Why do you need Gap Cover?

How can you plan for the unplanned using a Gap Cover Product?


Why do you need gap cover? Here is a quick overview.

Before reading further you might also be interested in find out out more about what Gap Cover is and how Gap Cover works.  


Everything is regulated, from the Simba chips you eat to the fuel you fill in your car.  

Doctors, however, are not regulated and as such will often charge above your medical aid rate of cover.

Your medical aid will only provide cover according to the scheme rate, apart from that, procedure and admission co-payments, as well as sub-limits, are becoming more and more prevalent within medical aids today.

Gap cover is not a luxury but a necessity if you are on a registered South African medical aid and will safeguard you from such shortfalls and co-payments.

Most clients who join Stratum Benefits all come to the same conclusion: “you never really know the value of Gap cover until you are sitting with medical bills that come to more than your monthly salary”

 It is only when you experience shortfalls, co-payments and sub-limits that you realise that Gap cover is a much-needed safeguard, so it is advisable to take the pro-active approach rather than the reactive approach and apply for Gap cover as waiting periods will apply from your first day of cover. 


Why do you need additional medical cover?


Medical aids will only provide cover at 100% of scheme rate (Sometimes 200% or 300% for the higher tier plans)

In medical terms, 100% does not mean everything will be covered (It would be great if this was so.)  

With there being no laws that govern what doctors charge, Doctors will always tend to charge anything between 200% and 500% extra for procedures.  


To cover these charges, Gap cover was brought about.

Besides Doctors charging above medical aid rates, medical aids will also require you to make upfront co-payments for certain procedures or admissions, which you can claim back from gap cover if you have the benefit in place.


Sub-limits are an entirely different ball game.

Certain medical aids impose annual or rand limits on what will be paid for internal prosthetic devices, MRI and CT scans or Renal Dialysis. If you do not have a gap cover with a sub-limit benefit, once your limit is reached you will be liable for all costs thereafter.



Why should you use Stratum Benefits as your Gap Cover company of choice?


At Stratum Benefits, we believe that the honest and transparent approach is the best approach.

There are far cheaper products in the market, some of which promise the world but deliver only a tiny island of benefits.

Our benefits and limits are carefully crafted according to real and actual information based on the claims we receive. So we ensure that your benefits will provide sufficient cover without exhausting your annual policy limit.

Gap providers tend to put limits on pregnancy procedures like only paying out R8000 for shortfalls relating to pregnancy and childbirth which is not in our case.

We have had clients transfer to Stratum Benefits due to valid claims being rejected by their current gap cover providers as well as premiums increasing between 10% and 40% for certain Gap providers.

We aim to pay out claims fast if we have all the required documentation and relevant amounts reflecting on these documents.

There is no age limit to your dependents, if they are dependants on you or your spouse’s medical aid, they can remain on your gap cover policy.

It is not a question of “why Join Stratum?” but “Why NOT join Stratum?”

Stratum Benefits (Pty) Ltd, an authorised FSP 2111, is underwritten by Constantia Insurance Company Limited, an authorised FSP 31111. Stratum Fuel Rewards is administered by YBH Rewards (Pty) Ltd, Registration Number 2018/579872/07 in association with Shell Downstream South Africa (Pty) Ltd, Registration Number 2007/016255/07. This document is a summary and does not replace any information provided in your policy documentation. In the event of any differences, your policy contract will apply. Terms and conditions apply.