As the gap covers evolve, so do the benefits that they offer.
Insurers are getting creative in what they cover, and benefits can include many extra add-ons that extend well beyond unpaid in-hospital medical bills.
No product offers all of these, so you need to read the marketing brochure carefully, or ask your broker.
- Pre and post surgery consultations (but for this to apply, medical aid usually needs to pay something towards the cost, from either risk or savings)
Example: Zest - Upgrades to a private room
This can be for any procedure, or specific to maternity
Example: Totalrisk, Netcare Plus - Preventative-care allowance,
eg Pap Smears or mammograms.
Example: Stratum - Take home medicine,
If your medical aid (eg. Discovery Health) does not pay for it - Help with the admin
Help you with complicated medical aid claims - International medical care
Cover for medical costs while travelling outside of South Africa, Does not apply to planned procedures or cancer treatment.
Example: Zest - Travel insurance
Cover for lost luggage, etc
Example: Turnberry, Stratum - Trauma counselling
Access to help lines or in-person consults following a traumatic event eg. violent crime or death of a loved one
Example: Zest - Hospital booster
Cash payout for every day you spend in hospital after an accident
Example: Kaelo - Product discounts
20% off certain items at Dischem, for an extra monthly payment
Example: Dischem Gap, Kaelo - Home birth shortfalls
12m waiting period
Example: Zest - Day to day maternity benefits
Extra cover for consults, scans, and high risk pregnancies
Example: Netcare Plus - Day to day costs
Very rare benefit for shortfalls on day-to-day specialists
Example: Netcare Plus, Stratum - Breast reconstruction costs
Medical aid often does not pay for the non-cancerous breast reconstruction as it’s seen as cosmetic procedure
Example: Stratum, Turnberry, Total Risk
