GAP COVER & OPTIMISER PRODUCT RANGES
Gap Cover Options for Individuals and Families
ENTRY
COVER
From R 275 p/m for individuals
BASE500
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Effective 1 January 2024, this option won’t form part of our active product range
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Our foundation option covers the most often experienced in– and out-of-hospital medical expense shortfalls.
Benefit Overview
• 500% GAP BENEFIT
• DENTAL COVER
-GAP BENEFIT
• MATERNITY COVER
-GAP BENEFIT
• RADIOLOGY COVER
-GAP BENEFIT
• CASUALTY BENEFIT
• TRAUMA COUNSELLING BENEFIT
• PAYOUT BENEFITS FOR:
– ACCIDENTAL DEATH AND DISABILITY
– FIRST-TIME CANCER DIAGNOSIS
• LIFESTYLE BENEFIT
ENTRY
COVER
From R 301 p/m for individuals
COMPACT300
Our well-rounded option is packed with benefits that cover the most often experienced in- and out-of-hospital medical expense shortfalls.
BENEFIT OVERVIEW
• 300% GAP COVER
• CO-PAYMENT BENEFIT FOR:
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
• DENTAL COVER
-GAP BENEFIT
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
• MATERNITY COVER
-GAP BENEFIT
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
• RADIOLOGY COVER
-GAP BENEFIT
– ADMISSIONS AND PROCEDURES
– SUB-LIMIT | MRI, CT AND PET SCANS
• SUB-LIMIT BENEFIT FOR:
– INTERNAL PROSTHETIC DEVICES
• CANCER BENEFIT
-CANCER TREATMENT SHORTFALLS
-CANCER TREATMENT TOP-UP
• CASUALTY BENEFIT
• TRAUMA COUNSELLING BENEFIT
• PAYOUT BENEFITS FOR:
– ACCIDENTAL DEATH AND DISABILITY
– FIRST-TIME CANCER DIAGNOSIS
MEDIUM
COVER
From R 228 p/m for individuals
MERIDIAN400
Our middle-of-the-range option covers the most often experienced
in-hospital medical expense shortfalls.
BENEFIT OVERVIEW
• 400% GAP BENEFIT
• CO-PAYMENT BENEFIT FOR:
– ADMISSIONS AND PROCEDURES
– PENALTY CO-PAYMENTS
– SCOPE CO-PAYMENTS
• DENTAL COVER
– SPECIALIST SHORTFALLS
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
• MATERNITY COVER
– CHILDBIRTH SHORTFALLS
– ADMISSIONS AND PROCEDURES
– PENALTY CO-PAYMENTS
• RADIOLOGY COVER
– RADIOLOGY SHORTFALLS
– MRI, CT AND PET SCAN CO-PAYMENTS
– MRI, CT AND PET SCANS SUB-LIMITS
• SUB-LIMIT BENEFIT FOR:
– INTERNAL PROSTHETIC DEVICES
• CANCER BENEFIT
-CANCER TREATMENT SHORTFALLS
• CASUALTY BENEFIT
– ACCIDENTAL EVENTS
– ILLNESS EVENTS
• TRAUMA COUNSELLING BENEFIT
HIGH
COVER
From R 438 p/m for individuals
ELITE500
Our top-of-the-range option offers the widest range of in- and out-of-hospital benefits at the highest level of cover.
Benefit Overview
• 500% GAP BENEFIT
• CO-PAYMENT BENEFIT FOR:
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
– ROBOTIC SURGERY
• DENTAL COVER
-GAP BENEFIT
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
• MATERNITY COVER
-GAP BENEFIT
– ADMISSIONS AND PROCEDURES
– THE USE OF A NON-NETWORK HOSPITAL
-OUT-PATIENT SPECIALIST CONSULTATION
-PRIVATE ROOM
• RADIOLOGY COVER
-GAP BENEFIT
– ADMISSIONS AND PROCEDURES
– SUB-LIMIT | MRI, CT AND PET SCANS
-TOP-UP | MRI, CT AND PET SCANS
• SUB-LIMIT BENEFIT FOR:
– COLONOSCOPIES, ENTEROSCOPIES AND GASTROSCOPIES
– INTERNAL PROSTHETIC DEVICES
– RENAL DIALYSIS TREATMENTS
• CANCER BENEFIT
-BREAST RECONSTRUCTION
-CANCER TREATMENT SHORTFALLS
-CANCER TREATMENT TOP-UP
• PHYSICAL REHABILITATION TOP-UP
• OUT-PATIENT SPECIALIST CONSULTATION BENEFIT
• CASUALTY BENEFIT
• TRAUMA COUNSELLING BENEFIT
• PREVENTATIVE CARE BENEFIT
• PRIVATE ROOM BENEFIT
• PAYOUT BENEFITS FOR:
– ACCIDENTAL DEATH AND DISABILITY
– FIRST-TIME CANCER DIAGNOSIS
• WAIVER BENEFITS FOR:
– MEDICAL AID CONTRIBUTION
– STRATUM POLICY PREMIUM
• LIFESTYLE BENEFIT
EXTRA
COVER
From R 179 p/m for families
ACCESS OPTIMISER
Our booster option covers specific medical procedures, treatments, scans, and surgeries that some medical aid plans exclude.
Benefit Overview
• ACCESS BENEFIT
– 15 LISTED MEDICAL PROCEDURES/EVENTS NOT COVERED BY YOUR MEDICAL AID
• CASUALTY BENEFIT
• PAYOUT BENEFIT FOR:
– ACCIDENTAL DEATH AND DISABILITY
EXTRA PLUS
COVER
From R 368 p/m for families
ACCESS
CO-PAY PLUS300
Our booster option covers specific medical procedures, treatments, scans, and surgeries that some medical aid plans exclude. It also covers the most often experienced in- and out-of-hospital
medical expense shortfalls for medical procedures that aren’t excluded, and refunds co-payments and deductibles.
Benefit Overview
• ACCESS BENEFIT
– 15 LISTED MEDICAL PROCEDURES/EVENTS NOT COVERED BY YOUR MEDICAL AID
•300% GAP BENEFIT
• CO-PAYMENT BENEFIT FOR:
– ADMISSIONS AND PROCEDURES
• DENTAL COVER
-GAP BENEFIT
• MATERNITY COVER
-GAP BENEFIT
• RADIOLOGY COVER
-GAP BENEFIT
• CASUALTY BENEFIT
• PAYOUT BENEFIT FOR:
– ACCIDENTAL DEATH AND DISABILITY
READY TO TALK, WE’LL CALL YOU BACK
