
5 Best Gap Cover Options for Under R500 (πΏπ¦ 2025*)
TheΒ 5 Best Gap Cover Options for Under R500 in South Africa revealed.
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πΒ We tested them side by side and verified their best gap cover options under R500.
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πΒ This is a complete guide to the best gap cover options under R500 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 Should you get gap cover if you already have medical aid?
- β Is R500 too much for gap cover?
- β Why should you have gap cover in South Africa?
- β What is the difference between gap cover and health insurance?
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π So if youβre ready to go βall inβ with the best gap cover options for under R500 in South Africa, this guide is for you.
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π Letβs dive right inβ¦
Best Gap Cover Options for Under R500 (2025)
π©Ί Medical Aid | βοΈ Offers Gap Cover Options? | βοΈ Monthly Premium | π PLAN |
1. TRA Gap Cover | β Yes | R380 | Super Cover Plus |
2. Sirago Gap Cover | β Yes | R466 | Plus Gap Cover |
3. Stratum Benefits Gap Cover | β Yes | R481 | Elite 500 |
4. Turnberry Gap Cover | β Yes | R441 | Synergy |
5. Bonitas Medgap Gap Cover | β Yes | R266 | Supreme |
5 Best Gap Cover Options for Under R500 Summary
- TRA Gap Cover – Overall, Best Gap Cover Options for Under R500 in South Africa
- Sirago Gap Cover – Includes a Cancer-Boost Benefit
- Stratum Benefits Gap Cover – Low-Cost Option for Healthcare Events
- Turnberry Gap Cover – Has Casuality and Co-Payment Cover
- Bonitas Medgap Gap Cover – Covers Medical Treatment Expenses
Introduction to Gap Cover Options for Under R500
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π Even with medical aid coverage, the overall cost of medical care in South Africa can be prohibitively expensive.
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π This cost has been rising at a rate that is significantly faster than the country’s average rate of inflation over the course of recent years, which has resulted in increased medical 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.
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π 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. Gap Cover is also known as bridge insurance.
What is Gap Cover?
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π The difference between the amount that is covered by a medical aid plan and the amount that is charged by healthcare providers is something that is covered by a form of insurance known as gap cover insurance.
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π Even the prescribed minimum benefits that Medical Aid plans in South Africa are required by law to cover (it is referred to as PMBs) may not cover the whole cost of medical care, which will leave members without adequate coverage.
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π Gap Cover Insurance can fill this coverage void by offering supplementary financial protection against medical costs. Private insurance firms are the most common providers of gap cover insurance, which serves as a complement to medical aid plans and is supplied at a minimal cost.
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π In South Africa, one of the lesser known advantages 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.
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π 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.
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π 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.
Why Should You Have Gap Cover in South Africa?
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π Gap Cover is not required, 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 A range of medical costs that are not covered by the Medical Aid plan include the following:
- β Β Co-payments, a component of a member’s medical cost that the member is responsible for paying out of their own personal funds, can be covered by gap cover insurance instead.
- β Healthcare professionals levy costs that are more than those established under the Medical Aid plan. These expenditures could be covered by gap cover insurance.
- β Β Medical expenses that are not paid for by the Medical Aid plan are referred to as non-PMBs. On the other hand, Gap Cover Insurance could protect you against these non-PMBs.
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READ more about the Best Hospital Plans under R2000 per month
Different Gap Coverage Providers
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π When looking for medical gap cover, it is crucial to compare gap cover providers in South Africa. 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:
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- 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 The prices for gap insurance might vary substantially depending on the provider you choose and the level of coverage that you purchase.
- β 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.
- 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 It 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.
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π 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 When comparing gap insurance providers, the first step is to conduct research on the various providers and the services that they offer.
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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 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. Look for plans that include coverage for co-payments, excess payments, and expenditures incurred outside of hospitals.
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π Additionally, some plans may also cover services such as counselling or transportation to medical facilities in case of an emergency.
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π Consider the quality of customer care provided by each supplier. Look for organizations who have a solid reputation for providing excellent customer service, have personnel that is courteous, and have rapid response times.
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π In addition, compare the cost of all the different plans and find one that offer you the best you can afford.
How to Choose the Best Gap Cover Plan
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π It might be 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 and advantages.
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π In order to make a choice that is based on accurate information, it is vital to first have an understanding of the different gap cover plan possibilities.
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π The following categories of gap cover policies are among the most common types:
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- β 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.
- β 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; however, comprehensive gap cover plans also provide more complete gap coverage.
- β 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.
- β 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. These plans are designed to fill the coverage gap left by health insurance policies.
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π You may consider any of the following 5 best known cover options for under R500 per month:
1. TRA Gap Cover
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Overview
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 Super Cover Plus Plan starts from R380 ZAR. Total Risk Administrators has a trust score of 4.2.
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TRA Super Cover Plus Benefits and Cover Breakdown
π₯ Gap Cover | Up to 700% cover. |
π« Tariff Shortfalls for Theatre and Ward Fees, Consumables, Laparoscopic/Endoscopic Equipment | R1 000 per policy per annum |
π§ Prescribed Minimum Benefits | Covered but subject to medical aid review. |
β¬ Shortfalls on Specialist Consultations | 3 consults per policy per annum |
π© Casualty Unit Benefit | Limited to R13 650 per policy per year. |
π¦ Co-payment Benefit (In the network) | Limited to R63,000 per policy per year. |
πͺ Co-Payment Benefit Out of Network | 1 co-payment per policy per annum Up to R5 250 |
π¨ Co-payment Benefit (Out-of-hospital) for MRIs, CTs, and PET scans | Limited to 1 MRI, CT, or PET scan per policy per year. Limited to R12,600 per scan. |
πͺ Sub-limit Benefit β Internal Prostheses | Limited to R11,550 per policy per year. |
π₯ Sub-limit Benefits for MRI, CT, and PET scans | Limited to 1 MRI, CT, or PET scan per policy per year. Limited to R3,780 per scan. |
π§ Sub-limit Benefits for Colonoscopies and Gastroscopies | Limited to R13,650 per policy per year and R3,780 per event. |
π© Dental Benefit | Unlimited cover provided. Subject to the aggregate annual limit per insured person per year. |
π¦ Global Fee Benefit | Limited to R12,600 per policy per year. |
π¨ Oncology Gap Benefit | Unlimited cover provided. Subject to the aggregate annual limit per insured person per year. |
πͺ Oncology Co-payment Benefit (in the network) | Limited to R63,000 per policy per year. |
β¬ Oncology Co-Payment Benefit: Out of Network | 1 co-payment per policy per annum. Up to R5 250 |
π₯ Oncology Extender Benefit | Limited to R36,750 per policy per year. |
π§ Oncology βNew-Techβ Benefit | Limited to R8,610 per policy per year. |
π© Oncology Gap Benefit for Breast Reconstruction Surgery | Limited to R18,900 per beneficiary per life of the policy. |
π¦ Accidental Death Cover | Limited to R21,000 per insured or spouse. Limited to R8,400 per dependent. |
π¨ Policy Extender | The cover is valid for 12 months. |
πͺ Medical Aid Contribution Waiver | Limited to 6 months. Limited to a maximum of R5,775 per month. |
π₯ TRA Assist | – |
π§ Home Drive | 6 trips per policy per annum. Limited to a 50km radius. |
π© Panic Button | You will have 24-hour access to a crisis manager who will walk you through an emergency. |
π¦ Medical Health and Trauma Counselling Line | Access to qualified nurses is unrestricted, 24 hours a day, 7 days a week, for telephonic emergency medical advice, symptom assessment, medical terminology explanation, etc. Insured persons have access to a COVID-19 care line. |
π¨ Claim Submission | Insured members can use the mobile app to submit their claim documents. |
πͺ Travel Benefit | Emergency Medical and Related expenses R1 000 000 Medical Evacuation, Repatriation, or Transportation to a Medical Centre Actual expense covered when arranged by Hepstar Financial Services Personal Accident Cover Death: R25 000 / Permanent Disability: up to R25 000 Theft or Accidental Damage during trip R 5 000 / Single item limit: R 1 500 Theft, Damage or loss by Airline R5 000 / Single item limit: R 1 500 Baggage Delay (more than 4 hours) R500 Baggage Delay (more than 24 hours) R1 000 |
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Our Verdict on Total Risk Administrators (TRA) Gap Cover
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Total Risk Administrators (TRA) is a very reputable provider offering members comprehensive gap cover plans.Β Their premiums start at R99 per month, making their plans affordable to many individuals.
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TRA also offers a range of value-added benefits. TRAβs claims process is quick and easy, with claims settled within 10 business days.
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π READ more aboutΒ Medical Insurance
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 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.
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π 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.
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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. The current monthly premiums for Sirago Gap-Lite areΒ R369Β for, andΒ R419Β for families if all are under 64.
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Sirago Gap Cover Options
- β TheΒ Sirago Plus Gap CoverΒ was created for todayβs 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.
- β Hospital stays, imaging tests, surgical procedures, and visits to doctors who arenβt in your network may be eligible for financial assistance. Out-of-network PMB treatments, such as those received at day hospitals or doctorsβ offices, are partially covered.
- β Doctor visits and maternity care are among the benefits available to new parents and infants.
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π Sirago Gap CoverΒ has eight plans to choose from:
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β‘οΈ Sirago Ultimate Gap
β‘οΈ Sirago Plus Gap
β‘οΈ Sirago Gov Gap
β‘οΈ Sirago Gap Only
β‘οΈ Sirago Gap Assist
β‘οΈ Sirago Exact Cover with Gap and Co-Pay
β‘οΈ Sirago Exact Cover
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Sirago Gap Cover Contact Details:Β
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- β Telephone: 010 599 1163
- β Fax: 086 555 2682
- β Email Addresses:
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General inquiries: [email protected]
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Applications: [email protected]
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Policy changes: [email protected]
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Payments: [email protected]
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Claims: [email protected]
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- β Physical Address:
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Registered Office: Irene Link Precinct, 7 Impala Avenue, Centurion, 0157
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Current Operational Address: Floor 2, Fauchard Clinic & Centre, Corner Jan Smuts & Jan Hofmeyer Ave, Florida Park, Roodepoort, Johannesburg, 1709
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Operational Address from 1 September 2024: Building 3, 2nd Floor, Quadrum Office Park, Constantia Boulevard, Constantia Kloof, Johannesburg
3. Stratum Compact 300 Gap Cover
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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:
- 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
General Inquiries:
- β Phone: 010 593 0981Fax: 086 633 3761
- β Email: [email protected]
β Physical Addresses:
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Head Office (Johannesburg):
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Stratum House
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β 8 Fir Drive
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Northcliff
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Randburg
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β 2194
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4. 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.
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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Turnberry Gap CoverΒ has five plans to choose from
β‘οΈ Turnberry Synergy
β‘οΈ Turnberry Premier
β‘οΈ Turnberry Optimal
β‘οΈ Turnberry Med Extend
β‘οΈ Turnberry Launch
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Turnberry Contact Details
β Phone: 011 677 9891
β Email: [email protected]
β Claims:
Email: [email protected]
β Physical Address:
4 Osborne Lane
Bedfordview
2007
5. Bonitas Medgap Gap Cover
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Bonitas MedGap offersΒ comprehensive gap cover products designed to protect members from medical expense shortfalls during hospitalisation and certain out-of-hospital procedures.
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π This supplementary insurance bridges the gap between what medical aids pay and the actual costs charged by healthcare providers, ensuring that members are not burdened with significant out-of-pocket expenses.
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π MedGap products are exclusively available to active medical scheme members and are not a substitute for medical aid membership.
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Medical Practitioner Shortfall Benefit
βοΈ Bonitas MedGap covers the shortfall between what medical practitioners charge and what the medical scheme pays, up to three times the schemeβs amount.
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βοΈ This benefit is applicable to in-hospital procedures, which include childbirth. This means that the costs for obstetricians, gynaecologists, and anesthetists are adequately covered, preventing unexpected expenses during delivery.
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Co-Payment Benefit
βοΈ This benefit covers the co-payments levied by medical schemes for approved in-hospital or out-of-hospital procedures.
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βοΈ For maternity-related procedures, this means that any upfront payments required by the medical scheme for hospital admissions or specific childbirth-related treatments are covered, easing the financial burden on expectant parents.
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Additional Benefits
βοΈ Bonitas MedGap also includes other benefits that can be indirectly beneficial during maternity. For example, the Casualty Benefit provides coverage for emergency visits to casualty wards, which can be crucial in the event of pregnancy-related emergencies.
βοΈ The Premium Waiver Benefit means that in the case of the principal memberβs accidental death or permanent disability, an amount is paid to cover medical scheme and gap cover premiums, providing financial stability for the family.
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What is the monthly premium for the Bonitas MedGap plans?
π The Bonitas MedGap plans start fromΒ R146 per month for studentsΒ and go up toΒ R753Β per month depending on the plan you choose and your specifics.
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What Is the Waiting Period for the Bonitas MedGap Benefits?
π When signing up for Bonitas MedGap plans, the following waiting periods apply:
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- βοΈΒ 3-Month General Waiting Period:Β Applies to private individuals not joining as part of an employer group. No claims can be made during this period.
- βοΈΒ 9-Month Pre-Existing Medical Condition Waiting Period:Β Applies to any procedure or surgery related to pre-existing conditions for which you have received advice or treatment in the 12 months prior to the cover start date.
- βοΈΒ 12-Month Waiting Period:Β Specifically for cancer, birth, or pregnancy-related claims.
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How to Claim for Bonitas MedGap Benefits
- β Obtain the claim form by emailingΒ [email protected]Β or calling 0860 102 936, or download it from the MedGap website.
- β Collect all related documents, including medical bills, statements, and any other required paperwork.
- β Submit Online: Visit www.medgaponline.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 MedGap Claims, PO Box 786015, Sandton, 2146.
- β Ensure all documents are submitted within 180 days from the date of treatment.
- β For any enquiries, contact the claims department at 0860 102 936 or via the provided email address.
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Bonitas Contact Details
- β Phone: 0860 002 108
- β International Calls: +27 11 351 2200
- β Email: [email protected]
- β Physical address :
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β 34 Melrose Blvd
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Birnam
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Johannesburg
Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β Β 2196
FAQs
What is meant by medical gap cover in South Africa?
Gap Cover gives you cover for costs above or additional to the medical scheme rate when your approved in-hospital or doctorβs claim is higher than what your medical scheme pays.
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How much does gap cover cost in South Africa?
Gap cover can cost anything from about R260 for a basic, compact type of cover, but for around R500 you can buy a decent policy.
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Can I get gap cover if I have a medical aid?
Yes, you can still get gap cover if you have a medical aid, because gap cover is designed to complement a medical aid.
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Is there a general waiting period for Gap Cover?
Yes, there is a general waiting period for gap cover, which varies depending on the provider and the plan.
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Is shortfall insurance and gap cover the same thing?
Shortfall insurance covers additional medical costs, or the difference between the fees charged by specialists and the funds provided by the medical aid and is also called gap cover.
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Can I keep my Gap Cover Policy?
Yes, you can keep your gap cover policy as long as you continue to pay your premiums although a few gap cover providers may have age restrictions or limitations on how long you can be covered.