BASE500
Our fondation option covers the most often experienced in- and out-hospital medical expense shortfalls.
BASE500
Our fondation option covers the most often experienced in- and out-hospital medical expense shortfalls.
One Gap Cover policy covers you and your spouse, even if you belong to different medical aid plans, including the dependants
registered on either medical aid plan. When a child dependant moves to their own medical aid plan, they must apply for cover on their own policy.
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PREMIUMS FOR INDIVIDUALS AND FAMILIES
LIMITED PAYOUT BENEFIT
If you claim from our GAP BENEFIT in the first 10 months of cover for any of the medical procedures or scans listed below and the medical event isn’t related to a pre-existing medical condition, we’ll pay 20% of the approved claim amount, subject to the benefit’s rand amount limits, where applicable:
- adenoidectomy;
- cardiovascular procedures;
- cataract removal;
- dentistry;
- hernia repair;
- hysterectomy (full cover if due to cancer diagnosed after the General Waiting Period);
- joint replacements;
- MRI, CT and PET scans;
- myringotomy/grommets;
- nasal and sinus surgery;
- pregnancy and childbirth;
- scopes (including medical events where a scope is used);
- spinal procedures; or
- tonsillectomy.
GOOD TO KNOW
• If your medical event is related to a medical condition for which you received advice or treatment 12 months before your cover start date, the claim will be subject to a Pre-Existing Medical Condition Waiting Period.
WAITING PERIODS
Waiting periods apply from your and your dependants’ cover start dates, but never to accidents that occur after your cover start dates.
3 MONTH GENERAL WAITING PERIOD
There’s no cover during this period except for accidents that occur after your and your dependants’ cover start dates.
Unless we confirm otherwise, the following benefits are subject to this waiting period:
- GAP BENEFIT
- FIRST-TIME CANCER DIAGNOSIS BENEFIT
12 MONTH PRE-EXISTING CONDITION WAITING PERIOD
There’s no cover during this period for investigations, medical procedures, surgeries or treatments related to any illness or medical condition diagnosed or for which advice or treatment was received 12 months before your or your dependants’ cover start dates.
Unless we confirm otherwise, the following benefits are subject to this waiting period:
- GAP BENEFIT
EXCEPTION TO THE RULE
The following benefits aren’t subject to waiting periods:
- CASUALTY BENEFIT
- TRAUMA COUNSELLING BENEFIT
- ACCIDENTAL DEATH AND DISABILITY BENEFIT
GOOD TO KNOW
Transfer underwriting applies to applicants who switch cover from another Gap Cover provider. Read more about our Gap Cover Transfer Process for Individuals here.
LIMITED PAYOUT BENEFIT
If you claim from our GAP BENEFIT in the first 10 months of cover for any of the medical procedures or scans listed below and the medical event isn’t related to a pre-existing medical condition, we’ll pay 20% of the approved claim amount, subject to the benefit’s rand amount limits, where applicable:
- adenoidectomy;
- cardiovascular procedures;
- cataract removal;
- dentistry;
- hernia repair;
- hysterectomy (full cover if due to cancer diagnosed after the General Waiting Period);
- joint replacements;
- MRI, CT and PET scans;
- myringotomy/grommets;
- nasal and sinus surgery;
- pregnancy and childbirth;
- scopes (including medical events where a scope is used);
- spinal procedures; or
- tonsillectomy.
GOOD TO KNOW
• If your medical event is related to a medical condition for which you received advice or treatment 12 months before your cover start date, the claim will be subject to a Pre-Existing Medical Condition Waiting Period.
WAITING PERIODS
Waiting periods apply from your and your dependants’ cover start dates, but never to accidents that occur after your cover start dates.
3 MONTH GENERAL WAITING PERIOD
There’s no cover during this period except for accidents that occur after your and your dependants’ cover start dates.
Unless we confirm otherwise, the following benefits are subject to this waiting period:
- GAP BENEFIT
- FIRST-TIME CANCER DIAGNOSIS BENEFIT
12 MONTH PRE-EXISTING CONDITION WAITING PERIOD
There’s no cover during this period for investigations, medical procedures, surgeries or treatments related to any illness or medical condition diagnosed or for which advice or treatment was received 12 months before your or your dependants’ cover start dates.
Unless we confirm otherwise, the following benefits are subject to this waiting period:
- GAP BENEFIT
EXCEPTION TO THE RULE
The following benefits aren’t subject to waiting periods:
- CASUALTY BENEFIT
- TRAUMA COUNSELLING BENEFIT
- ACCIDENTAL DEATH AND DISABILITY BENEFIT
GOOD TO KNOW
Transfer underwriting applies to applicants who switch cover from another Gap Cover provider. Read more about our Gap Cover Transfer Process for Individuals here.
