Best gap cover in South Africa in 2024: Top 15 list and more

Unexpected and unforeseen circumstances happen in life, and being unprepared for them can mean finding yourself in dire financial distress. In this regard, having a gap cover is pivotal to ensuring you receive a helping hand from your insurance company. Learn more about the best gap cover in South Africa as of 2024.

The South African gap cover landscape boasts a diverse range of providers, each vying to offer the most comprehensive and cost-effective plans. The list of the best gap covers in SA was selected based on their reputation within the industry, customer reviews, the comprehensiveness of their coverage plans. While this list serves as a valuable starting point, remember that the "best" gap cover ultimately depends on your unique circumstances and priorities.

Top 15 best gap cover in South Africa in 2024

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What is the best gap cover in South Africa?

The 'gap' bridges the amount between what medical aid schemes cover and what healthcare providers charge. South Africa has a variety of the best gap covers which are distinct from medical aid schemes.

Some have no waiting periods, while others do. Furthermore, such a cover from different medical insurance companies can finance in and out-of-hospital expenses. Here are some of the best medical gap covers in South Africa.

1. Sanlam Comprehensive Gap Cover

The Sanlam Gap Cover ensures that its members are not left with large excess amounts to settle. Some of its benefits include receiving cash for every day spent in the hospital due to an accident or premature birth. The monthly premiums are as follows:

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2. Absa Extended Cover

The Absa Extended Cover is offered by Absa is tailored for vehicle-related matters. For R104 per month, you can access benefits such as Road Accident Fund assistance, photofinish and violation cover. However, to qualify, the purchase of your car must be financed by Absa.

3. Zestlife Universal

Zestlife Universal is one of the best medical gap cover in South Africa. Its benefits include general and specialist hospital consultations and approximately 50 out-of-hospital procedures. Claims are paid up to an overall annual limit of R182,700 per insured. The monthly premiums for Zestlife Universal include:

Zestlife optimal and essential gap covers

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Zestlife universal gap covers

4. Momentum Gap Cover

The Momentum Gap Cover allows beneficiaries to bridge the gap of any unexpected medical costs shortfall. The coverage fills in the gap between your medical aid coverage and hospital bills.

When your medical aid doesn't fully cover the charges, you can utilize your coverage to help pay for both in- and out-of-hospital costs. The current monthly premiums for Momentum cover are:

5. Discovery Gap Cover

Discovery Health’s gap cover benefits include cover for shortfall approved emergency international claims, pays 250% of the medical scheme rate on the core option and 500% on the comprehensive option. For business, depending on your Discovery Vitality status, you get a gap cover of up to R15,000 per year.

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Discovery also offers coverage of up to R100,000 annually for deficits in approved cancer-related claims once the medical scheme's oncology threshold is surpassed. For individuals, you get to pay as low as R143 a month for your cover.

6. Old Mutual Gap Cover

R270 per month gets you the Old Mutual 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.

7. Auto & General Essential

Auto and General’s essential gap cover does not cover any medical expenses that do not fall under the category of those covered by your medical aid scheme and it offers immediate cover with no waiting period. The insurance company also covers shortfalls of approved medical procedures.

The monthly premiums for Auto & General Essential are as follows:

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8. Liberty Essential

Liberty remains a trusted brand among South Africans, providing affordable health and financial products. Liberty Essential gap cover provides R192,000 in shortfall expenses for covered members, including accidental injury and out-of-hospital fees for specialists and doctors.

9. Bonitas MedGap

Bonitas offers its members the most affordable gap cover packages from for individuals and families in the supreme package. It covers hospitalisation fees and medical treatment expenses. The monthly premiums for Bonitas MedGap are:

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10. Turnberry

The Turnberry gap cover protects clients and their families from bearing hefty medical expenses uncovered by their medical aid. The package’s benefits include R198,660.43 per annum for one member’s medical expenses, casualty benefits, and co-payments for MRI, CT and PET scans.

11. Sirago Gap-Lite Cover

Sirago Gap-Lite Cover is specifically tailored for young individuals and families. It provides coverage for medical aid shortfalls, extending up to 250% of the scheme rate, with a maximum annual limit of R183,000 per person.

The benefits encompass limited co-payment coverage for hospital admissions, scans, surgical procedures, and utilizing non-designated service providers. The current monthly premiums for Sirago Gap-Lite Cover are:

12. Stratum Compact 300

The Stratum Compact 300 is a comparatively low gap cover for individuals and families. With a cover for common health events, the gap cover issues funds annually of up to R 177,838 per person covered. Its premiums for individuals are as follows:

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13. Total Risk Administrators

Total Risk Administrators prides itself on offering the best gap cover plans ensuring the protection and coverage of you and your family. TRA gap cover plans range in price from around R99 per month to R435 per month.

14. Ambledown

Ambledown provides distinctive plans encompassing chronic conditions, emphasising social impact, and featuring transparent pricing. Policyholders are entitled to benefits matching the expenses accrued due to the gap during authorized in-patient hospital admissions. The Ambledown gap cover offers the following premiums:

15. Santam gap cover

Santam is a South African insurance company that offers an array of insurance services to South Africans. A gap cover, such as a vehicle credit shortfall, is available to interested vehicle owners. Santam gap cover assists its members in covering the difference between the vehicle’s retail value and how much was paid in its purchase, in instances where the car is stolen or written off.

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What are the tips for optimising your medical aid?

Optimizing your medical aid and considering gap cover can help ensure that you have comprehensive healthcare coverage while managing costs effectively. Some of the top tips to do this include:

• Understand your medical aid plan: Familiarize yourself with the details of your current medical aid plan. Understand the coverage limits, co-payments, and exclusions.
• Consider your health status: If you have any pre-existing conditions or require regular specialist care, gap cover can be crucial in managing medical expenses.
• Compare different plans: Research and compare different medical aid plans available in the market. Consider factors such as coverage, premiums, network of healthcare providers, and additional benefits.
• Consider day-to-day benefits: Some gap cover plans offer additional benefits like consultations, medication cover, or dental care. Choose a plan that complements your medical aid.
• Consider your family needs: If you have a family, consider their healthcare needs when selecting a medical aid plan and gap cover. Some plans may offer family packages or discounts.

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What are the advantages of taking gap cover?

Some of the advantages of taking a gap cover include:

• Gap cover provides additional financial protection.
• Policyholders can minimize out-of-pocket expenses associated with medical treatments.
• It allows individuals to access specialized medical care without worrying about excessive charges.
• Gap cover policies typically have streamlined and efficient claim processing procedures, allowing policyholders to receive reimbursements promptly and without unnecessary delays.
• Can assist in covering co-payments and deductibles imposed by the primary medical aid.
• They are generally more affordable than comprehensive medical aid plans, making it a cost-effective option for individuals.

What is the difference between medical aid and gap cover?

Medical aid is primary health insurance covering a range of medical expenses, while gap cover is supplemental insurance addressing financial shortfalls between healthcare provider charges and medical aid coverage.

How does gap cover work in South Africa?

Gap cover bridges the gap between your in-hospital medical bills and your medical aid cover. It is meant to complement your existing medical aid or health insurance, not replace it.

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What is a complimed gap cover?

A complimed gap cover is a shortfall insurance that covers additional medical costs, whose monthly premium is less. Accordingly, it covers the difference between the fees charged by specialists and the funds provided by the medical aid.

Is a gap cover worth having?

Having a gap cover is extremely important since medical aid shortfalls happen. Therefore, if you have medical aid, you should also have a gap cover to complement it for instances where your medical aid does not have sufficient funds to cover all medical expenses you might have.

Which gap cover has no waiting period?

Among many medical insurance companies in South Africa, the Zestlife gap cover does not have a three-month waiting period. It offers immediate cover from the inception of the policy date. It is important to note that submitting a claim relating to pregnancy or cancer treatment is not covered for the first 12 months.

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Who offers the best gap cover in South Africa?

Liberty offers the best gap cover through its Liberty Universal Gap, which provides extensive payments for shortfalls in treatments and procedures conducted in and out of hospital. Claims are covered at a medical aid scheme rate of 500%.

What is the best medical aid in South Africa?

Bestmed is regarded as the best medical aid scheme in South Africa according to overall customer satisfaction. Under this medical aid scheme, members are offered 75% less on co-payments for medical expenses. Additionally, it gives members free health assessments and visits to the dietitian through its Tempo Wellness Programme.

Does a gap cover finance in-hospital expenses only?

Laws that govern medical expenses differ for various companies. There are a few that only cover in-hospital expenses and for situations where a person finds themselves requiring cosmetic surgery, costs for the procedure in question will have to be financed without any assistance from gap cover.

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Does Sanlam offer gap cover?

Sanlam offers both comprehensive and standard gap cover, each with different levels of coverage and benefits.

How long do you have to wait for a Sanlam Gap Cover?

A general waiting period of three months applies to all benefits offered by the Sanlam gap cover. This period also applies to individuals and families under the age of 60.

What does Hippo medical aid do?

Hippo is a South African company that helps individuals and businesses compare and choose medical aid plans from leading providers in the country. Hippo quotes help you compare various medical covers and how much they each charge.

What is the best gap cover in SA?

Some of the best gap covers in SA are the Sanlam Comprehensive Gap Cover, Absa Extended Cover, Zestlife Universal and Momentum Gap Cover.

The information provided above can guide you if you are looking for the best gap cover in South Africa. Gap covers focus on covering the co-payments, deductibles, and shortfalls that may arise from your medical aid benefits.

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DISCLAIMER: This article is not sponsored by any third party. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional advice or help and should not be relied on to make decisions of any kind. Any action you take upon the information presented in this article is strictly at your own risk and responsibility!

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Source: Briefly News