
5 Best Gap Cover Options for Under R1500 (πΏπ¦ 2025*)
TheΒ 5 Best Gap Cover Options for Under R1500 in South Africa revealed.
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π We tested them side by side and verified their gap cover options.
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π This is a complete guide to the best gap cover options under R1500 in South Africa.
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π In this in-depth guide youβll learn:
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- β What is gap cover?
- β Why do you need gap cover?
- β Do you need gap cover if you already have medical aid?
- β Do you need gap cover when you have a hospital plan?
- β What benefits does gap cover have?
- β Is R1500 affordable for gap cover?
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π So if youβre ready to go βall inβ with the best gap cover under R1500 in South Africa, this guide is for you.
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π Letβs dive right inβ¦
Best Gap Cover Options for Under R1500 (2025)
π©Ί Medical Aid | βοΈ Plans Under R1500? | βοΈ Plan Offered | π Sign Up |
1. Liberty Health Gap Cover | Yes | Liberty β Essential Gap Cover | π Apply Now |
2. Sirago Gap Cover | Yes | Sirago β Gap Cover | π Apply Now |
3. Zestlife Gap Cover | Yes | Zestlife β Universal Gap Cover | π Apply Now |
4. Stratum Benefits Gap Cover | Yes | Stratum Benefits β Base Gap Cover | π Apply Now |
5. Turnberry Gap Cover | Yes | Med-Extend | π Apply Now |
5 Best Gap Cover Options for Under R1500 Summary
- Liberty Health Gap Cover – Overall, Best Gap Cover Options Under R1500 in South Africa
- Sirago Gap Cover – Offers Cover for Use of Non-Designated Service Providers
- Zestlife Gap Cover – Wider Variety of Benefits with Gap Coverage
- Stratum Benefits Gap Cover – Best Variety of Gap Protection Options
- Turnberry Gap Cover – Covers Co-Payments for MRI’s, CT’s and PET Scan’s
Introduction to Gap Cover
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π A form of health insurance known as gap cover can assist with covering out-of-pocket costs that your primary health insurance policy might not pay for. Its purpose is to make up the difference between the amount that your medical aid plan covers and the amount that you are personally responsible for paying out of pocket for medical expenses.
What is gap cover?
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π Gap insurance helps pay the costs of medical treatments that are not covered by your primary health insurance policy, such as pricey surgeries, visits to specialists, and prescription medicines.
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π Gap cover comes with a number of key benefits, like as the ability to access more medical services and to assist lower the overall cost of receiving medical treatment. It also helps to protect you from high out-of-pocket medical bills, which can be difficult to handle if you do not have insurance coverage for them. In addition to this, having health insurance may provide you the peace of mind that comes from knowing that any unexpected medical expenses will be covered.
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π However, gap cover does come with a few drawbacks that should not be ignored. It is possible that some people may find the cost of the premiums to be unaffordable due to the fact that it is so pricey. Additionally, it does not cover all medical expenditures; therefore, it is possible that you may still need to pay for some medical treatments out of your own money.
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π It is crucial to research and evaluate the various gap cover plans that are available before selecting a supplier of gap coverage. Check if the price of the cover is reasonable in relation to your other considerations. In addition to this, it is essential to read all of the fine print and be familiar with the policy’s terms and conditions. You also need to investigate the provider’s reputation and determine whether or not there have been any formal complaints filed against them.
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π Even with medical aid coverage, the overall cost of medical care in South Africa can be prohibitively expensive. Gap Cover is a supplemental insurance policy that can assist bridge the gap between what medical aid covers and what you actually spend out of pocket for medical expenses.
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π Gap Cover Insurance is designed to fill a coverage void by offering supplementary financial protection against medical costs that are not covered by the Medical Aid plan. Private insurance firms are the most common providers of gap cover insurance, which serves as a complement to medical aid plans and is supplied by these businesses.
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π In South Africa, one of the perks of gap cover is that it can help pay for the main policyholder’s medical aid premiums and benefits if they die. This is the most important thing for families where the main insured is the only one who can pay for their health care costs.
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π Also, some gap cover plans may include extra benefits, like a funeral benefit, which can help cover the costs of the policyholder’s funeral if the policyholder dies. This can be a huge help to families, since many of them do not have the money to pay for these bills on their own.
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π READ more about Hospital Plans in SA
What does Gap Cover Insurance cover?
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π A range of medical costs that are not covered by the Medical Aid plan are covered by the Gap Cover Insurance policy. These costs include the following:
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- β Β Co-payments are a component of a member’s medical cost that the member is responsible for paying out of their own personal funds. These co-payments can be covered by gap cover insurance instead.
- β Β Deductibles are a predetermined sum that the member is responsible for paying out of pocket before the Medical Aid plan begins to pay for the expenses of medical care. Protecting yourself from these deductibles is something that Gap Cover Insurance can Β aid.
- β Β It is permissible for healthcare professionals to levy costs that are more than those established under the Medical Aid plan. These expenditures could be covered by gap cover insurance.
Is Gap Cover Compulsory in South Africa?
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πGap Cover is not required in South Africa, but it offers additional financial protection against medical costs that are not covered by insurance. In order to guarantee that you are covered for all of your medical expenses, even if you already have medical aid, it is a good idea to look into gap cover insurance.
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π The cost of medical treatment in South Africa has been rising at a rate that is significantly faster than the country’s average rate of inflation over the course of recent years. This has resulted in increased medical system payments as well as increased expenditures paid out of pocket for medical treatment.
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π In addition, many of people find out the hard way that the medical aid coverage they have purchased is not enough to cover all of their necessary medical expenses, leaving them with a significant strain on their finances.
Choosing a Gap Cover Provider
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π It is crucial to compare gap cover providers in South Africa when looking for medical gap cover. This will allow you to verify that you are receiving the greatest coverage available at a price that is within your budget.
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π Here are some reasons why you should compare gap cover providers, as well as several ways to do so:
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- β Many gap cover policies require their customers to wait for a certain amount of time before they begin providing coverage.
- β You might choose a company that has a shorter waiting period or offers instant coverage by comparing the various suppliers.
- β There is a possibility that the gap cover you obtain will be contingent on the network of healthcare professionals with which some gap cover providers collaborate.
- β The prices for gap insurance might vary substantially depending on the provider you choose and the level of coverage that you purchase.
- β There is a wide variety of gap cover providers, each of which offers its own unique set of advantages and coverage.
- β By shopping around, you might choose a carrier that offers the coverage and benefits that are appropriate for your needs.
- β By evaluating several providers, you should be able to select one that has a network that include your chosen healthcare providers.
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π Check out their waiting times, prices, and coverage and perks, as well as their provider network. When you have narrowed down your list of possible providers, it is a good idea to acquire quotations from each one so that you can compare the prices they charge and the locations that they service.
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π You may also learn about the experiences that other people have had with the service provider by reading reviews that have been posted by current clients as well as clients who have used the provider in the past.
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π In addition, by doing this, you will know that you can depend on your provider to answer any questions that you may have and to address any issues that may arise.
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π Then, determine which gap cover plan is right for you by gaining an understanding of the various types of gap coverage plans because there are many different kinds of plans available on the market, each with its own set of characteristics and advantages.
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π Gap cover plans start at low prices, but those options provide much less benefits. If you can afford it, it is better to opt for a more comprehensive gap cover policy that cover more shortfalls and give you peace of mind in any possible emergency situation.
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π READ more about Gap Cover Plans under R300 per month
1. Liberty Health Gap Cover
Overview
π Liberty Health was founded in 2008 and is a leading provider of health insurance to over 400 000 people in 27 African countries.
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π Liberty Healthβs breadth of knowledge and expertise stems from their experience offering comprehensive, flexible health care solutions to multinational corporations, corporations, SMEs, and individuals in South Africa and throughout Africa.
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π The interests of the corporation include health insurance products as well as health administration technology systems and services.
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πLiberty Holdings includes Liberty Health. Liberty is a leading financial services firm on the African continent, having a Standard & Poorβs long-term rating of AAA.
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π Liberty provides a complete suite of long-term insurance products and services to address the evolving financial, investment, and lifestyle risk requirements of both the retail and corporate markets.Β Liberty Health Gap CoverΒ is one of those products.
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π Liberty remains a trusted brand among South Africans, which provides various health and financial products in South Africa at affordable rates. TheΒ Liberty essential gap cover provides R230,000 in shortfall expenses for covered members and an addition of accidental injury fees and out-of-hospital fees for specialists and doctors. The Optimal plan costsΒ R253Β per month per individual.
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π TheΒ LibertyΒ Essential Gap Cover isΒ anΒ affordable protection againstΒ theΒ common medicalΒ expensesΒ thatΒ fallΒ inΒ shortΒ when your medical aid doesnβtΒ coverΒ theΒ treatments or proceduresΒ in full.
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π This planΒ providesΒ coverΒ forΒ the shortfall for when going to theΒ hospital, selectedΒ procedures outside theΒ hospital, andΒ specifiedΒ co-payments,Β makingΒ sureΒ thatΒ oneΒ isnβtΒ burdenedΒ withΒ anyΒ unforeseenΒ medicalΒ accounts.
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Liberty Health Gap Cover Options
πΒ Liberty Essential Gap CoverΒ provides dependable medical scheme top-up coverage for the most common treatment cost deficits at a competitive price.
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πΒ Coverage includes a low-cost Medical Expense Shortfall. In a calendar year, the policy provides coverage of up to R182 700 per person insured, as well as several health insurance benefits. The benefits of this gap cover include:
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- β In-hospital cover for doctor and specialist charges up to 3 times the medical scheme tariff
- β Out-of-hospital cover for doctor and specialist charges up to 3 times the medical scheme tariff for approximately 50 out-of-hospital treatments.
- β Medical scheme co-payment cover for hospital admissions, scans and certain surgical procedures, and
- β Emergency Room Cover for accidental injury.
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π Key Benefits of Essential Gap Cover:
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In-Hospital Cover:Β CoversΒ theΒ shortfallΒ inΒ doctorsΒ and specialistsΒ chargesΒ overΒ andΒ aboveΒ medical aid tariff,Β which is included in the specific medical tariff, or contribution thereto, whichever is the greatest of these two amounts. The shortfallΒ willΒ beΒ the difference between doctorsΒ and specialistsΒ charges lessΒ medical tariff orΒ yourΒ contribution toΒ theΒ charges.
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Β Out-of-Hospital Procedures:Β CoversΒ aroundΒ 50 defined out-of-hospital proceduresΒ toΒ helpΒ youΒ beΒ moreΒ coveredΒ than mereΒ hospital admissions.
β Β Co-Payment Cover:Β CoversΒ theΒ co-paymentΒ costsΒ for hospital admissions and scans,Β whichΒ will reduceΒ your out-of-pocket expenses.
πΒ For further details about, orΒ to apply for Essential Gap Cover,Β visit Libertyβs Gap Cover page or contactΒ the policy administrator,Β Zestlife,Β onΒ 021 180 4220 orΒ [email protected].
πΒ InvestΒ in Libertyβs Essential Gap CoverΒ toΒ protectΒ you and your loved onesΒ fromΒ unexpectedΒ medical expensesΒ withΒ peace of mind when you need it most.
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π READ more aboutΒ Medical Insurance230
2. Sirago Gap Cover
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Overview
πΒ SiragoΒ is dedicated to providing unique Gap Cover products to the South African market. Sirago pursues market opportunities in unique niche products as an underwriting manager.
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πΒ Siragoβs product creation involves benefit determination based on medical scheme design, premium rating, policy language development, and distribution and marketing strategy.
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πΒ GENRIC Insurance Company Limited, an authorized Financial Services Provider and registered Short-term Insurer, underwrites Sirago. Their core business is to provide crucial benefits to policyholders who are facing unexpected medical expense gaps that are not fully covered by their medical plans.
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π Sirago Gap CoverΒ is a good gap cover for the younger generation since it is designed for young individuals and families. Medical aid shortfalls are covered at up to 250% of the scheme rate, based on an overall annual limit of R183,000 per person.
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π Benefits include limited co-payment cover for hospital admissions, scans, surgical procedures and the use of non-designated service providers. Thereβs basic cover for the treatments of PMBs at non-DSPs and procedures conducted in day hospitals or doctorsβ rooms.
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π It includes a cancer-boost benefit, new-born baby benefit, and emergency room and preventative care cover.
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π The current monthly premiums for Sirago Gap Only areΒ R289Β for individuals of 64 years of age and younger.
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Sirago Gap Cover Options
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1. Gap Liberal
β This plan offers comprehensive gap cover benefits, including coverage for co-payments, sub-limits, and cancer-related treatments.
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
π Ages 60+: R365
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Family Premiums:
π Ages 0-64: R365
π Ages 65+: R365
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2. Ultimate Gap Cover
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
π Ages 60+: R365
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Family Premiums:
π Ages 0-64: R365
π Ages 65+: R365
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β This option provides extensive gap cover benefits, including coverage for co-payments, sub-limits, and cancer-related treatments.
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Β Plus Gap Cover
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
π Ages 60+: R365
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Family Premiums:
π Ages 0-64: R365
π Ages 65+: R365
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β This plan offers comprehensive gap cover benefits, including coverage for co-payments, sub-limits, and cancer-related treatments.
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4. Gap Assist Cover
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
π Ages 60+: R365
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Family Premiums:
π Ages 0-64: R365
π Ages 65+: R365
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β This option provides essential gap cover benefits, including coverage for co-payments and sub-limits.
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5. Gap Core Cover
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
π Ages 60+: R365
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Family Premiums:
πAges 0-64: R365
π Ages 65+: R365
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β This plan offers fundamental gap cover benefits, focusing on in-hospital shortfalls.
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6. Gov Gap Cover
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
πAges 60+: R365
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Family Premiums:
π Ages 0-64: R365
π Ages 65+: R365
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β This option is tailored for government employees, providing gap cover benefits that complement GEMS medical scheme options.
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7. Exact with Gap and Co-Pay
Individual Premiums:
π Ages 0-29: R172
π Ages 30-39: R202
π Ages 40-49: R229
π Ages 50-59: R320
π Ages 60+: R365
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Family Premiums:
π Ages 0-64: R365
π Ages 65+: R365
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Sirago Contact Details
Β β Physical Address:
Irene Link Precinct
7 Impala Avenue
Centurion
0157
South Africa
β Telephone:
010 599 1163
β Fax:
086 555 2682
β Email Addresses:
General Enquiries:Β [email protected]
3. Zestlife Gap Cover
Overview
π Zestlife is an authorised provider of financial services that concentrates on meeting your individual and familyβs specific insurance needs. Death, disability, injury, or illness are all covered financially by Zestlife insurance.
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π Recognizing that healthcare providers often charge more than the amounts covered by medical aids,Β Zestlife offersΒ several gap cover options for different needs and budgets.
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π These options mean that members are not left with substantial out-of-pocket expenses for in-hospital and specified out-of-hospital treatments. Zestlife Gap Cover is not a substitute for medical aid but complements it by covering the gaps, ensuring comprehensive coverage and financial peace of mind.
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π Zestlife Gap CoverΒ pays medical spending shortages that occur when medical aids do not pay doctor and specialist fees for in-hospital and some out-of-hospital procedures.
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π The difference between what medical aids cover and what private practitioners charge regularly amounts to tens of thousands of Rand losses, for which the patient is held responsible.
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π Hospital patients should focus on getting well rather than stressing about how to deal with unexpected medical costs that are not covered by medical aids. Zestlife Gap Cover pays for unforeseen medical expenditures, allowing patients to concentrate on getting back on their feet.
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Zestlife Gap Cover Options
- βοΈ Zestlife Universal Gap Cover provides the most complete medical bill shortfall coverage, as well as significant financial protection against a variety of health risks. This option is available as single or family coverage.
- βοΈ Zestlife Essential Gap Cover provides low-cost coverage for the most common medical expense shortfalls, as well as supplementary financial protection for specific health risks. This option is available as single or family coverage.
- βοΈ Zestlife Optimal Gap Cover provides excellent levels of coverage at an affordable price to meet the demands of people under the age of 35.
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Maternity Benefits Under Zestlife Gap Cover
βοΈ Zestlife Gap Cover includes specific benefits that address the financial challenges associated with maternity-related medical expenses. Here are the key maternity benefits provided by Zestlife Gap Cover options:
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Medical Expense Shortfall Cover
- βοΈΒ Universal Gap Cover: Zestlifeβs Universal Gap Cover provides extensive financial protection by covering medical expense shortfalls up to 500% of the medical aid tariff. This benefit covers in-hospital shortfalls on doctors and specialist charges for a wide range of procedures, including childbirth.
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βοΈ It ensures that the costs associated with obstetricians, gynaecologists, and anaesthetists are adequately covered, significantly reducing out-of-pocket expenses for maternity-related hospital stays.
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- βοΈΒ Essential Gap Cover: The Essential Gap Cover option covers shortfalls up to 300% of the medical aid tariff. This option offers substantial coverage for maternity-related procedures, ensuring that expectant mothers are not burdened with significant medical expenses due to the gaps between what their medical aid covers and the actual costs charged by healthcare providers.
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- βοΈΒ Optimal Gap Cover: Optimal Gap Cover, designed for single individuals under 35, covers shortfalls up to 400% of the medical aid tariff. This option provides reliable coverage for maternity-related medical expense shortfalls, making it an excellent choice for young, expecting mothers who may face substantial healthcare costs.
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Co-Payment Benefit
βοΈ All Zestlife Gap Cover options include a co-payment benefit, which covers the co-payments imposed by medical aids for hospital admissions and specified medical procedures. This benefit ensures that any upfront payments required by medical aids for maternity-related procedures are covered, alleviating the financial strain on expectant parents.
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Casualty Facility Treatment for Injury in an Accident
π While primarily focused on accidental injuries, this benefit covers treatment in a hospital casualty facility within 48 hours following an injury. This can be particularly useful for emergency situations that may arise during pregnancy, ensuring that mothers-to-be receive immediate care without worrying about the associated costs.
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What is the monthly premium for the Zestlife gap cover plans?
π° Zestlifeβs gap cover plans start atΒ R253 per monthΒ and can go up toΒ R838Β per month, depending on the plan you choose.
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What Is the Waiting Period for the Zestlife Gap Cover Benefits?
π When signing up for Zestlife Gap Cover, the following waiting periods apply:
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- βοΈ General Waiting Period: No general waiting periods apply after the commencement date of the policy.
- βοΈ Pre-existing Condition Waiting Period:Β A 12-month waiting period applies for conditions where medical advice, diagnosis, care, or treatment was received in the 12 months before the start date of the cover.
- βοΈ Pregnancy Waiting Period: Pregnancy and birth-related claims are excluded for 12 months if the pregnancy started before the cover commencement date.
- βοΈ Extended Cancer Cover Waiting Period:Β A 6-month upfront waiting period from the date of commencement of cover for the optional Extended Cancer Cover.
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How to Claim for Zestlife Gap Cover Benefits
- β Download the claim form from www.zestlife.co.za or contact Zestlife to obtain a copy.
- β Collect all related documents, including medical bills, statements, and any other necessary paperwork.
- β Submit Online: Visit www.zestlife.co.za to submit your completed claim form and related documents online.
- β Email Submission: Alternatively, scan and email the completed claim form and documents toΒ [email protected].
- β Postal Submission: Mail the completed claim form and related documents to the specified address provided by Zestlife.
- β Ensure all documents are submitted within 180 days of the medical treatment giving rise to the claim.
- β For expert advice or assistance, contact Zestlife on (021) 180 4220 / 0860 009 378 or emailΒ [email protected].
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Zestlife Contact Details
Sunclare Building
21 Dreyer St
Claremont
Cape Town
7708
4. Stratum Benefits Gap Cover
β Β Stratum BenefitsΒ provides a comprehensive range of gap cover products designed to bridge the gap between what your medical aid pays and the actual costs charged by healthcare providers. With Stratum Benefits, you can ensure that unexpected medical costs do not become a financial burden.
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πΒ Download Stratum Gap Cover 2025 here
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Maternity Benefits Under Stratum Benefits Gap Cover
βοΈ Stratum Benefits offers several gap cover options that include maternity benefits to address the financial challenges associated with pregnancy and childbirth. Here are the key maternity benefits provided by Stratum Benefits Gap Cover:
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Compact 300 Gap Cover
βοΈΒ Compact 300Β is an affordable option that provides significant coverage for maternity-related expenses:
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- βοΈΒ Childbirth Shortfalls:Β Covers the shortfall between what the medical aid pays and the actual costs for both natural and caesarean deliveries.
- βοΈΒ Admissions and Procedures:Β Covers additional costs related to hospital admissions and procedures for childbirth.
- βοΈΒ Penalty Co-Payments:Β Covers co-payments imposed by the medical aid for not adhering to certain requirements, such as using a non-network hospital.
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Meridian400 Gap Cover
βοΈ Meridian400 offers mid-range coverage with several maternity-related benefits:
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- βοΈ Childbirth Shortfalls: Covers up to 400% of the medical aid tariff for shortfalls related to natural and caesarean deliveries.
- βοΈ Admissions and Procedures: Covers costs associated with hospital admissions and specific maternity procedures.
- βοΈ Penalty Co-Payments: Covers penalty co-payments for non-network hospital usage and other conditions.
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Elite500 Gap Cover
βοΈ Elite500 is the top-tier option providing the most extensive maternity coverage:
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- βοΈ Childbirth Shortfalls: Covers up to 500% of the medical aid tariff for natural and cesarean deliveries.
- βοΈ Admissions and Procedures: Covers extensive costs for hospital admissions and various maternity-related procedures.
- βοΈ Out-Patient Specialist Consultation: Covers out-patient specialist consultations related to maternity care.
- βοΈ Private Room Benefit: Provides coverage for the cost of a private room during hospital stays for childbirth.
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Additional Benefits
βοΈ All Stratum Benefits gap cover options include additional features that indirectly support maternity care:
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- βοΈ Casualty Benefit: Covers treatment costs in a hospital casualty facility for emergency situations.
- βοΈ Trauma Counselling Benefit: Provides financial support for trauma counselling sessions, which can be beneficial for postnatal mental health.
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What is the monthly premium for the Stratum Benefits gap cover plans?
π° Stratum Benefits offers a variety of pricing options on different gap cover plans, ranging fromΒ R197 (Access Optimiser)Β to R481 (Elite 500) for single person each month.
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What Is the Waiting Period for the Stratum Benefits Gap Cover Benefits?
βοΈWhen signing up for Stratum Benefits Gap Cover, the following waiting periods apply:
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- βοΈΒ 3-Month General Waiting Period:Β No claims can be made during the first three months of the policy, except for accidental injury claims.
- βοΈΒ 12-Month Pre-Existing Condition Waiting Period: No claims can be submitted for any medical procedures related to pre-existing conditions that were treated or diagnosed in the 12 months prior to the policy start date.
- βοΈΒ 10-Month Limited Payout Benefit: Applies to specific medical events, limiting the payout for these events during the first ten months of the policy.
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How to Claim for Stratum Gap Cover Benefits
- β Obtain and fill out the claim form, which can be downloaded from the Stratum Benefits website.
- β Collect all necessary supporting documents, including the medical aidβs claims transaction statement, the healthcare providerβs account, and proof of payment if applicable.
- β Submit Online: Visit the Stratum Benefits website and submit the completed claim form and supporting documents online.
- β Email Submission: Alternatively, scan and email the completed claim form and all supporting documents toΒ [email protected].
- β Postal Submission: Mail the completed claim form and all related documents to the postal address provided by Stratum Benefits.
- β Ensure all claims are submitted within 6 months from the date of the medical event.
- β If additional documents are needed, submit them within 90 days. Claims are typically assessed within 10 working days of receiving all necessary information.
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Stratum Benefits Contact Details
Stratum House
8 Fir Dr
Northcliff
Randburg
2195
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β οΈ Read more about theΒ best gap covers for pregnancyΒ
5. Turnberry Gap Cover
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Overview
πΒ Turnberry, formed in 2001, offers a variety of solutions best suited to your needs, giving unrivalled service while assisting you in avoiding the potential financial weight of expensive medical bill deficits.
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πΒ Turnberry Management Risk Solutions (Pty) Ltd is an authorised Financial Services Provider (FSP no. 36571). Underwritten by Lombard Insurance Company, an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.
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Turnberry Gap Cover
πΒ Turnberry Insurance Group provides a variety of solutions aimed to alleviate the financial pressures associated with medical bills during hospitalisation.
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πΒ The majority of medical aids pay hospital expenses up to 100% of the medical aid rate. However, it is the fees charged by experts that can leave you out of cash if you do not have shortfall insurance. This is whereΒ Turnberry Gap CoverΒ become a necessity.
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πΒ Charges that exceed the recommended medical aid rate are covered by your policy. They offer up to 500% coverage. Co-payments are also covered in some cases.
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π Turnberry offersΒ variousΒ Gap Cover productsΒ from R169 per monthΒ thatΒ Β wouldΒ Β safeguardΒ youΒ againstΒ Β unforeseenΒ Β medicalΒ Β expensesΒ shortfalls not fully covered by your medical aid. Their plans are compatible with all registered open medical schemes and most closed schemes in South Africa, ensuring broad accessibility.
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Turnberry Gap Cover Options
- β Premier serves as an umbrella for the complete family. It provides comprehensive cancer benefits as well as a wide range of benefits to cover unforeseen medical price gaps.
- β Optimal offers a wide range of benefits, including increasing your medical aid by up to 500%, all at a family-friendly price.
- β Synergy provides a wide range of health advantages at an affordable price. It protects you and your family against the most prevalent forms of claims and pays medical bill gaps up to 500%.
- β Launch key benefits for specialists and cover medical spending gaps up to 350% of medical assistance rate. Launch is one of the most affordable Gap Cover options on the market.
- β Med-Extend was created to help clients with medical spending gaps for Specialists as well as covering Defined Procedures that were previously prohibited from their individual Medical Scheme option.
- β If you have extended family or an additional dependant registered on your Medical Scheme and they do not meet our definition of a βFamilyβ as per the description above, you may add them to Med Extend.
- β On request, Turnberry Policyholders can obtain international travel insurance through TIC. The coverage provides complete emergency help by air, land, or sea.
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π Key Benefits Across Turnberryβs Gap Cover Plans:
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πΒ Medical Expense Shortfall Cover: Enhances your medical aid rateΒ up to 600%Β forΒ the cost ofΒ specialists, GPs, anesthetists, radiology, pathology, and other in-hospital services.
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πΒ Co-Payment Cover: Assists withΒ theΒ co-paymentsΒ thatΒ your medical aidΒ may requestΒ forΒ specificΒ treatments and procedures,Β thereforeΒ reducing out-of-pocket expenses.
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πSub-Limit Cover:Β ExtraΒ coverΒ when your medical aidΒ hasΒ sub-limitsΒ forΒ certain procedures or treatments,Β forΒ comprehensive protection.
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πΒ Non-DSP Hospital Penalty Cover: CoversΒ theΒ penaltiesΒ whenΒ treatmentΒ is sought inΒ non-designated service provider hospitals,Β thusΒ affordingΒ flexibilityΒ onΒ choiceΒ ofΒ facilities.
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πThe Turnberry gap cover protects clients and their families from bearing hefty medical expenses uncovered by their medical aid.
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πΒ Turnberry gap cover has the folloing plans to choose from:
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FAQs
How Do I qualify for gap cover?
You need to be an existing member of a registered medical aid scheme to qualify for gap cover.
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Is Gap Cover worth the money you pay for it?
Yes, If you have to have an expensive medical procedure or illness that isn’t covered in full by your medical aid, gap cover can make up the shortfall.
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What treatments are not paid for by gap cover?
Treatment for obesity, cosmetic surgery (unless necessitated by a trauma or as a result of oncology treatment, and specialised dentistry are usually not paid by gap cover.
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How long is the waiting period for a Gap Cover?
A general waiting period of three months applies to all benefits offered by gap cover providers.
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Who is covered by a gap cover policy
Gap cover usually covers the principal member, their spouse and children until they reach the age of 27.