5 Best Gap Cover Options for Under R200 (🇿🇦 2025*)
The 5 Best Gap Cover Options near R200 in South Africa revealed.
We tested them side by side and verified their gap cover options side by side.
This is a complete guide to the best gap cover options under R200 in South Africa.
In this in-depth guide you’ll learn:
- ☑️ What is a Gap Cover?
- ☑️ Should you have a gap cover if you already have medical aid?
- ☑️ Is gap cover affordable in South Africa?
- ☑️ What exactly does gap cover protection cover?
- ☑️ Should you have a gap cover when you have a hospital plan?
- ☑️ What benefits do you get from having gap cover?
So if you’re ready to go “all in” with the best gap cover options for under R200 in South Africa, this guide is for you.
👉 Let’s dive right in…
Best Gap Cover Options for Under R200 (2025)
| 🩺 GAP Cover Provider | ✔️ Offers Plans Under R200? | ⚕️ Plan Offered | 👉 Monthly Premium |
| 1. TRA Gap cover | ✅ Yes | Basic Cover 300 | R99 |
| 2. GapCover.co.za | ✅ Yes | Primary Gap Cover | R130 |
| 3. Turnberry Gap cover | ✅ Yes | Luanch | R169 |
| 4. Stratum Gap Cover | ✅ Yes | Access optimiser | R197 |
| 5. Sirago Gap Cover | ✅ Yes | Sirago Gap Liberal | R172 |
5 Best Gap Cover Options for Under R200 Summary
- TRA Gap Cover – Broadest Range of Low-Cost Gap Cover Plans
- Gacover.co.za Cover – Top Extensive Gap Cover Protection in South Africa
- TurnBerry Gap Cover – Best Customer Service Gap Cover.
- Stratum Gap Cover and Optimize – Best Pay-As-You-Go Private Healthcare
- Sirago Gap Cover – Overall, Best Gap Cover Options Under R200 in South Africa
Introduction to Gap Cover
Even if you have medical aid coverage, the overall cost of medical care in South Africa remains prohibitively expensive.
What is Gap Cover
💙 One solution for this issue, is Gap Cover, a supplemental insurance policy that can assist members of medical aid plans to bridge the gap between what their medical aid covers and what they actually have to spend out of pocket for medical expenses.
💙 That is why Gap Cover is also known as bridge insurance because it covers or “bridges” the difference between the amount that is covered by a medical aid plan and the amount that is charged by healthcare providers through a form of insurance.
How Gap Cover Can Assist You
One of the first things Gap Cover can assist with, is costs related to any medical treatment that does not qualify as a prescribed minimum benefit (PMB), which medical aid plans in South Africa are required by law to cover. Many of these PMBs require treatment more expensive than the aid pays for, which will leave members without adequate coverage.
Gap Cover Insurance is designed to fill this coverage void by offering supplementary financial protection against the medical expenses 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.
In South Africa, a further advantage of gap cover is that it can contribute towards covering medical aid premiums and benefits in the event that the primary policyholder passes away. This is of utmost significance for households in which the primary policyholder is the sole provider of financial support for the family’s healthcare costs.
It is possible that the medical aid premiums may no longer be reimbursed in the case that the primary policyholder passes away. If this occurs, the surviving members of the family would be left without medical insurance coverage. Because of the exceptionally high cost of medical treatment in South Africa, this might have a disastrous effect on one’s financial situation.
Additionally, certain gap cover plans may give extra benefits, such as a funeral benefit, which can assist in covering the costs of the policyholder’s funeral in the event that the policyholder passes away. This can be of tremendous assistance to families, many of which do not possess the financial means necessary to pay for such costs.
Easy to compare medical aid schemes with benefits, prices and plans to ensure you have the right plan for your needs with our medical compare tool.
What Type of Costs are Covered by Gap Cover Insurance?
A range of medical costs that are not covered by medical aid plan but are covered by the Gap Cover Insurance policy, includes the following:
- ✅ Co-payments, 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.
- ✅ Deductibles, which 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 do.
- ✅ 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.
- ✅ Non-PMBs, in other words medical expenses that are not paid for by the medical aid plan. Gap Cover Insurance could protect you against these non-PMBs.
- ✅ The gap between the amount that a medical aid plan pays, and the fees charged by healthcare providers – especially specialist providers.
If a claim is verified and found to be valid, the medical aid plan will pay the covered amount. After that, the participant will contact the provider of the Gap Cover Insurance and make a claim for the outstanding balance that is not covered by the medical aid plan.
It is essential to be aware that plans for Gap Cover Insurance may include restrictions on the amount of benefits that may be paid out on an annual, per-event, or per-beneficiary basis.
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5 Best Gap Cover Options for Under R500
How to Find the Right Gap Cover Provider
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.
Here are some reasons why you should compare gap cover providers, as well as several ways to do so:
- ✅ There is a wide variety of gap cover providers, each of which offers its own unique set of advantages and coverage.
- ✅ By shopping around, you might choose a carrier that offers the coverage and benefits that are appropriate for your needs.
- ✅ prices for gap insurance might vary substantially depending on the provider you choose and the level of coverage that you purchase.
- ✅ If you look about, you should be able to discover a plan that satisfies your requirements at a cost that is within your budgetary comfort zone.
- ✅ Many gap cover policies require their customers to wait for a certain amount of time before they begin providing coverage.
- ✅ You might choose a company that has a shorter waiting period or offers instant coverage by comparing the various suppliers.
- ✅ 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.
- ✅ By evaluating several providers, you should be able to select one that has a network that include your chosen healthcare providers.
When comparing gap insurance providers, the first step is to conduct research on the various providers, the services that they offer, and at what price they offer it. Check out their waiting times, prices, and coverage and perks, as well as their provider network.
Due to the fact that every medical aid gap cover plan will have its own unique set of advantages, it is essential to do a comparison of the benefits offered by each plan at a certain cost. Look for plans that include coverage for co-payments, excess payments, and expenditures incurred outside of hospitals but are still affordable.
Some plans may also cover services such as counselling or transportation to medical facilities in case of an emergency, but they will be more expensive. When evaluating different alternatives for medical aid gap cover, it is essential to take into account the quality of customer care provided by each supplier. Look for organisations who have a solid reputation for providing excellent customer service, have personnel that is courteous, and have rapid response times.
The Final Choice: Determine Which Gap Cover Plan Is Right for You
It is further challenging to select the appropriate gap cover plan because there are many different kinds of plans available on the market, each with its own set of characteristics, advantages, and costs attached.
The following categories of gap cover policies are among the most common types:
- ✅ Your medical aid plan may not cover all of your in-hospital medical charges, but you can purchase a plan called Basic Gap Cover that will cover some of those costs. The premiums for basic gap cover policies are often lower than those for more comprehensive plans, but these plans offer a smaller number of benefits.
- ✅ Comprehensive Gap Cover is a form of plan that offers more broad coverage for in-hospital medical bills, in addition to some outpatient charges and co-payments. This type of plan may also cover certain outpatient expenses. The premiums for comprehensive gap cover policies are often more than those for basic plans.
- ✅ Top-up Gap protection is a sort of plan that is meant to augment the protection that is given by your medical aid programme, particularly for operations or treatments that are costly. Top-up gap cover policies are beneficial for people who already have a comprehensive medical aid plan but want additional protection against excessive medical bills.
- ✅ A disease-specific gap cover is a type of plan that offers coverage for certain medical illnesses or treatments, such as therapy for cancer or long-term medication. People who have a greater chance of acquiring certain medical diseases or who require continuing treatment for a particular ailment may benefit from disease-specific gap cover plans.
👉🏿 Poll: Best medical aid plans under R1500 per month
5 of the Best Known Gap Cover Options for Under R200
It speaks for itself that the cheapest Gap Cover plans would not provide comprehensive cover. Here is a list of the very cheapest plans, some with monthly premiums less than R200:
1. TRA Gap Cover
Overview of TRA
Total Risk Administrators Super Cover Plus is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Total Risk Administrators Basic Cover 300 Plan starts from R99 ZAR per month. Total Risk Administrators has a trust score of 4.2.
Total Risk Administrators – Advantages Over Competitors
Choosing TRA Gap Cover includes a wide range of advantages, including:
- ✅ TRA provides comprehensive gap cover to ensure that certain medical expenses not covered by medical aids are taken care of.
- ✅ Members can access gap cover benefits, ensuring they are fully protected.
- ✅ TRA offers affordable rates, with monthly premiums starting at as little as R99.
- ✅ TRA offers a range of gap cover plans, ensuring members can find a plan that suits their needs.
- ✅ TRA offers a 10-month condition-specific waiting period, lower than the industry standard of 12 months.
- ✅ TRA offers a 6-month waiting period for pre-existing medical conditions, lower than the industry standard of 12 months.
- ✅ TRA’s claims process is quick and easy, settling claims within 10 business days.
- ✅ TRA has a 24/7 helpline to assist members with any queries or concerns.
- ✅ Auto & General, a reputable and well-established insurer, underwrites TRA.
and much, MUCH more!
2. GapCover® Primary
South African medical aid schemes fail to pay the complete medical costs that generate out-of-pocket expenses which patients must bear. Healthcare providers created gap cover insurance policies which help patients overcome the monetary difference between their medical aids payments and their medical bills. Aiming for economical gap cover protection during 2025 will find a solution in The GapCover® Primary Plan.
GapCover® Primary Plan Overview
- ✅ Premiums: GapCover® Primary Plan is offered at R130 per individual and R190 per family per month, which makes it very affordable for people seeking to complement their medical aid cover without paying an arm and a leg in additional costs.
- ✅ GapCover® Primary Plan Overview: Customers can obtain the GapCover® Primary Plan through monthly premiums of R130 per person and R190 for family coverage which ensures a cost-effective solution for medical aid supplement coverage.
- ✅ The plan extends medical expense protection to hospital procedure shortfalls by paying benefits that reach three times medical aid rate maximum coverage. Under the GapCover® Primary Plan your medical care costs exceeding medical aid rates will receive reimbursement up to triple the medical aid amount.
- ✅ In-term medical procedures get co-payment coverage through the plan along with payments for specialized radiology scans such as MRI and CT. Each person may receive two co-payment benefits from this policy that do not exceed R3,000 each time throughout the year. This coverage allows policyholders to access up to R2000 from their selected DSP hospital when they only receive co-payment services during their policy year once.
- ✅ GapCover® Primary Plan from GAPCOVER.CO.ZA provides second-pay benefits for digestion-related procedures conducted by doctors that are limited to two scopes annually for each patient. Under this coverage option the emergency ward can provide benefits of R1000 and it offers post-surgical physiotherapy services for joint replacement or back surgery patients.
3. Turnberry Gap Cover
Turnberry offers various Gap Cover products from R169 per month that would safeguard you against unforeseen medical expenses 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.
Key Benefits Across Turnberry’s Gap Cover Plans
💙 Medical Expense Shortfall Cover: Enhances your medical aid rate up to 600% for the cost of specialists, GPs, anesthetists, radiology, pathology, and other in-hospital services.
💙 Co-Payment Cover: Assists with the co-payments that your medical aid may request for specific treatments and procedures, therefore reducing out-of-pocket expenses.
💙Sub-Limit Cover: Extra cover when your medical aid has sub-limits for certain procedures or treatments, for comprehensive protection.
💙 Non-DSP Hospital Penalty Cover: Covers the penalties when treatment is sought in non-designated service provider hospitals, thus affording flexibility on choice of facilities.
💙The Turnberry gap cover protects clients and their families from bearing hefty medical expenses uncovered by their medical aid.
👉 Turnberry gap cover has the following plans to choose from:
4. Stratum Extra Cover Access Optimiser
➡️ South African medical aid schemes create financial responsibility for their members because they specifically deny payment for specified procedures and events which forces members to pay all associated costs.
➡️ The Access Optimiser plan from Stratum Benefits fulfills its purpose of covering specific medical procedures and events that traditional medical aid plans exclude.
Access Optimiser Plan includes these main characteristics
- ✅ The interactive medical insurance plan from Access Optimiser provides complete coverage for diverse medical procedures which regular medical aids normally reject.
- ✅ The Access Optimiser plan includes protection for arthroscopic surgery as well as back and neck surgery and cochlear implant surgery and dental procedures and additional medical procedures. Medical members can get essential medical care through the plan’s benefits system without paying high expenses from their own pockets.
- ✅ The plan provides casualty benefits that include emergency medical treatment for injuries that occur through accidental causes within a 24-hour time period. Any medical care obtained from signed medical facilities and offices and hospital emergency rooms receives protection under this benefit plan.
- ✅ Members who suffer accidental death or disability receive financial aid through the Access Optimiser plan which grants comfort to their dependents during difficult circumstances.
- ✅ The medical plan provides lifestyle additions which encompass further high school educational assistance. Participants in grades 8 to 12 from the CAPS curriculum gain immediate access to educational content which assists them in their studies and develops their understanding for better academic results.
Premiums
- ✅ The Access Optimiser plan keeps its costs competitive to provide affordable health coverage.
- ✅ Individuals and Families (64 years or younger): R179 per month. Individuals and Families (65 years or older): R239 per month. The premiums of this plan depend on the age of the oldest member at enrollment without any age restriction which creates access for all population groups.
Waiting Periods
- ✅ The Access Optimiser plan includes waiting times that require attention in several ways.
- ✅All benefits except those following accidents are subject to a general waiting period that spans three months. Any medical investigations together with procedures and surgeries or treatments concerning pre-existing illnesses have a 12-month waiting period starting from the start date of the medical cover.
- ✅ Health plans have these waiting periods implemented to stop insurers from choosing less-risky customers while they keep their plan sustainable.
Eligibility
- ✅ The Access Optimiser plan extends coverage to people who hold membership with any South African medical aid organization that has registered with the scheme. This policy provides benefits to members of the main member including their spouse along with any dependent members who have enrolled on a medical aid plan. Medical aid members can keep their child dependents on their plans until the dependents start their own medical aid coverage. Full-time students below 26 years old can stay on the policy as long as they send annual documentation showing their enrollment in full-time studies although they may belong to different medical aid plans.
Conclusion
Through its Stratum Benefits Access Optimiser plan the organization provides valuable expanded medical insurance options above basic medical aid benefits. The complete coverage of excluded medical procedures combined with casualty compensation and lifestyle assistance secures members against unpredictable healthcare expenses. The plan has affordable rates along with membership rules that welcome various groups of people to healthcare benefits optimization.
5. Sirago Gap-Cover
Overview of Sirago Gap Cover
Sirago 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. Sirago’s product creation involves benefit determination based on medical scheme design, premium rating, policy language development, and distribution and marketing strategy.
GENRIC Insurance Company Limited, an authorised 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.
Sirago Gap-Plus Cover 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.Benefits include limited co-payment cover for hospital admissions, scans, surgical procedures and the use of non-designated service providers. There’s basic cover for the treatments of PMBs at non-DSPs and procedures conducted in day hospitals or doctors’ rooms.
It includes a cancer-boost benefit, new-born baby benefit, and emergency room and preventative care cover. The current monthly premiums for Sirago Gap Only are R289 for individuals of 64 years of age and younger. The current monthly premiums for Sirago Gap-Lite are R369 for, and R419 for families if all are under 64.
Sirago Gap Cover Options
- ✅ The Sirago Plus Gap Cover was created for today’s busy households. To compensate for gaps in medical coverage, the scheme will pay up to R183,000 per year, or 250% of the scheme subscription.
- ✅ Hospital stays, imaging tests, surgical procedures, and visits to doctors who aren’t in your network may be eligible for financial assistance. Out-of-network PMB treatments, such as those received at day hospitals or doctors’ offices, are partially covered.
- ✅ Doctor visits and maternity care are among the benefits available to new parents and infants.
Sirago Gap Cover has eight plans to choose from:
- ➡️ Sirago Ultimate Gap
- ➡️ Sirago Plus Gap
- ➡️ Sirago Gov Gap
- ➡️ Sirago Gap Only
- ➡️ Sirago Gap Assist
- ➡️ Sirago Exact Cover with Gap and Co-Pay
- ➡️ Sirago Exact Cover
Sirago Gap Cover Contact Details
- ✅ Telephone: 010 599 1163
- ✅ Fax: 086 555 2682
- ✅ Email Addresses:
- General inquiries: [email protected]
- Applications: [email protected]
- Policy changes: [email protected]
- Payments: [email protected]
- Claims: [email protected]
6. Momentum Gap Cover
Download Momentum Gap Cover brochure here
💙 Momentum Gap Cover is a supplementary insurance product designed to cover the shortfalls between what your medical aid pays and the actual costs incurred during in-hospital and certain out-of-hospital treatments.
💙 It means that policyholders are not left with hefty out-of-pocket expenses by covering additional fees charged by medical practitioners, co-payments, and other unexpected medical costs. Momentum Gap Cover offers a range of plans to suit different needs, providing comprehensive financial protection against medical expense shortfalls.
✅ By covering these co-payments, Momentum Gap cover ensures continuous and uninterrupted access to vital cancer care without the added financial strain.
What is the monthly premium for the Momentum Gap Cover plans?
The Momentum Gap Cover plans start from R259 per month and go up in price depending on the coverage you choose.
What Is the Waiting Period for the Momentum Gap Cover Benefits?
- ✔️ A three-month general waiting period applies, during which no claims are payable except for claims related to accidents.
- ✔️ A 12-month condition-specific waiting period applies for any pre-existing conditions that required treatment or advice in the 12 months prior to the cover start date.
- ✔️ A nine-month waiting period applies for maternity benefits.
- ✔️ No waiting periods apply if the policyholder moves from another gap cover provider to Momentum GapCover, provided there is no break in coverage.
How to Claim for Momentum Gap Cover Benefits
You can submit your claim for Momentum Gap Cover with the following steps:
- ✅ Obtain a claim form from the Momentum website or by contacting their support.
- ✅ Complete the claim form with all necessary details.
- ✅ Attach all required supporting documents, such as medical bills and statements from the medical aid.
- ✅ Submit the completed claim form and documents via email, fax, or postal mail to Momentum’s claims department.
- ✅ Ensure the submission is within the stipulated time frame, typically within six months of the treatment date.
Momentum Health Contact Details
✅ General Inquiries:
Phone: 0860 102 903 / Email: [email protected]
✅ Customer Care:
Phone: 0860 111 818 / Email: [email protected]
7. Discovery Gap Cover
Discovery Gap Cover provides a financial safety net by covering shortfalls on approved in-hospital specialist claims, specific out-of-hospital costs related to an approved hospital admission, and co-payments on approved cancer-related claims.
It offers two options to address different needs, resulting in comprehensive protection against unexpected medical expenses that exceed what the medical aid covers.
👉🏾 Download Discovery Gap Cover here
Co-payment Coverage
✅ The gap cover includes provisions for co-payments specifically related to oncology treatments. These include co-payments applied once the medical aid limits are exceeded, ensuring that patients can continue receiving essential treatments without the additional financial burden of co-payments.
Comprehensive Cancer Support
✔️ For those who opt for the Discovery Gap Comprehensive option, additional benefits include the Travel Benefit Extender, which covers shortfalls on approved emergency medical claims incurred while traveling internationally.
✔️ Also, the Scopes and Scans Benefit Extender provides coverage for co-payments and deductibles associated with MRI and CT scans conducted out-of-hospital, and for in-hospital endoscopies.
What is the monthly premium for the Discovery Health gap cover plans?
Discovery Health’s gap cover plans start at R157 per month, depending on the plan and coverage elements.
What Is the Waiting Period for the Discovery Health Gap Cover Benefits?
When registering for Discovery Health Gap Cover, the following waiting periods apply:
- General Waiting Period: A three-month period during which no claims can be filed, with the exception of those linked to accidents.
- Condition-Specific Waiting Period: A 12-month waiting period for claims involving pre-existing conditions. This includes any medical conditions for which advice, diagnosis, care, or treatment was received within the 12 months preceding the start date of the policy.
- Pregnancy Waiting Period: If the pregnancy occurred before the coverage began, the 12-month pre-existing condition waiting period applies.
How to Claim for Discovery Health Gap Cover Benefits
To file a claim for Discovery Health Gap Cover benefits, follow these steps:
- ✅ You can scan and upload your claim documentation using the Discovery Health app or website.
- ✅ Download the Discovery Health app from the App Store or Google Play, log in, go to “My cover,” then “Claims,” and pick “Scan claim documents”.
- ✅ Log into the Discovery Health website, go to the claims section, and upload your scanned documents.
- ✅ Scan and submit your claim documentation to [email protected]. Send claims with updated or additional information to [email protected].
- ✅ Alternatively, send your claim paperwork to PO Box 784262, Sandton, 2146.
- ✅ To track the status of your claims, use the Claims Search tool on the Discovery Health website, call 0860 99 88 77, or SMS ‘Claim’ to 31347.
Discovery Health Contact Details
✅ Physical Address:
1 Discovery Place
Sandton
2196
South Africa
✅ Telephone:
Members: 0860 99 88 77
Health Partners: 0860 44 55 66
✅ Website: www.discovery.co.za
8. Old Mutual Gap Cover
💙 R270 per month gets you the Old Mutual Gap Cover even if you and your spouse are on different medical aid schemes. Medical tests for this cover are not compulsory and its benefits package includes shortfall payments of up to 100% on maxillofacial or spinal surgery.
💙 As of 1 January 2025, Old Mutual’s Gap Cover is underwritten by GENRIC Insurance Company Limited, a member of the Old Mutual Group.
Key Benefits of Old Mutual Gap Cover
✅ Better Cover: Medical aid rate shortfall of up to 500% in-hospital treatment, meaning there is cover for significant shortfalls.
✅ Cover Your Whole Family: One policy provides cover for yourself, your spouse or life partner, and your children up to the age of 26 years who are registered as dependants on your medical aid, to ensure your whole family is covered against unexpected medical expenses.
✅Gap Cover for Most Medical Procedures: It covers gaps in hospitalizations resulting from accidents and illnesses, to other medical procedures like chemotherapy, radiotherapy, oncology treatment, and joint replacements.
Why Choose Old Mutual Gap Cover?
💙 With a long-standing history in the financial services industry, Old Mutual offers solid and dependable gap cover options to fit your every health need.
💙 The partnership with GENRIC ensures that current policyholders will find very little, if any changes, similar benefits and no new waiting periods.
Who Should Consider Gap Cover?
💙 Gap cover is necessary for any member subscribed to a registered South African medical aid scheme for protection against unforeseen medical expense shortfalls.
💙 Most healthcare providers charge more than the rate covered by medical aids for their services, which means that you may still have to pay out-of-pocket expenses. Old Mutual Gap Cover fills in the difference, giving you financial peace of mind during medical treatments.
💙 Protect your health and financial well-being with Old Mutual Gap Cover so that unexpected medical expenses do not derail your financial stability.
FAQs
Does a gap cover finance in-hospital expenses only?
There are a few gap cover companies that only cover in-hospital expenses while others cover more, depending on the plan you chose.
How long do you have to wait for Gap Cover benefits?
A general waiting period of three months applies to benefits offered by most companies.
Who offers the best gap cover in South Africa?
The best gap cover will depend on what your needs are and what you can afford.
Is shortfall insurance and gap cover the same thing?
Yes, shortfall insurance and gap cover is the same, and covers additional medical costs, or the difference between the fees charged by specialists and the funds provided by the medical aid.
Can I Get Gap Cover if I Have a Pre-Existing Condition?
Yes, you can still get gap cover if you have a pre-existing condition, but you may have to undergo a waiting period or exclusion for that pre-existing condition.
