Gap cover bridges the gap between your in-hospital medical bills and your medical aid cover.
If you want an obligation-free gap cover quote, speak to your financial adviser or call us today on 0861 111 818.
- Use gap cover to pay for medical aid shortfalls.
- Choose a plan suitable for you.
R236 per month
What is gap cover?
Momentum GapCover+ bridges the gap between your in-hospital medical bills and medical aid cover. You can use your cover to help pay for in- and out-of-hospital fees when your medical aid doesn't cover all the costs.
With Momentum GapCover, you can choose a suitable plan to ensure you’re prepared for any unexpected shortfall.
Gap cover is not a medical aid. This product is not a substitute for medical aid cover.
How much does it cost?
No dependants may be added to gap cover if the principal insured is over the age of 65 at the time of applying for the cover.Rates are per policy per month. No dependants may be added to Momentum GapCover if the principal insured is over 65, or on Millennial GapCover.
Gap cover benefits
These benefits aggregate to a maximum benefit of R190 000 per insured person per year.
Covers up to 3 times the amount paid by the medical aid if there is a shortfall between what is charged by the medical practitioner and what is paid by the medical aid.
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.
Covers the casualty cost fees associated with admissions to the emergency room, at a registered hospital casualty facility, due to a medical emergency or accident.
Limited to 5 casualty visits and up to R23 000 per policy per calendar year.
Three of these casualty ward visits, up to R4 000, may be used in an emergency for child dependants 7 years or younger.
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.
These benefits do not aggregate to the R190 000 cap.
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.