Gap & Travel Cover

Gap cover is insurance that pays the difference between what your medical aid scheme covers and what healthcare providers actually charge. Many specialists charge 200-500% above medical aid rates, leaving you with significant out-of-pocket expenses. Gap cover protects you from these unexpected costs, ensuring you can access quality healthcare without financial stress.

Gap cover works alongside your medical aid as a complementary policy. When you receive treatment, your medical aid pays its portion first. If there's a shortfall (the gap), your gap cover policy pays the difference directly to the healthcare provider or reimburses you. There's no duplication of benefits – gap cover only pays what your medical aid doesn't.

The international travel benefit provides comprehensive emergency medical coverage when you're abroad, including unlimited emergency medical expenses, emergency evacuation up to R2 million, repatriation of remains, and 24/7 emergency assistance. It covers medical emergencies in over 180 countries and ensures you're not left with massive medical bills while traveling.

Most gap cover benefits have no waiting periods, meaning you're covered immediately for accidents and emergencies. However, there may be a 3-month general waiting period and a 12-month waiting period for certain pre-existing conditions. Maternity benefits typically have a 12-month waiting period.

Yes! Hospital plans often have lower scheme rates and benefit limits, making gap cover even more valuable. Gap cover helps bridge the larger shortfalls common with hospital plans, ensuring you can still access quality specialists and facilities without facing massive out-of-pocket costs.

Yes, gap cover is generally available regardless of pre-existing conditions. However, there may be waiting periods or exclusions for certain conditions. It's important to declare all conditions during the application process to ensure proper coverage and avoid claim disputes.