What is gap cover, and do I need it if I already have medical aid cover?

February 13, 2016

Gap cover is a form of short-term insurance that covers potential shortfalls between the cost of medical procedures in hospital and the percentage that your medical aid pays towards these costs. For example, some medical practitioners charge up to 400% of MSR rate. If your medical aid only covers 100% of MSR rate, then a shortfall of 300% will be payable by you. Gap cover will cover this outstanding amount. Although gap cover does not cover out-of-hospital procedures, it does cover certain listed procedures performed on an out-patient basis.

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