Gap cover

Covers the shortfall between what the medical practitioner charged and the medical scheme paid, at 300% of the Scheme Rate.

Covers co-payments applied by your medical aid, including the 20% co-payment applied to oncology treatment after reaching the medical aid limit. This benefit does not cover co-payments payable for voluntary use of non-Designated Service Providers.

Up to R25 200 for costs after an accident, subject to the annual visit limits.

Covers shortfalls on internal prosthesis costs, up to a maximum amount of R35 000 per policy per year. Cover for stents and pacemakers are now included to a max of R8 000 per claim event.

If you are diagnosed with minimum stage 2 local and malignant cancer whilst covered by this policy, we will pay you R8 000.

If, however, you are diagnosed with minimum stage 2, regional and malignant cancer, we will pay you R20 000.

If, after receiving the R20 000 benefit, your medical aid pays more than R200 000 for the cost of your oncology treatment within 12 months of your diagnosis, we will pay you a further R15 000.

The benefit of R55 000 is payable for death or permanent disability due to an accident. Subject to one claim per insured per lifetime.

If you are a victim of, or witness to, an act of violence (such as murder, assault, robbery, rape, kidnapping or hijacking) or a traumatic accident, we will refund a fixed amount of R800 per session for any trauma counselling you’ve had, limited to R30 000 per family per year.

• Violent crime benefit – R110 000 payable for death or permanent disability due to a violent crime.
• Premium waiver benefit - R36 000 payable upon the death or permanent disability of the premium payer.
• Baby bump benefit - Benefit of R2 500 payable when existing GapCover members fall pregnant.
• Breast reconstruction benefit for non-affected breast - if you are diagnosed with breast cancer and require cosmetic breast reconstruction for the non-affected breast due to a mastectomy, we will provide cover of R15 000 per policy per year.