Elixi Plans
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Blue
Elixi
Β· Health Insurance
Best suited for individuals seeking affordable primary healthcare with unlimited GP consultations and essential day-to-day benefits.
Principal Member
From
R486
per month
Adult Dependant
From
R486
per month
Child Dependant
From
R486
per month
Hospital
Savings
Day-to-day
Chronic
Dental
Optical
Maternity
Mental health
Purple
Elixi
Β· Health Insurance
Best suited for individuals seeking affordable primary healthcare with accident-only private hospital cover. Not a medical aid.
Principal Member
From
R654
per month
Adult Dependant
From
R654
per month
Child Dependant
From
R654
per month
Hospital
Savings
Day-to-day
Chronic
Dental
Optical
Maternity
Mental health
Gold
Elixi
Β· Health Insurance
Best suited for individuals seeking comprehensive day-to-day healthcare with accident-only hospital cover & chronic medication benefits. Not a medical aid.
Principal Member
From
R781
per month
Adult Dependant
From
R781
per month
Child Dependant
From
R781
per month
Hospital
Savings
Day-to-day
Chronic
Dental
Optical
Maternity
Mental health
Black
Elixi
Β· Health Insurance
Best suited for individuals seeking premium day-to-day healthcare with comprehensive hospital, chronic medication, dental & optical benefits. Not a medical aid.
Principal Member
From
R1,026
per month
Adult Dependant
From
R1,026
per month
Child Dependant
From
R1,026
per month
Hospital
Savings
Day-to-day
Chronic
Dental
Optical
Maternity
Mental health
Elixi Gap Cover (πΏπ¦ 2025)
Overall, Elixi Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Elixi Gap Cover Plans start from R282 ZAR. Elixi has a trust score of 9.5 on Hello Peter Elixi Gap CoverΒ has eight plans to choose from| π€ The average number of members | 1,000+ |
| 1οΈβ£ Number of Markets | 1 |
| π Market Share | <5% |
| 8οΈβ£ The number of plans offered | 8 |
| π± Mobile App | β Yes |
| β οΈ Waiting Period | 3 β 12 months |
| β Exclusions | β Yes |
Elixi Gap Cover - Analysis of Providers' Main Features
- β Elixi Gap Cover β Advantages over Competitors
- β Elixi Single/Individual Plans
- β Elixi Family Plans
- β Elixi Value-Added Services
- β Elixi Gap Cover Premiums
- β How to apply for Gap Cover with Elixi
- β How to Submit a Claim for Gap Cover with Elixi
- β Elixi Gap Cover Exclusions
- β Elixi Gap Cover Waiting Periods
- β Elixiβs Customer Reviews
- β Elixi Gap Cover vs Other Notable Providers
- β Elixi Gap Cover Pros and Cons
- β Our Verdict on Elixi Gap Cover
- β Elixi Gap Cover Frequently Asked Questions
Elixi Gap Cover for medical aid - Advantages over Competitors
πThe advantages of choosing Elixi Gap Cover include:- β The affordable premiums of Elixi Gap Cover provide a cost-effective solution for covering medical expenses above medical aid scheme benefits.
- β When you join Elixi Gap Cover, there are no waiting periods or exclusions for pre-existing conditions.
- β Elixi Gap Cover reimburses up to 600% of the Medical Scheme Rate for in-hospital specialist procedures and consultations, ensuring you have access to the best medical care.
- β The coverage includes unlimited accidental injury and emergency room treatment, ensuring that you can receive immediate medical care in an emergency without worrying about the associated costs.
- β Elixi Gap Cover covers the full shortfall amount for approved in-hospital treatments, so there are no co-payments or other out-of-pocket expenses.
- β Elixi Gap Cover provides a straightforward and convenient online claims process, allowing you to submit and receive payments efficiently.
- β Due to Elixi Gap Cover's high annual limit of R210,580 you can claim for as many in-hospital treatments as necessary throughout the year without worrying about exceeding the limit.
- β The coverage provides oncology benefits, which include chemotherapy, radiotherapy, and cancer-related medication coverage.
- β The 24-hour medical advice line Elixi Gap Cover provides medical advice and assistance whenever needed.
Elixi Single/Individual Plans
Elixi Single Plan
| β€οΈ Overall Annual Limit per insured | R210,580 |
| 𧑠Hospital Excess Cover | Hospital Excess Cover is subject to a minimum excess of R200,000. |
| π Casualty Benefit | This benefit covers hospital casualty unit emergency care. R11,000 per insured per year. |
Single Co-Plus
| π΄ Overall Annual Limit per insured | R210,580 |
| π Overall Cover | Cover ranges from 101% to 600%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π‘ Casualty Benefit | This benefit covers hospital casualty unit emergency care. R11,000 per insured per year. |
| π’ Sub-Limit Benefits | This covers costs greater than most cap levels for hospital procedures and treatments beyond the cap levels the medical scheme sets. |
| π΅ Co-Payment Benefits | Co-payment can assist you in covering the cost if you have to make an upfront payment before receiving medical assistance (for an MRI scan, for example). |
| π£ Premium Waiver | The benefit will cover the medical aid premiums at the time of the incident for six months within the stated restrictions if the primary member of the medical scheme suffers a total and permanent disability due to an accident. This benefit will start in the first month following the incident's date. |
Executive Single Plus
| π₯ Overall Annual Limit per insured | R210,580 |
| π§ Overall Cover | Cover ranges from 101% to 600%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π¨ Casualty Benefit | This benefit covers hospital casualty unit emergency care. R10,000 per insured per year. |
| π© Sub-Limit Benefits | This covers costs greater than most cap levels for hospital procedures and treatments beyond the cap levels the medical scheme sets. |
| π¦ Co-Payment Benefits | Co-payment can assist you in covering the cost if you have to make an upfront payment before receiving medical assistance (for an MRI scan, for example). |
| πͺ Oncology Benefits | This benefit covers biological cancer drugs for specific oncological conditions and subgroups of cancer in a private hospital, subject to the medical scheme's sub-limits and co-payments. This benefit covers private cancer treatment up to R200,000 per cycle. |
| π₯ Hospital Excess Cover | Covers amounts above the Medical Aid option and hospital limitation. Hospital Excess Cover requires an R200,000 excess. |
| π§ Premium Waiver | The benefit will cover the medical aid premiums at the time of the incident for six months within the stated restrictions if the primary member of the medical scheme suffers a total and permanent disability due to an accident. This benefit will start in the first month following the incident's date. |
πRead more about 5 Best Medical Aids for Seniors and Elderly People
Elixi Family Plans
Family Double
| π °οΈ Overall Annual Limit per insured | R210,580 |
| π ±οΈ Overall Cover | Cover ranges from 101% to 200%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π₯ Casualty Benefit | This benefit covers hospital casualty unit emergency care. R10,000 per insured per year. |
Family
| β€οΈ Overall Annual Limit per insured | R210,580 |
| 𧑠Overall Cover | Cover ranges from 101% to 600%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π Casualty Benefit | This benefit covers hospital casualty unit emergency care. R10,000 per insured per year. |
Family Co-Plus
| π΄ Overall Annual Limit per insured | R210,580 |
| π Overall Cover | Cover ranges from 101% to 600%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π‘ Casualty Benefit | This benefit covers hospital casualty unit emergency care. R10,000 per insured per year. |
| π’ Sub-Limit Benefits | This covers costs greater than most cap levels for hospital procedures and treatments beyond the cap levels the medical scheme sets. |
| π΅ Co-Payment Benefits | Co-payment can assist you in covering the cost if you have to make an upfront payment before receiving medical assistance (for an MRI scan, for example). |
| π£ Premium Waiver | The benefit will cover the medical aid premiums at the time of the incident for six months within the stated restrictions if the primary member of the medical scheme suffers a total and permanent disability due to an accident. This benefit will start in the first month following the incident's date. |
Executive Family
| π₯ Overall Annual Limit per insured | R210,580 |
| π§ Overall Cover | Cover ranges from 101% to 600%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π¨ Casualty Benefit | This benefit covers hospital casualty unit emergency care. R10,000 per insured per year. |
| π© Sub-Limit Benefits | This covers costs greater than most cap levels for hospital procedures and treatments beyond the cap levels the medical scheme sets. |
| π¦ Co-Payment Benefits | Co-payment can assist you in covering the cost if you have to make an upfront payment before receiving medical assistance (for an MRI scan, for example). |
| πͺ Hospital Excess Cover | Covers amounts above the Medical Aid option and hospital limitation. Hospital Excess Cover requires an R200,000 excess. |
| π₯ Premium Waiver | The benefit will cover the medical aid premiums at the time of the incident for six months within the stated restrictions if the primary member of the medical scheme suffers a total and permanent disability due to an accident. This benefit will start in the first month following the incident's date. |
Executive Family Plus
| π₯ Overall Annual Limit per insured | R210,580 |
| π§ Overall Cover | Cover ranges from 101% to 600%. Covers in-hospital and certain outpatient medical practitioner fees. The Medical Scheme Tariff covers only a percentage of the prosthesis, materials, and medication costs. Covers Specialists, general practitioners, and medical professionals who provide hospital services. |
| π¨ Casualty Benefit | This benefit covers hospital casualty unit emergency care. R10,000 per insured per year. |
| π© Sub-Limit Benefits | This covers costs greater than most cap levels for hospital procedures and treatments beyond the cap levels the medical scheme sets. |
| π¦ Co-Payment Benefits | Co-payment can assist you in covering the cost if you have to make an upfront payment before receiving medical assistance (for an MRI scan, for example). |
| πͺ Oncology Benefits | This benefit covers biological cancer drugs for specific oncological conditions and subgroups of cancer in a private hospital, subject to the medical scheme's sub-limits and co-payments. This benefit covers private cancer treatment up to R200,000 per cycle. |
| π₯ Hospital Excess Cover | Covers amounts above the Medical Aid option and hospital limitation. Hospital Excess Cover requires an R200,000 excess. |
| π§ Premium Waiver | The benefit will cover the medical aid premiums at the time of the incident for six months within the stated restrictions if the primary member of the medical scheme suffers a total and permanent disability due to an accident. This benefit will start in the first month following the incident's date. |
πREAD more about the 5 Best Dental Gap Cover
Elixi Value-Added Services
| β€οΈ Crisis Centre | An innovative crisis management center is open 24 hours a day, seven days a week. Expert crisis assistance and emergency coordination are provided for all public services. |
| 𧑠Call a GP or Nurse | Medical professionals staff the 24-hour GP helpline. This vital service offers guidance and assistance. Members will be able to speak with a qualified GP or nurse about a variety of medical issues, including medical advice, second opinions, confirmation and clarification of medical diagnoses, drug regimen guidance, referral to a specialist GP, guidance, and advice on the side effects of prescribed treatment, and telephonic follow-up after diagnosis and treatment. |
| π C5 HIV Prevention Program | Suppose a policyholder is exposed to HIV due to trauma or assault. In that case, the member will have access to the following services: A 24-hour Telephonic HIV advice and counseling line Emergency evacuation to an HIV treatment facility (ER24 only) Medical consultation A three-day starter pack A 25-day antiretroviral HIV treatment regimen that includes sexually transmitted disease therapy and pathology tests |
| π Trauma Counselling | If a member engages in or witnesses a traumatic event, the member will have unlimited telephonic counseling, referral to a qualified counselor, and face-to-face counseling with a qualified counselor. Each event is limited to R3,000. |
| π Household Assistance | The Elixi Gap Members are covered for a callout and up to one hour of labor (for the initial fault only) for emergencies involving plumbing, electrical faults, appliance faults, damage to external windows, and locksmith emergencies. |
Elixi Gap Cover Premiums
Elixi Single Plans
| π Elixi Plan | 1οΈβ£ Single | 2οΈβ£ Single Co-Plus | 3οΈβ£ Executive Single Plus |
| πΆ Average Cost | R282 | R391 | R486 |
| πΆ Senior Premiums | R359 | R483 | R610 |
Elixi Family Plans
| π Elixi Plan | 1οΈβ£ Family Double | 2οΈβ£ Family | 3οΈβ£ Family Co-Plus | 4οΈβ£ Executive Family | 5οΈβ£ Executive Family Plus |
| πΆ Average | R285 | R428 | R544 | R633 | R726 |
| πΆ Senior | R372 | R528 | R654 | R732 | R964 |
How to apply for Gap Cover with Elixi
πTo apply for Elixi Medical Insurance's Gap Cover, go to their website and follow the steps outlined below:- β Navigate to the "Gap Cover" page on the Elixi Medical Insurance website.
- β Choose the "Apply Now" option.
- β Fill in your personal information and preferred plan option on the online application form.
- β Fill out the form and submit it.
How to Submit a Claim for Gap Cover with Elixi
πWith Elixi Medical Insurance, submitting a claim for Gap Cover is straightforward. Here are the subsequent steps:- β Contact the applicable healthcare provider and request an itemized bill or account statement for the treatment or procedure received.
- β Download and complete the Elixi Gap Cover claim form from the Elixi Medical Insurance website or request a copy from customer service.
- β Submit the claim form, the itemized bill or account statement, and any other supporting documentation required by Elixi, such as your policy schedule and proof of payment for any co-payments or deductibles.
- β Ensure that the claim is submitted within the time specified by Elixi, typically four months from the date of the service or procedure.
Elixi Gap Cover Exclusions
Elixi does not indicate any specific exclusions on the website.
Elixi Gap Cover Waiting Periods
There is typically a three-month general waiting period for all benefits and an additional 12-month waiting period for pre-existing conditions, during which neither you nor your family is eligible for coverage.
Elixi's Customer Reviews
Very Pleased. I am pleased to share that my experience with Elixi Gap Cover has been exceptional. I have had negative experiences with gap cover plans. However, Elixi has provided me with a product that meets my unique requirements. - Madiha Kerr Prompt and Efficient. I would like to express my gratitude for the prompt and efficient handling of my recent claim submission. The entire process was seamless and hassle-free, and my claim was fully paid. I could not have asked for better service. - Gareth Sutherland Very Positive Experience! I would like to share my positive experience with your product. As a first-time user, I requested the necessary forms, which were promptly delivered with instructions on the required documents. I submitted the relevant documentation for processing and received my payout briefly, which was a pleasant surprise. - Keane Humphrey
Elixi Gap Cover vs Other Notable Providers
| π Gap Cover Provider | π₯ Elixi | π₯ Kaelo | π₯ Dis-Chem |
| π₯ Underwriters | Unity Health | Centriq Insurance Company Limited | Kaelo Risk (Pty) Ltd |
| π§ Number of Plans | 8 | 2 | 2 |
| π¨ Average Price | R282 β R964 | R255 β R941 | R23 |
| π© Waiting Periods | 3 β 12 months | 12 months | 3 β 12 months |
| π¦ Exclusions | β Yes | β Yes | β Yes |
| πͺ Oncology Benefit | βοΈ Yes | βοΈ Yes | βοΈ Yes |
| π₯ In-Hospital Benefit | β Yes | β Yes | β Yes |
| π§ Out-of-Hospital Cover | βοΈ Yes | βοΈ Yes | βοΈ Yes |
| π¨ Maternity Benefit | β Yes | None | None |
| π© Scopes and Scans | βοΈ Yes | βοΈ Yes | βοΈ Yes |
| π¦ Co-payment Cover | β Yes | β Yes | β Yes |
| πͺ Emergency Room | βοΈ Yes | βοΈ Yes | βοΈ Yes |
| π₯ Accidental Cover | β Yes | β Yes | β Yes |
| π§ Trauma Counseling | βοΈ Yes | βοΈ Yes | βοΈ Yes |
| π¨ Premium Waiver | β Yes | β Yes | β Yes |
| π© Non-DSP Co-Payment | None | βοΈ Yes | βοΈ Yes |
| π¦ Prostheses | β Yes | β Yes | β Yes |
| πͺ Accidental Death/ Permanent Disability | βοΈ Yes | βοΈ Yes | βοΈ Yes |
| π₯ Travel Cover Extender | None | β Yes | β Yes |
Elixi Gap Cover Pros and Cons
| β Pros | β Cons |
| Affordable premiums | Limited information on the underwriting process |
| No waiting period for certain claims | Limited online presence |
| Covers in-hospital and out-of-hospital costs | Limited additional benefits |
| Covers co-payments and deductibles | Only available as an add-on to Elixi Medical Insurance |
| Covers medical aid shortfalls | Limited information on the claims process |
πWomen might consider making use of our free Ovulation Calculator
