AskAdam Gap Cover 2020

Gap cover is an essential addition to your health cover. It helps you pay unexpected in-hospital medical bills not covered by your medical aid.
rehealth and Argentum Services have designed a gap cover that has optimal benefits at the ideal price:
R320/month per family

In-hospital shortfall, 500%

A six hour cardio surgery can cost you upwards of R50,000 out of pocket! Most medical aids pay up to 100% scheme rate but many doctors charge 300% scheme rate and more. Gap pays the difference between what your doctor charges, and what the medical aid will pay.

Co-payments paid

Almost every medical aid has some sort of co-payment for certain in-hospital procedures (eg: Discovery charges co-payments for dental procedures on all plans). Gap will pay those co-payments. NEW! Includes R10,000 benefit for non-network use of hospitals

Sublimits increased

Gap cover increases most in-hospital sublimits imposed by your medical aid. A common sublimit, for example, is for MRI scans. Gap will cover the differnce between sublimit and actual cost. Even better: gap will also increase the limit for out-of-hospital MRI and CT scans too!

R20,000 ER benefit per person

Gap cover gives you peace of mind for all accident and emergency ER visits that your medical aid will not pay for. You won't have to think twice about going to the ER again!

Dread Disease diagnosis payout

With our Blue plan, you get R50,000 payout on first diagnosis of cancer. This can be used for anything, and does not form part of the R165,000 annual limit. Gap cover will also pay your medical aid premium for 6 months in case of death of principal member.

Cancer treatment benefit

Gap cover will pay any co-payments or increase your sublimit for all cancer treatment, once your medical aid has paid the first R200,000. This is a crucial benefit, as almost every medical plan has a sublimit or co-payment for cancer tr

Blue Plan 2020

R 320 /m/family
R445 for 65yrs+.
A fully comprehensive gap cover for maximum protection from unexpected medical bills.
  • Shortfall Benefit, up to 500%
  • Co-payments
  • Sublimits
  • Cancer treatment topup
  • ER benefit
  • Dread Disease (R50,000)
  • Premium Waiver benefit

Red Plan 2020

R 120 /m/family
R170 for 65yrs+.
Limited gap cover Ideal, for plans that require use of network specialists
  • Shortfall Benefit
  • Co-payments
  • Sublimits
  • Cancer treatment topup
  • ER benefit
  • Dread Disease benefit
  • Premium Waiver

HOT TIP! If you have a good gap cover, you can choose a much cheaper medical aid plan with lots of sublimits and co-payments , as these no longer worry you! You can save R1,000s, and still be fully protected!

AskAdam

Your genius medical cover expert
  • Limit of R165,000 /person/year (excluding dread disease and premium waiver)
  • You pay one premium per family (adult, spouse and children)
  • Spouse and/or children can be on different medical aid
  • 50% surcharge if anyone is older than 65yrs (Blue=R445 and Red=R170pm)
  • 3 month general waiting period and 12 month pre-existing condition waiting period, unless moving from another gap
  • Cancer treatment benefit requires R200,000 to have been paid by you or medical aid before benefit kicks in
Underwritten by Constantia Insurance Company Limited (CICL), Reg. No. 1952/001514/06, FSP No: 31111 (The Insurer)