For unexpected medical life-changing events get up to 500% in-hospital specialist cover.
Gap cover offers cover for tariff shortfalls on in-hospital specialist claims and specified out of hospital costs, relating to approved admissions
Medical Schemes will cover in-hospital expenses defined as services rendered by a Medical Practitioner at the Medical Scheme rate. However, today most specialists charge rates that are higher than the Medical scheme rate and you, as the member are liable for the difference, known as the tariff gap
Gap Cover (Top-up Cover) is an insurance product that provides cover for you and your immediate family for the shortfall (GAP) resulting from any Medical Practitioner charging above the Medical Aid Tariff for in-hospital surgical procedures and certain out of hospital procedures. The insured will receive a benefit equivalent to the costs incurred as a result of the GAP for any hospital admission as an in-patient. The GAP is defined as services rendered by a medical practitioner who charges above the medical scheme tariff.