Zestlife Essential (🇿🇦 2025*)

💙 Overall, Zestlife Essential Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Zestlife Essential Gap Cover Plans start from R397 ZAR. Zestlife has a trust score of 4.1.

Zestlife Essential Gap Cover – 7 Key Point Quick Overview

1. ✅ Zestlife Essential Overview
2. ✅ Zestlife Essential Premiums
3. ✅ Zestlife Essential Benefits and Cover Breakdown
4. ✅ Zestlife Essential Exclusions and Waiting Periods
5. ✅ Zestlife Essential vs Other Gap Cover Plans
6. ✅ Our Verdict on Zestlife Essential
7. ✅ Zestlife Essential Frequently Asked Questions

Zestlife Essential Overview

💙 The Zestlife Essential is one of three plans that starts from R397 per month. The Zestlife Essential Plan has benefits for scans (MRI, CT, PET), casualty and emergency room treatment, trauma counseling, accidental dentistry, premium waivers, and more.

👉🏿 Zestlife Gap Cover has three plans to choose from:

✅ Zestlife Universal

✅ Zestlife Optimal

✅ Zestlife Essential

Zestlife Essential Premiums

Zestlife Essential Benefits and Cover Breakdown

💙 Zestlife Essential Gap Cover offers extensive medical expense shortfall cover and financial protection against various health risks.

Zestlife Essential Section A – Medical Expense Shortfall Cover

• ✅️ In-hospital covers up to 300% of the medical aid tariff.
• ✅️ Out-of-Hospital covers up to 300% of the medical aid tariff.
• ✅️ Covers general co-payments for hospital admission, CT, PET, and MRI scans.
• ✅️ Covers casualty and emergency room treatment up to R25,400 per policy annually.
• ✅️ Covers casualty facility emergency treatment for children under 11 up to R2,800 per policy per year.
• ✅️ Covers robotic medical procedures up to R37,600 per policy annually.

Zestlife Essential Section B – Health Insurance Benefits

• ✅️ Accidental dentistry covers up to R25,700 for accidental tooth fractures.
• ✅️ Accidental Death and Disability cover up to R50,000 for members under 65.
• ✅️ Trauma Counselling covers up to R900 per session, with an annual limit of R30,300 for treatment started within 6 months of the event.

👉🏿 Medical Aid Gap Cover Premium Waiver covers 12 times the combined medical aid premiums, up to R122,400, for insured persons under 65.

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Zestlife Essential Exclusions and Waiting Periods

Zestlife Essential Exclusions

👉🏿 Zestlife Essential Gap Cover does not cover the following items and services:

• ✅ 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.

👉🏿 Zestlife will not cover the following Pre-existing Conditions:

• ✅ Nuclear weapons or nuclear or ionizing radiation.
• ✅ Suicide, attempted suicide, or intentional self-injury.
• ✅ Illness or injury caused by using alcohol.
• ✅ Illegal behavior or breaking the law of the Republic of South Africa.
• ✅ Aviation accidents, except on a commercial flight as a fare-paying passenger.

Zestlife Essential Waiting Periods

👉🏿 General or condition-specific waiting periods are not typically imposed. However, the following conditions apply:

• ✅ Medical conditions for which advice, diagnosis, care, or treatment was received or would reasonably have been recommended within 12 months before the policy’s start date will not be eligible for benefits for the first 12 months.
• ✅ 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.

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

Zestlife Essential vs Other Gap Cover Plans

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Our Verdict on Zestlife Essential

💙 According to our research, Zestlife Essential Gap Cover offers comprehensive coverage for medical expense shortfalls and various health risks.  It includes valuable benefits such as in-hospital and out-of-hospital cover, accidental dentistry, and a premium waiver.

💙 However, our findings show that Zestlife Essential has limitations regarding specific exclusions and waiting periods.  Zestlife Essential does not cover oncology, maternity, and several other benefits covered by similar gap cover plans competitors offer.

Frequently Asked Questions

What is Zestlife Essential Gap Cover?

Zestlife Essential Gap Cover is a comprehensive insurance policy designed to cover medical expense shortfalls and financial protection against various health risks. It offers affordable options with benefits tailored to meet essential healthcare needs.

What are the key benefits of Zestlife Essential Gap Cover?

Zestlife Essential Gap Cover offers in-hospital, out-of-hospital, general co-payments, casualty, and emergency room treatment, accidental dentistry, trauma counseling, and a medical aid gap cover premium waiver.

How much does Zestlife Essential Gap Cover cost?

Zestlife Essential Gap Cover premiums start from R397 per month for individuals below 35. However, the premium amount may vary based on the age of the insured and the selected cover options.

Can I add my family members to Zestlife Essential Gap Cover?

Yes, Zestlife Essential Gap Cover offers coverage for both individuals and families. In addition, options are available for families with all insured members below 65 years old and for families over 65 years old.

Does Zestlife Essential Gap Cover include cover for dental expenses?

Zestlife Essential Gap Cover covers accidental dentistry, including accidental tooth fractures. However, routine dental procedures and regular check-ups are generally not covered under this policy.