and it will be sent to Zestlife for review.

 

 

How can I change my Zestlife Gap Cover option?

 

To change your Zestlife Gap Cover option, you can follow these steps:

 

• ✅ You can contact Zestlife through their customer service hotline or email their customer support team.
• ✅ When you reach out to Zestlife, you must provide your full name, policy number, and contact information. This will help the representative to verify your identity and access your account information.
• ✅ Once your account has been verified, you can discuss your options for changing your Gap Cover option with a Zestlife representative. They will be able to explain the available options and assist you in deciding what best suits your needs.

 

 

Once you have chosen your new Gap Cover option, the representative will assist you in completing the change process, including any necessary paperwork or documentation.

 

How to Submit a Claim for Gap Cover with Zestlife

 

For efficient processing of your Gap Cover claim, kindly observe the following steps:

 

Step 1 – Determining the Type of Claim

 

Your Gap Cover policy offers numerous benefits that can be claimed. Please visit the designated link to determine the type of claim you are making and the accompanying supporting documents required.

 

Step 2 – Complete the Claim Form

 

• ✅ Download the editable version of the claim form from the Zestlife website.
• ✅ All claimants must fill out sections 1, 2, and 3 of the form.
• ✅ In section 4, indicate the type of claim (as per Step 1).
• ✅ Complete sections A, B, C, D, E, or F according to the type of claim, and ensure that the declaration in section 1 is signed.

 

 

Step 3 – Identity Supporting Documents to be provided with the Claim Form

 

• ✅ Identify the necessary supporting documents that must be submitted with your claim on the Zestlife website. In addition, these documents are also listed on the completed claim form.

 

 

Step 4 – Submitting the Claim to Zestlife

 

• ✅ Before sending in the completed claim form, ensure that all required fields have been filled out and that you have acquired all the necessary supporting documents.
• ✅ Submit the claim form and supporting documents by emailing them to [email protected].
• ✅ Policyholders should note that Gap claims must be submitted within 6 months of the procedure or treatment date.
• ✅ Zestlife will not assess your claim until a fully completed claim form and all relevant supporting documentation have been received.

 

 

Furthermore, you will be informed of the claim process via SMS, email, and telephone regarding the progress of your claim.

 

 

Zestlife Gap Cover Exclusions and Waiting Periods

 

Zestlife Specific Exclusions

 

Zestlife Gap Cover does not provide cover or benefits for any of the following:

 

• ✅ Cosmetic surgery unless required due to illness or injury.
• ✅ Penalty co-payments imposed by medical aids for non-compliance with rules.
• ✅ Medication and other materials.
• ✅ External prosthetics.
• ✅ Pre- and post-hospitalization doctor and specialist charges.
• ✅ Treatment for obesity or treatments required because of obesity.
• ✅ Treatment for depression, mental, or stress-related conditions.
• ✅ Claims not covered by medical aid.
• ✅ Split billing charges.
• ✅ Private and home nursing.
• ✅ Hospital charges and day-to-day medical practitioner charges.
• ✅ Breast or dental implants.
• ✅ Emergency medical transportation.
• ✅ Out-of-hospital dental procedures.
• ✅ Diagnosis or treatment for sleeping disorders.

 

 

Treatment costs for services rendered by allied health care professionals, such as dietitians, podiatrists, audiologists, chiropractors, acupuncturists, speech therapists, biokineticists, occupational therapists, physiotherapists, diagnostic medical sonographers, radiographers, and respiratory therapists.

 

Zestlife Pre-existing Condition Exclusions

 

Benefits are not paid for claims that originate from the following:

 

• ✅ Nuclear weapons or nuclear or ionizing radiation.
• ✅ Suicide, attempted suicide, or intentional self-injury.
• ✅ Use of drugs or narcotics not prescribed and taken according to the instructions of a registered medical practitioner.
• ✅ Illness or injury caused by using alcohol.
• ✅ Illegal behavior or breaking the law of the Republic of South Africa.
• ✅ Participation in war, terrorism, invasion, rebellion, active military duty, police duty, civil commotion, labor disturbances, riots, strikes, or activities of locked-out workers.
• ✅ Aviation accidents, except on a commercial flight as a fare-paying passenger.

 

 

Participation in any race or speed test involving any mechanically propelled vehicle, vessel, craft, or aircraft.

 

Zestlife Gap Cover Waiting Periods

 

Zestlife does not typically impose any general or condition-specific waiting periods. However, the following will apply:

 

• ✅ Zestlife does not impose general or condition-specific waiting periods after the policy’s commencement date.
• ✅ However, medical conditions for which medical advice, diagnosis, care, or treatment was received or would reasonably have been recommended 12 months before the policy’s start date will not be eligible for benefits 12 months from the start date.
• ✅ Pregnancy before the policy’s start date is considered a pre-existing condition, and pregnancy and birth-related claims will be excluded for 12 months from the start date.
• ✅ If the policyholder had prior coverage under another Medical Expense Shortfall Policy with similar benefits, the pre-existing condition waiting period would only apply to the remaining portion of the waiting period from the previous policy.

 

 

For benefits not provided under the previous policy, the full 12-month exclusion will apply.

 

 

Zestlife Gap Cover vs. Other Notable Providers

 

🔎 Gap Cover Provider	🥇 Zestlife	🥈 Sirago	🥉 Liberty
🟥 Number of Plans	3	8	2
🟧 Average Price	R239	R289	R372
🟨 Waiting Periods	3 – 12 months444	3 months	12 Months
🟩 Exclusions	✅ Yes	✅ Yes	✅ Yes
🟦 Oncology Benefit	✅ Yes	✅ Yes	✅ Yes
🟪 In-Hospital Benefit	✅ Yes	✅ Yes	✅ Yes
🟥 Out-of-Hospital Cover	✅ Yes	✅ Yes	✅ Yes
🟧 Maternity Benefit	None	✅ Yes	✅ Yes
🟨 Scopes and Scans	✅ Yes	None	✅ Yes
🟩 Co-payment Cover	✅ Yes	✅ Yes	✅ Yes
🟦 Emergency Room	✅ Yes	✅ Yes	✅ Yes
🟪 Accidental Cover	✅ Yes	✅ Yes	✅ Yes
🟥 Trauma Counseling	✅ Yes	✅ Yes	✅ Yes
🟧 Premium Waiver	✅ Yes	✅ Yes	✅ Yes
🟨 Non-DSP Co-Payment	✅ Yes	✅ Yes	✅ Yes
🟩 Prostheses	✅ Yes	None	✅ Yes
🟦 Accidental Death/ Permanent Disability	✅ Yes	✅ Yes	None
🟪 Travel Cover Extender	None	None	✅ Yes

 

 

Zestlife Gap Cover Pros and Cons

 

✅ Pros	❎ Cons
Zestlife offers three versatile and comprehensive plans that suit different individuals and families according to their needs	There are several exclusions and limits on cover
There are typically no waiting periods	There are some negative reviews in terms of claims and customer support
The claims process is quick and extremely efficient	Some gap cover policies are more expensive than that of competitors who offer similar plans

 

You might also like the 5 Best Gap Cover Options for Under R200

 

 

Our Verdict on Zestlife Gap Cover

 

Zestlife is a reputable and licensed South African-based Gap Cover insurance provider designed to help policyholders cover the costs of medical procedures not fully covered by their medical aid.

Zestlife offers a range of benefits and features, including comprehensive coverage, flexible policy options, and a quick and efficient claims process.

Furthermore, some of the most recent Zestlife reviews by users have praised the company’s customer service, noting that representatives are helpful and responsive.  Overall, we found that Zestlife is a suitable option for South Africans seeking cover for shortfalls with medical expenses that medical aids do not cover.

 

Zestlife Gap Cover Frequently Asked Questions

 

What is the claims process like with Zestlife Gap Cover?

The claims process with Zestlife Gap Cover is quick and efficient, with many policyholders reporting that claims are settled quickly and without hassle. Once a claim is submitted, Zestlife will assess the claim and communicate with the policyholder via SMS, email, or telephone during the process.

 

Is Zestlife Gap Cover expensive?

The cost of Zestlife Gap Cover can vary, depending on the selected policy option and the desired coverage level. Some users may find that Zestlife’s Gap Cover policies are more expensive than those offered by other providers, so it is important to consider the cost when deciding.

 

Can I cancel my Zestlife Gap Cover policy?

Yes, you can cancel your Zestlife Gap Cover policy at any time. However, it is important to review the terms and conditions of your policy to understand any fees or penalties that may apply.

 

How do I claim with Zestlife Gap Cover?

To claim with Zestlife Gap Cover, you must complete a claim form and provide the required supporting documentation. Claims can be submitted by email to [email protected]. Claims must be submitted within 6 months from the procedure or treatment date.

 

What does Zestlife Gap Cover, cover?

Zestlife Gap Cover covers the costs of medical procedures that are not fully covered by a policyholder’s medical aid.

Furthermore, cover can include the difference between the medical aid rate and the actual procedure cost and other expenses such as co-payments and deductibles.

 

Who owns Zestlife?

Zestlife is underwritten by Guardrisk Life Limited (FSP 76) and Guardrisk Insurance Company Limited (FSP 75).

 

What is the waiting period for Zestlife?

Zestlife does not typically have waiting periods. However, where there are pre-existing conditions, waiting periods range from 3 to 12 months.

 

Sharpen your knowledge with a better understanding of Affordable Medical Aids South Africa

Is Zestlife a good gap cover?

Zestlife is a good gap cover option for South Africans. Zestlife Universal Gap Cover offers comprehensive medical shortfall benefits at a low cost.

Furthermore, claims are paid up to an R182,700 annual limit per insured. Furthermore, in- and out-of-hospital GP and specialist consultations are covered at up to 500% of the medical scheme tariff.