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Why should you get
Primary Cover
Primary Plan offers you affordable cover against medical expense shortfalls that occur as the private tariff charged by medical practitioners are often higher than what the medical scheme pays out. Accessing Primary Plan is easy and hassle-free.
Primary Plan policy holders receive dedicated support and quality service from a skilled team who ensures that your claim is quickly finalised. There is a preferred rate for cover with Primary Plan.
Why Wouldn’t you get it?
Primary Cover
Shortfalls are covered on gastroscopies & colonoscopies performed in the GP or specialist’s rooms up to 300% of scheme tariff limited to 2 scopes/beneficiary/annum. All of our claims are paid out directly to the member. Benefit confirmation prior to a planned procedure.
Why should you choose
GapCover®Primary
The GapCover Primary Option was created with our first-time clients in mind. This option caters for those clients just entering the market, for our more established clients who need to scale down, especially in our current economic climate. It mimics our very popular Combined option, but, at a much lower cost, and streamlined benefits at 300% coverage.
MAKE SURE YOU’RE COVERED FOR 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.
PRIMARY 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 to hospital, up to 300%.
CoPay Cover on the Primary Plan provides cover for co-payments charged by your medical scheme for in-patient or out-patient procedures. This includes specialised radiology such as MRI and CT scans. CoPay terms and Conditions below:
Limited to R3 300, limited to 2 events, per person, per annum.
Non-DSP hospital co-payments up to R2 250, limited to one event per policy per year.
Limited to R3 300, limited to 2 events, per person, per annum.
Non-DSP hospital co-payments up to R2 250, limited to one event per policy per year.
Dental is limited per family for R2 250 on shortfalls and R2 250 on co-payments.
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.
CoPay Cover on the Primary Plan provides cover for co-payments charged by your medical scheme for in-patient or out-patient procedures. This includes specialised radiology such as MRI and CT scans. CoPay terms and Conditions below:
Limited to R3 300, limited to 2 events, per person, per annum.
Non-DSP hospital co-payments up to R2 250, limited to one event per policy per year.
Limited to R3 300, limited to 2 events, per person, per annum.
Non-DSP hospital co-payments up to R2 250, limited to one event per policy per year.
Primary will provide additional benefits for Emergency/Casualty ward benefits, limited to 1 event, up to R1 150.00.
Physiotherapy for post-operative joint replacement/back surgery rehabilitation, limited to R700, for 1 event.
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).