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Why should you choose
COMBINED COVER
GapCover® is a short-term insurance product that offers you affordable cover for your whole family against medical expense shortfalls occurred for in-hospital procedures.
CoPay Cover provides cover for procedural co-payments charged by your medical scheme for in-patient or out-patient procedures. This includes specialised radiology such as MRI and CT scans.
Combined Cover includes both
GapCover® and CoPay Cover from R333 per family, per month
MAKE SURE YOU’RE COVERED FOR MEDICAL SHORTFALLS!
GapCover® is a short-term insurance product that offers you affordable cover for your whole family against medical expense shortfalls occurred for in-hospital procedures.
HOW DOES THE CLAIMS PROCESS WORK?
All GapCover® claims are paid out directly to the member. You can find out more about our easy claims process by clicking the button below, or getting in touch with us through the contact page.
COMBINED COVER CORE BENEFITS
IN-HOSPITAL BENEFITS
Benefits in this section will provide cover for the difference in the amount charged by a Registered Medical Professional and the Medical Scheme Rate for services rendered while admitted in hospital.
Benefits in this section will provide cover for procedural co-payments (the excess imposed in terms of your Medical Scheme Rules) for procedures performed as an In-Patient, hospital admission fees, as well as Specialised Radiology such as MRI and CT Scans limited to R17 500 per event.
Co-payments for the use of a non-DSP (Designated Service Provider) Hospital limited to R17 000 once per calendar year, per policy.
Co-payments for the use of a non-DSP (Designated Service Provider) Hospital limited to R17 000 once per calendar year, per policy.
Benefit provides cover for shortfalls on all dental procedures paid from risk limited to R8 400 per policy, per annum.
Benefit provides cover for procedural co-payments on all dental procedures limited to R8 400 per policy, per annum.
Benefit provides cover for procedural co-payments on all dental procedures limited to R8 400 per policy, per annum.
OUT-OF-HOSPITAL BENEFITS
Benefit provides cover for shortfalls on Gastroscopies and Colonoscopies performed in the GP or Specialist’s rooms, limited to 2 scopes per beneficiary, per annum.
Benefits in this section will provide cover for procedural co-payments (the excess imposed in terms of your Medical Scheme Rules) for procedures performed as an Out-Patient (Gastroscopies and Colonoscopies performed in the GP or Specialist’s rooms limited to 2 scopes per beneficiary, per annum) as well as Specialised Radiology such as MRI and CT Scans limited to R17 500 per event.
Benefit provides cover for the shortfalls on cost incurred for the treatment of an injury caused by an external force at an emergency ward limited to 2 events to a maximum benefit of R6 500 per policy, per annum provided that payment was made by the Medical Scheme.
Benefit provides cover for out of hospital physiotherapy limited to R2 500 per policy, per annum for postoperative joint replacement/back surgery rehabilitation provided that payment was made by the Medical Scheme for services rendered within 30 days after discharge.
GapCover® is underwritten by Western National Insurance Company Ltd, Reg. No: 2005/017349/06,
FAIS: Juristic Representative under (FSP 9465).
Administered by, GapRisk Administrators (Pty) Ltd Reg. No.2021/500446/07, an authorized financial services provider (FSP: 51758).