Zestlife Universal (🇿🇦 2026*)

  Overall, Zestlife Universal Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Zestlife Universal Gap Cover Plans start from R591 ZAR. Zestlife has a trust score of 4.1.     👉🏿 Zestlife Gap Cover has three plans to choose from:   ✅ Zestlife Universal ✅ Zestlife Optimal ✅ Zestlife Essential    

Zestlife Universal Gap Cover - 6 Key Point Quick Overview

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

Zestlife Universal Premiums

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Zestlife Universal Benefits and Cover Breakdown

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

Zestlife Universal Section A - Medical Expense Shortfall Cover

• ✅️ In-hospital covers up to 500% of the medical aid tariff.
• ✅️  Out-of-hospital covers up to 500% of the medical aid tariff.
• ️✅ Covers general co-payments imposed by the policyholder's medical aid for hospital admission, CT, PET, and MRI scans.
• ✅️ Covers non-network co-payments for treatment with non-DSP providers, up to R16,000 per policy per year.
• ✅️ Covers MRI, PET, and CT scan over the medical aid sub-limit, up to R5,000 per insured person annually.
• ✅️ Covers casualty and emergency room treatment, up to R26,700 per policy annually.
• ✅️ Covers casualty facility emergency treatment for children under 11, up to R2,950 per policy per year.
• ✅️ Covers internal prostheses and artificial joints with shortfalls or co-payments, up to R46,000 per policy annually.
• ✅️ Covers stents, up to R5,000 per insured individual per year.
• ️✅ Covers robotic medical procedures, up to R39,500 per policy annually.
• ✅️ Covers oncology treatment co-payments, up to 25% of the treatment cost.
• ✅️ Covers continued treatment for oncology treatments exceeding medical aid limits, up to 20% of the insured person's treatment costs.

Zestlife Universal Section B - Health Insurance Benefits

• ✅ Cancer Assist Cover: This benefit offers coverage of R8,000 for the unforeseen expenses that may arise from a first-time diagnosis of cancer at least at stage 2, which is local and malignant in nature. If you are later diagnosed with regional and malignant cancer (including leukemia and Hodgkin’s Disease) at a minimum of stage 2 for the first time, you will then be entitled to an additional one-time Cancer Assist benefit of R12,000.
• ✅ Covers cosmetic breast reduction after a single mastectomy due to breast cancer, up to R29,000 per insured person.
• ✅Alternatively, a one-time benefit of R20,000 is available upon the first diagnosis of at least stage 2, regional, and malignant cancer (which includes leukemia and Hodgkin’s Disease).
• ✅ Additionally, a further benefit of R15,000 is available for regional and malignant cancer, provided that the insured has successfully claimed either the R12,000 or R20,000 benefit, and their medical scheme has incurred expenses of R200,000 or more on oncology treatment within 12 months following the diagnosis.
• ✅ Any cancer diagnosis that fails to meet the minimum eligibility requirements or is not a first-time diagnosis is excluded. All skin cancers, as well as all cancers diagnosed and treated solely through primary biopsy, which do not necessitate surgical, medical, or radiotherapy treatment, are excluded.
• ✅️ Covers accidental dentistry for accidental tooth fracture, up to R27,000 at a rate of R3,900 per fractured tooth.
• ✅️ Provides accidental death and disability cover, up to R55,000, for members under 65.
• ✅️ Covers trauma counseling up to R950 per session, with an annual limit of R32,000 for treatment within 6 months of the event.
• ✅️ Covers Trauma and Bereavement Counseling. This benefit offers coverage for the expenses associated with trauma and bereavement counseling needed after the insured individual has been a victim or a witness to an act of violence, a traumatic accident, or the loss of an immediate family member.
• ✅️ This benefit allows for reimbursement of up to R950 per session, with a total maximum benefit of R32,000 for counseling services that begin within six months following the traumatic event, and it is applicable for a single treatment period lasting up to six months per policy each calendar year.
• ✅️ Offers medical aid gap cover premium waiver, 12 times the combined medical aid premium, up to R130,000 for insured persons under 65 years old.

Zestlife Universal Exclusions and Waiting Periods

Zestlife Universal Exclusions

  Zestlife Universal 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.
• ✅ Cancer treatment or planned procedures received outside the Republic of South Africa.
• ✅ 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.

  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 Universal 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.

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

Zestlife Universal vs Other Gap Cover Plans

   

Our Verdict on Zestlife Universal

  According to our research, Zestlife Universal Gap Cover offers comprehensive benefits, particularly in oncology, in-hospital and out-of-hospital cover, and trauma counseling.   However, it lacks coverage for maternity benefits, co-payment coverage, accidental benefits, and travel cover extender. Furthermore, in our experience, the final decision on whether Zestlife Universal Gap Cover is suitable for an individual or family will depend on their specific needs and priorities.  

Zestlife Universal Frequently Asked Questions

What is Zestlife Universal Gap Cover?

Zestlife Universal Gap Cover provides extensive cover for medical expense shortfalls and financial protection against various health risks. In addition, it offers individual and family plan options.  

What does Zestlife Universal Gap Cover include?

It includes in-hospital and out-of-hospital cover, comprehensive oncology benefits, co-payments and shortfalls, and a premium waiver for medical aid and gap cover.  

How does Zestlife Universal Gap Cover help with medical expenses?

It covers the difference between what your medical aid pays and what doctors and specialists charge, protecting you from unexpected medical expense shortfalls.  

Can I choose Zestlife Universal Gap Cover for my family?

Yes, Zestlife Universal Gap Cover offers options for individuals and families, providing cover for all lives insured, including those over 65.  

Does Zestlife Universal Gap Cover include cover for maternity benefits?

No, maternity benefits are not included in the cover provided by Zestlife Universal Gap Cover.