MERIDIAN400
Our middle-of-the-range option covers the most often experienced in-hospital medical expense shortfalls.
MERIDIAN400
Our middle-of-the-range option covers the most often experienced in-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.
Child dependants registered on your or your spouse’s medical aid plan may remain on your Gap Cover policy regardless of age. However, when a child dependant applies for their own medical aid membership, they must apply for their own policy.
A full-time student 26 or younger may remain on your policy even if they belong to a different medical aid plan, provided proof of full-time studies is submitted annually. Distance and online learning don’t qualify.
CLICK THE IMAGE BELOW TO VIEW OR DOWNLOAD OUR COMPREHENSIVE OR CONDENSED MERIDIAN400 BROCHURE.
PREMIUMS FOR INDIVIDUALS AND FAMILIES
IF YOU’RE
35 OR YOUNGER
IF YOU’RE BETWEEN
36 AND 64
IF EVERYONE IN THE FAMILY
IS 64 OR YOUNGER
IF YOU OR ANYONE IN THE
FAMILY IS 65 OR OLDER
LIMITED PAYOUT BENEFIT
If you claim from our GAP BENEFIT, CO-PAYMENT BENEFITS or SUB-LIMIT BENEFIT in the first 10 months of cover for any of the medical events listed below, we’ll cover 20% of the approved claim amount subject to benefit limits where applicable:
- adenoidectomy;
- cardiovascular procedures;
- cataract removal;
- dentistry;
- hernia repairs;
- hysterectomy (full cover applies if required due to cancer when 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
• The 10 Month Limited Payout Benefit applies to medical events unrelated to pre-existing medical conditions. If the medical event is related to a medical condition for which you or your dependants received advice or treatment 12 months before your policy’s start date or their cover start date, the claim will be subject to a Pre-Existing 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
- CO-PAYMENT BENEFITS
- SUB-LIMIT BENEFIT
- CANCER 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
- CO-PAYMENT BENEFITS
- SUB-LIMIT BENEFIT
EXCEPTION TO THE RULE
The following benefits aren’t subject to waiting periods:
- CASUALTY BENEFIT
- TRAUMA COUNSELLING 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
- adenoidectomy;
- cardiovascular procedures;
- cataract removal;
- dentistry;
- hernia repairs;
- hysterectomy (full cover applies if required due to cancer when 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
• The 10 Month Limited Payout Benefit applies to medical events unrelated to pre-existing medical conditions. If the medical event is related to a medical condition for which you or your dependants received advice or treatment 12 months before your policy’s start date or their cover start date, the claim will be subject to a Pre-Existing 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
- CO-PAYMENT BENEFITS
- SUB-LIMIT BENEFIT
- CANCER 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
- CO-PAYMENT BENEFITS
- SUB-LIMIT BENEFIT
EXCEPTION TO THE RULE
The following benefits aren’t subject to waiting periods:
- CASUALTY BENEFIT
- TRAUMA COUNSELLING 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.
