Gap Cover: Bonus Benefits (2025)

What's on this page:

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


What does a “PMBs only” restriction mean?
In this case, the scheme will only pay for diagnosis, treatment and management of a claim for one of 270 pre-defined conditions (PMBs). Read more, and see full list of PMB conditions. 

What does “From Risk” mean?
The scheme will pay for this claim from its own funds, not from your savings or other day-to-day benefits. 

What is a DSP?
A Designated Service Provider. The scheme has a network of providers, and will often only pay claims in full if you use a DSP. If you choose another provider, you might have a co-payment, or even no cover.