29 Sep Gap cover Review Season: Is Your Cover Still Protecting You?

Every year, medical scheme members across South Africa take a closer look at their benefits and premiums. This period, known as review season, is the perfect time to ask: is your gap cover still giving you the protection you need, or is it quietly costing you?

What “review season” means for gap cover

Review season is when medical schemes and gap cover providers announce their benefit updates, premium adjustments, and exclusions for the year ahead.

Because gap cover is short-term insurance for medical scheme members, designed to cover in-hospital shortfalls, these updates can have a direct impact on how well your policy protects you. Reviewing your gap cover at the same time as your medical aid means you can make adjustments without risking gaps in cover.

It’s also worth checking whether your cover includes an overall annual limit that keeps pace with rising costs. For example, GapCover pays up to R198 660 per beneficiary, per year towards medical shortfalls, giving families real peace of mind that large specialist bills won’t derail their finances.

A 5-step check to see if your cover still fits

Here’s a simple, 10-minute self-audit to help you decide whether your current plan is still right for you:

1. Check your dependants – Have you added a spouse, child, or ageing parent to your medical aid? Your gap cover may need updating too.
2. Compare today’s hospital tariffs – Specialist costs and co-payments rise every year; does your benefit still cover the likely shortfall?
3. Look at your policy limits – What is the maximum your plan will pay per year? Is it enough for today’s real costs? As a benchmark, GapCover provides cover up to R198 660 per beneficiary per year, far above what most members would ever want to pay out-of-pocket for a single procedure.
4. Watch waiting periods – If you switch now, when do your full benefits kick in? Avoid surprises by checking upfron
5. Do the math on total cost – Don’t just look at the entry price. Consider how increases apply year-to-year and whether your premium model is sustainable.

Myth vs. Reality: “You’ll always pay what you paid at 20”

You may have heard promises that your gap cover price will never change. The reality? Gap cover premiums are reviewed annually, and can be influenced by inflation, benefit caps, and portfolio adjustments.

The key is predictability. Ask:

• How are my premiums calculated?
• How predictable are increases year to year?
• What is the maximum payout in a year?
• How long before I qualify for full benefits?

GapCover makes this process simple and transparent, with a single affordable premium per family (covering you plus up to six dependants), ensuring your household stays protected without hidden surprises. Understanding these basics gives you confidence that you’re not buying into a myth, but into cover that genuinely protects your wallet.

How to compare gap cover prices the right way

Not all gap cover is equal, and the cheapest option upfront isn’t always the best value long-term. Here’s what to focus on when comparing:

• Premium model – Age-at-entry vs. annual risk adjustment.
• Inflation link – Will your cover keep up with rising medical tariffs?
• Benefit limits – What is the maximum the plan pays per claim and per year?
• Waiting periods – When does full cover apply?
• Exclusions – What’s not covered, and how might that affect you?:

With GapCover, you also gain access to dedicated claims support and benefit confirmations before planned procedures, so you know exactly what’s covered before you step into hospital.

Call us for a zero-pressure quote

Sometimes the simplest step is just to talk to a real person. In one quick call, we’ll walk you through:

• How your current benefits stack up against today’s medical shortfalls..
• What a tailored quote looks like; clear, transparent, and designed around your needs.
• Answers to your questions, without sales pressure.

Call now for a quick GapCover quote: +27878200627
Prefer online? [Request a callback]

Final word

Review season is the best time to check whether your gap cover is still providing you and your loved ones with sufficient cover. With rising hospital tariffs, changing family needs, and shifting benefits, a 10-minute check today can save you thousands tomorrow. And with GapCover starting from just R267 per family per month, you get protection that’s affordable, comprehensive, and designed to safeguard your household when it matters most.

Need help with a claim or unsure what’s covered? Get personalised support here.

For more details or to sign up, visit GapCover.co.za.