5 Best Dental Gap Cover
The 5 Best Dental Gap Covers in South Africa revealed.
We tested them side by side and verified their gap cover plans.
This is a complete guide to the best dental gap cover in South Africa.
In this in-depth guide you’ll learn:
- What is a Dental Gap Cover?
- Why do you need a Dental Gap Cover?
- Can you get dental insurance only?
- Which dental gap covers implants?
- Which dental gap covers has no waiting period?
So if you’re ready to go “all in” with the best dental gap cover in South Africa, this guide is for you.
Let’s dive right in…
Best Dental Gap Cover (2024)
| 🩺 Gap Cover | ✔️ Best for Dental Cover? | ⚕️ Plan Offered | 👉 Sign Up |
| 1. Zestlife | Yes | Core dentistry coverage | 👉 Apply Now |
| 2. Discovery Health | Yes | Discovery Gap Comprehensive | 👉 Apply Now |
| 3. Liberty Health | Yes | Liberty Optimum Gap Cover | 👉 Apply Now |
| 4. Sirago Gap Lite Cover | Yes | Gap-Lite Cover | 👉 Apply Now |
| 5. Stratum | Yes | Stratum Gap Cover | 👉 Apply Now |
Best Dental Gap Cover Summary
- Zestlife – Overall, Best Dental Gap Cover in South Africa
- Discovery Health – Top Value-Based Healthcare Provider
- Liberty Health – Best Menu of Long-Term Healthcare Options
- Sirago Gap Lite Cover – Best Provider of Necessary Health Insurance
- Stratum Benefits – Top Customer Support Services for Gap Cover
Overview
If you need help paying for routine dental care, but your health insurance doesn’t cover it, consider Dentistry Gap Cover. Every day, unexpected, and health-related dental care costs are covered, up to the policy maximum.
Here, we explore the 5 best dental gap cover options available to South Africans in 2024.
How dental gap cover works
Gap cover is not meant to replace medical aid. When a doctor’s fees exceed the medical aid rate and the medical aid plan only covers the medical aid rate (either the Risk or hospital benefit), the gap cover will kick in to make up the difference.
Gap insurance won’t kick in if medical aid doesn’t contribute to or cover the full cost of a service.
Your dental visit and any approved medical procedures will be covered by your medical aid, with coverage rates varying depending on the type of medical aid plan you chose.
Gap cover protects you from financial hardship in the event that your doctor’s fees exceed the amount your medical aid plan will pay (either the risk co-payment or the medical aid benefit).
1. Zestlife
Overview
Zestlife is a licenced financial services company that offers customised health and life insurance plans based on your individual requirements. Swiss Re and Gen Re are the reinsurers for Zestlife’s insurance policies.
The fact that Zestlife is covered by two of the largest insurance providers in the world should offer you peace of mind that they can and will fulfil their policy obligations in the event of a valid claim.
Zestlife dental gap cover
If you and your loved ones struggle to afford the exorbitant expense of private dentistry, Dental Cover may be able to help.
Both those with private dental insurance and people with public health insurance can benefit from Dental Cover because it offers a way to pay for dental care.
Most medical aid plans nevertheless leave members responsible for paying some of the expense of dental care out of pocket, even if they are members of the plan.
Zestlife provides multiple Dental Coverage choices.
Costs associated with a wide variety of dental procedures are covered by these plans. The actual costs of dentistry, dental emergencies, dental injuries, dental illnesses, and dental specialities are covered, in whole or in part, by generous specified cover amounts.
Affordable dental care is made possible by the plan’s “core dentistry coverage.” To help with the actual costs of dentistry, including emergency, accidental, and illness-related dental treatment costs, this option pays reduced stated cover amounts.
Discover the 5 Best Value Medical Aids under R1500
2. Discovery Health
Overview
Discovery Medical Health is a non-profit organisation controlled by the Medical Schemes Act 131 of 1998, as amended, and the Medical Schemes Council (CMS). According to the Scheme guidelines, it is a recognised open medical scheme that anybody can join.
Members own the Scheme, and its operations are controlled by an independent Board of Trustees (the Trustees or the Board). The Scheme outsources its administration and managed care functions to Discovery Health (Pty) Limited under a formal contractual relationship.
One of the Scheme’s strategic priorities is value-based healthcare. Their strategy, which places their members at the centre of care, compensates providers based on health outcomes rather than the volume of services they deliver.
It gives members access to programmes and providers committed to continuous quality improvement.
Discovery Health strives to ensure that our members have access to the safest, most efficient, and effective healthcare available in South Africa through a variety of quality of care programmes and innovations that are regularly examined by the Scheme on an ongoing basis.
The Scheme also provides its participants with information relevant to their needs.
Discovery Health Dental Gap Cover
Your specialist’s bill at the hospital can be higher than what your health insurance would pay for. All authorised in-hospital claims made by specialists will have any resulting tariff gaps covered by this Discovery Health Gap Cover.
If you have already used your plan’s hospital benefit to pay for a claim with your dentist’s office, you may be eligible for payment under this benefit as well.
With Discovery Gap Comprehensive, you’re covered for up to 500% of the medical scheme rate while in the hospital, while Discovery Gap Core only covers up to 250%.
3. Liberty Health
Overview
In operation since 2008, Liberty Health is Africa’s most trusted provider of healthcare insurance solutions. Liberty Health’s wide network of healthcare professionals and multinational clients across the continent is the source of their extensive knowledge and skills.
Liberty Health able to provide first-rate services to businesses, health insurance providers, and consumers all over Africa.
Liberty Health operates in more than 27 African countries, offering a full menu of long-term insurance options. The organisation is involved in the healthcare industry at multiple levels, including insurance, IT, and management.
Standard Bank Group, the largest African banking group by assets, includes Liberty Health as a wholly owned subsidiary. Customers may rest easy knowing that their money is in good hands with this reputable financial services firm due to its robust infrastructure and stellar track record.
Liberty Health Dental Gap Cover
All three of the Liberty Gap Cover plans help cover the costs that medical aid recipients incur when they fall short on their own payments.
Liberty Gap Cover is an insurance plan for members of medical schemes that allows them to protect themselves and their families from unexpectedly high medical bills.
Liberty Universal Gap Insurance provides additional financial protection against a wide variety of health risks in addition to comprehensive medical bill shortfall cover. You can choose between individual and family coverage when you go with this alternative.
Affordably covering the most common gaps in coverage, Liberty Essential Gap Insurance also provides additional financial security against certain health risks. You can choose between individual and family coverage when you go with this alternative.
Those younger than 35 might find an affordable and comprehensive solution with Liberty Optimal Gap Cover.
No matter what your medical insurance company pays towards your broken tooth’s repair, you are still entitled to get R3 200 as an incidental dentistry benefit.
Under this benefit, a tooth fracture is defined as the loss of 50 percent or more of the tooth’s visible portion and irreversible injury to the dental nerve.
Every permanent tooth that is broken as a result of an external harm to the mouth is covered by the benefit (crowns and implants are not included).
READ more about Medical Insurance
4. Sirago Gap Lite Cover
Overview
Sirago is a part of South Africa’s thriving financial services sector. This dynamic setting is what allows specialised UMAs like Sirago to step in and provide necessary health insurance assistance.
Sirago is a South African company that specialises in the Gap Cover industry. Sirago’s job as an underwriting manager involves looking for growth prospects in specialised product categories.
The design of medical schemes informs their selection of benefits, premiums, the creation of policy language, and the implementation of a sales and marketing plan.
Short-term insurer and licenced financial services provider GENRIC Insurance Company Limited backs Sirago’s operations. Providing essential benefits to policyholders whose medical expense deficits are not fully covered by their medical schemes is important to their business model.
Sirago Dental Gap Cover
The modern family is what inspired Sirago to create the Gap-Lite Cover. Up to R183,000, or 250% of the programme rate, is reimbursed annually for medical aid shortfalls.
There may be some help with the cost of a hospital stay, imaging, or surgery performed by a non-preferred physician. Procedures and treatments for PMBs at day hospitals and doctors’ offices are partially reimbursed.
Emergency room visits, wellness exams, and benefits for infants and their families are all covered.
Dental gap cover from Sirago includes the following:
• Dental Procedures for Reconstructive Plastic Surgery due to an Accident – R80 000
Dental procedures for impacted wisdom teeth for children under 18 years old – R15 000
5. Stratum Benefits
Overview
In South Africa, Stratum Benefits has been offering gap coverage for medical aid scheme members for over a decade. This highly regarded temporary insurer provides numerous options for gap coverage to meet your specific requirements.
Individuals, families, and businesses alike can choose from Stratum Gap Cover’s wide selection of gap insurance policies. Stratum Benefits has been a leading provider of Medical Assistance Gap Insurance for over a decade, and for the past two years, they have been recognised as FIA’s Product Supplier of the Year.
Stratum Dental Gap Cover
Stratum’s Gap Cover plans were developed to work in tandem with any medical insurance policy in South Africa and are governed by the Commission for Medical Schemes.
When it comes to medical events like medical procedures, dental-related procedures, specialised radiology, pathology, physiotherapy, and more, Stratum supplements your medical aid plan’s rate by an extra 300% or 500% to cover the most commonly experienced medical expense shortfalls on healthcare and service providers’ accounts.
Almost any medical emergency is covered by Stratum. Stratum is here for you from the time you’re a young single in need of the most fundamental coverage all the way through the time you’re an elderly individual in need of the most extensive coverage possible.
Health insurance is a primary healthcare option that can be used by those who do not have access to medical aid or who wish to supplement their current coverage for things like regular doctor visits, acute and chronic medicines, and dental and vision care.
READ more about the 5 Best Gap Cover Options for Under R1000 in South Africa
Frequently Asked Questions
What is dental gap cover?
If you need help paying for routine dental care, but your health insurance doesn’t cover it, consider Dentistry Gap Cover. Everyday, unexpected, and health-related dental care costs are covered, up to the policy maximum.
Can I use dental gap cover instead of medical aid?
Gap cover is not meant to replace medical aid. When a doctor’s fees exceed the medical aid rate and the medical aid plan only covers the medical aid rate (either the Risk or hospital benefit), the gap cover will kick in to make up the difference.
Why should I use dental gap cover?
Gap cover protects you from financial hardship in the event that your doctor’s fees exceed the amount your medical aid plan will pay (either the risk co-payment or the medical aid benefit).
What will dental gap cover give me?
Your dental visit and any approved medical procedures will be covered by your medical aid, with coverage rates varying depending on the type of medical aid plan you chose.
Who offers gap cover in South Africa?
The five medical aid schemes listed in this article provide some of the best dental gap cover in South Africa. The include:
- Discovery Health
- Liberty Health
- Sirago Gap Lite Cover
- Stratum Benefits
- Zestlife
