What is gap cover 

Gap cover is a form of short-term insurance that covers potential shortfalls between the cost of medical procedures in hospital and the percentage that your medical aid pays towards these costs. For example, some medical practitioners charge up to 400% of medical aid rates. If your medical aid only covers 100% of medical aid rates, then a shortfall of 300% will be payable by you. Gap cover will cover this outstanding amount. 

Over the years gap cover products have been enhanced to include many excellent benefits, such as co-pay cover, cancer benefit, emergency room cover, to name a few. It has become an indispensable tool to supplement where your medical has fallen short.

For a small monthly premium, you can enjoy benefits with an annual benefit to R185,000 (Discovery Gap) or R191,000 (Sirago Gap) per beneficiary for your family.

What do we do?

Gap cover for individuals, companies, young couples, elderly people and family.

• Detailed explanation on how the different options cover
• Completion of application for members
• Processing the applications on behalf of prospective members
• Adding new members to the policy
• Removing members from the policy
• Providing advice with regards to any changes to cover
• Advise on most suitable option according to budget
• Updating members on changes to gap cover year on year
• We assist companies of all sizes to implement gap cover for the benefit of their employees. Which includes the above mentioned, annual premiums and plan changes update; and handling of company payment queries.

Our product providers

We are brokers for the following reputable gap cover providers:

• ​Sirago
• Discovery
• Stratum

Our preferred provider

We select Sirago as our preferred provider for the following reasons:

1. Reputable gap cover product provider;
2. Underwritten by Genric Insurance Company;
3. A comprehensive range of gap cover products to meet client needs;
4. Rich benefits per Rand premium;
5. Customer centric;
6. Readily work with brokers to resolve client queries;
7. Efficient administration and claim payment;
8. Clear policy wording;
9. Value-added benefits such as premium waiver;
​10. Continuous product enhancements.

More on Sirago Gap Cover

How to claim

​To claim from gap cover, you’ll need the hospital bill, claim form (Sirago) plus your medical aid’s statement of the shortfall with explanatory codes. If your medical aid is with Discovery, and gap is also with the same company then the claim process will be automatic and seamless. The gap cover payout will be paid to you, and you will need to make payment to the hospital or medical practitioner.