Understanding Gap Cover: Bridging the Healthcare Expense Gap

In today’s world, medical expenses can quickly pile up, leaving individuals and families with financial burdens that can be overwhelming. That’s where Gap Cover comes into play. Stratum Benefits (Pty) Ltd offers a comprehensive Gap Cover policy designed to fill the financial gaps left by your medical aid plan, providing peace of mind during times of medical need.

Understanding Gap Cover: Bridging the Healthcare Expense Gap

In today’s world, medical expenses can quickly pile up, leaving individuals and families with financial burdens that can be overwhelming. That’s where Gap Cover comes into play. Stratum Benefits (Pty) Ltd offers a comprehensive Gap Cover policy designed to fill the financial gaps left by your medical aid plan, providing peace of mind during times of medical need.

 

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What is Gap Cover?

Gap Cover is a supplementary insurance product that complements your existing medical aid plan. Stratum Benefits‘ Gap Cover policy, authorized under FSP 2111 and underwritten by Guardrisk Insurance Company Limited (FSP 75), is a robust solution that steps in when your medical aid falls short, ensuring you have access to the care you need without worrying about the cost.

gap cover

What is Gap Cover?

Gap Cover is a supplementary insurance product that complements your existing medical aid plan. Stratum Benefits‘ Gap Cover policy, authorized under FSP 2111 and underwritten by Guardrisk Insurance Company Limited (FSP 75), is a robust solution that steps in when your medical aid falls short, ensuring you have access to the care you need without worrying about the cost.

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HEALTH INSURANCE PRODUCT RANGE

DAY-TO-DAY BENEFIT OPTION

Whether you belong to a medical aid and want additional day-to-day cover or whether you need primary health cover, we have the solution!

Benefit Overview
  • CONSULTATION COVER
  • GP CONSULTATIONS AND MEDICAL PROCEDURES
  • OUT-OF-NETWORK GP CONSULTATIONS
  • TELEMEDICINE GP CONSULTATIONS
  • INTERCARE ONLINE GP CONSULTATIONS
  • NURSE CONSULTATIONS
  • SPECIALIST CONSULTATIONS
  • PRE-BIRTH CONSULTATIONS
  • ACUTE MEDICATION
  • CHRONIC MEDICATION
  • BLOOD TESTS AND X-RAYS
  • DENTAL CARE
  • EYE CARE
  • WELLNESS ASSESSMENT
  • PREVENTATIVE CARE
  • ESSENTIAL ASSISTANCE PROGRAMME (EAP)
  • EXTRA HIGH SCHOOL LEARNING SUPPORT

EMERGENCY & ACCIDENT BENEFIT OPTION

We offer a wide range of benefits from private hospitalisation and casualty visits, to specialised radiology scans and 24-hour medical emergency services, and…

Benefit Overview
  • HOSPITAL CARE
  • EMERGENCY COVER
  • ACCIDENT COVER
  • CASUALTY ACCIDENT COVER
  • MRI AND CT SCANS
  • PHYSIO AND OCCUPATIONAL THERAPY
  • 24-HOUR MEDICAL EMERGENCY SERVICES
  • ACCIDENTAL DEATH
  • ESSENTIAL ASSISTANCE PROGRAMME (EAP)
  • EXTRA HIGH SCHOOL LEARNING SUPPORT

Key Features of Stratum Benefits Gap Cover:

 

1. Comprehensive Coverage: Stratum Benefits offers a range of coverage options, including the BASE option, designed to address the most common medical expense shortfalls individuals and families are likely to encounter. This foundation option covers various medical events, from blood tests to surgeries, ensuring you’re protected when you need it most.

2. Tailored Premiums: Premiums for Gap Cover are determined by age at entry, with no maximum entry age. This means you can secure coverage that suits your specific needs and budget.

3. GAP BENEFIT: The Gap Cover policy provides an additional 500% cover on top of what your medical aid offers for in- and out-of-hospital medical events. This includes covering shortfalls related to doctors’ fees, specialist consultations, and healthcare providers’ charges.

4. DENTAL, MATERNITY, and RADIOLOGY COVER: In addition to the Gap Benefit, Stratum Benefits offers specialized coverage for dental procedures, maternity-related expenses, and radiology costs, ensuring that no important aspect of your healthcare is left unattended.

5. CASUALTY BENEFIT: The Gap Cover policy also includes a Casualty Benefit that covers you and your family for medical expenses related to accidents and illness treated at registered medical facilities. This benefit is available immediately upon policy activation and is not subject to waiting periods.

6. TRAUMA COUNSELLING BENEFIT: Stratum Benefits understands the importance of mental health, offering a Trauma Counselling Benefit to assist with the costs of seeing a counsellor in times of traumatic events.

7. BENEFITS NOT SUBJECT TO OVERALL POLICY LIMIT (OPL): Certain benefits, such as Accidental Death and Disability and First-Time Cancer Diagnosis, are not subject to the overall policy limit, ensuring you receive the maximum support when it’s needed most.

8. LIFESTYLE BENEFITS: Stratum Benefits goes the extra mile by offering complimentary value-add products, such as Extra High School Learning Support and International Travel Insurance, to enhance your overall coverage.

Key Features of Stratum Benefits Gap Cover:

1. Comprehensive Coverage: Stratum Benefits offers a range of coverage options, including the BASE option, designed to address the most common medical expense shortfalls individuals and families are likely to encounter. This foundation option covers various medical events, from blood tests to surgeries, ensuring you’re protected when you need it most.

2. Tailored Premiums: Premiums for Gap Cover are determined by age at entry, with no maximum entry age. This means you can secure coverage that suits your specific needs and budget.

3. GAP BENEFIT: The Gap Cover policy provides an additional 500% cover on top of what your medical aid offers for in- and out-of-hospital medical events. This includes covering shortfalls related to doctors’ fees, specialist consultations, and healthcare providers’ charges.

4. DENTAL, MATERNITY, and RADIOLOGY COVER: In addition to the Gap Benefit, Stratum Benefits offers specialized coverage for dental procedures, maternity-related expenses, and radiology costs, ensuring that no important aspect of your healthcare is left unattended.

5. CASUALTY BENEFIT: The Gap Cover policy also includes a Casualty Benefit that covers you and your family for medical expenses related to accidents and illness treated at registered medical facilities. This benefit is available immediately upon policy activation and is not subject to waiting periods.

6. TRAUMA COUNSELLING BENEFIT: Stratum Benefits understands the importance of mental health, offering a Trauma Counselling Benefit to assist with the costs of seeing a counsellor in times of traumatic events.

7. BENEFITS NOT SUBJECT TO OVERALL POLICY LIMIT (OPL): Certain benefits, such as Accidental Death and Disability and First-Time Cancer Diagnosis, are not subject to the overall policy limit, ensuring you receive the maximum support when it’s needed most.

8. LIFESTYLE BENEFITS: Stratum Benefits goes the extra mile by offering complimentary value-add products, such as Extra High School Learning Support and International Travel Insurance, to enhance your overall coverage.

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