Medical Gap Cover
Rely on Auto&General Medical Gap Cover for:
In-hospital specialist shortfalls
Prescribed minimum benefits
Treatment for accidents in a casualty unit
In network hospital co-payments
Out of network hospital co-payments
Sub-limit benefit: Internal Prostheses
Sub-limit benefit: MRI/CT/PET Scans
Dental treatment shortfalls
Oncology
Global fees
In-hospital specialist shortfalls
Prescribed minimum benefits
Treatment for accidents in a casualty unit
In network hospital co-payments
Out of network hospital co-payments
Sub-limit benefit: Internal Prostheses
Sub-limit benefit: MRI/CT/PET Scans
Dental treatment shortfalls
Oncology
Global fees
Gap Cover
Gap Cover
Cover
(Per policy per month)
(Per policy per month)
(Per policy per month)
(Per policy per month)
300%
of the medical scheme tariff.
Covered, subject to medical aid review
Up to R8 610 per policy per annum
No benefit
No benefit
No benefit
No benefit
No benefit
Unlimited but subject to the aggregate annual limit per insured person per
annum
No benefit
500%
of the medical scheme tariff.
Covered, subject to medical aid review
Up to R17 325 per policy per annum
Up to R60 000 per policy per annum
1 co-payment per policy per annum. Up to R4000
1 MRI/CT/PET scan per policy per annum up to R12 600
Up to R21 600 per policy per annum
No benefit
Unlimited but subject to the aggregate annual limit per insured person per annum
Up to R12 600 per policy per annum
700%
of the medical scheme tariff.
Covered, subject to medical aid review
Up to R23 100 per policy per annum
Unlimited but subject to the aggregate annual limit per insured person per annum
2 co-payments/deductibles per policy per annum to a combined maximum of R16 000
2 scans per policy per annum. Unlimited but subject to the aggregate annual limit per insured person per annum.
Unlimited but subject to the aggregate annual limit per insured person per annum. Up to R42 000
per event
2 MRI/CT/PET scans per policy per annum up to R5 500 per scan
Unlimited but subject to the aggregate annual limit per insured person per annum
Up to R25 200 per policy per annum
Cancer Cover
Unlimited but subject to the aggregate annual limit per insured person per annum
No benefit
No benefit
No benefit
No benefit
No benefit
Unlimited but subject to the aggregate annual limit per insured person per annum
No benefit
1 co-payment per policy per annum. Up to R4 200
No benefit
Up to R8 610 per policy per annum
Lump sum payout of R21 000 based on first diagnosis of cancer (as defined -
check the full policy document for full definition and exclusions).
Unlimited but subject to the aggregate annual limit per insured person per annum
Unlimited but subject to the aggregate annual limit per insured person per
annum. Up to R42 000 per event
2 Co-payments per policy per annum up to a combined limit of R16 000
Unlimited but subject to the aggregate annual limit per insured person per annum
Up to R17 325 per policy per annum
No benefit
Please download the brochure for more detailed information.
Download the full brochure
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click below to complete the
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Essential
Gap Cover
Covers in-hospital specialist bills up to 500% of medical aid tariff
300%
of the medical scheme tariff.
(Per policy per month)
R99
For members younger than 65
R394
For members older than 65
(Per policy per month)
R197
Where all members are younger than 65
R394
Where one or more members are 65+
Benefits
Prescribed minimum benefits (Covered, subject to medical aid review).
Treatment for accidents in a casualty unit up to R8 610 per annum.
Dental Treatment Benefit Unlimited (subject to the aggregate annual limit per insured person per annum.
Oncology Benefits
Oncology Gap Benefit
Unlimited (subject to the aggregate annual limit per insured person per annum).
Comprehensive
Gap Cover
Covers in-hospital specialist bills, co-pays, boosts sub-limits and covers cancer up to 500% of medical aid tariff
500%
of the medical scheme tariff.
(Per policy per month)
R345
For members younger than 65
R572
For members older than 65
(Per policy per month)
R345
Where all members are younger than 65
R572
Where one or more members are 65+
Benefits
Prescribed minimum benefits
(Covered, subject to medical aid review).
Treatment for accidents in a casualty unit up to R17 325 per annum.
In network hospital co-payments up to R60 000 per annum.
Sub-limit benefit: Internal prostheses up to R21 600 per annum.
Dental Treatment benefit Unlimited (subject to the aggregate annual limit per insured person per annum.
Global fee benefit up to R12 600 per annum.
Oncology Benefits
Oncology Gap Benefit Unlimited (subject to the aggregate annual limit per insured person per annum).
Oncology “New tech” benefit Up to R8 610 per policy per annum.
Enhanced Cancer Cover Lump sum payout of R21 000 based on first diagnosis of cancer.
Absolute
Gap Cover
Covers in-hospital specialist bills, co-pays, boosts sub-limits and covers cancer up to 700% of medical aid tariff
700%
of the medical scheme tariff.
(Per policy per month)
R591
For members younger than 65
R821
For members older than 65
(Per policy per month)
R591
Where all members are younger than 65
R821
Where one or more members are 65+
Benefits
Prescribed minimum benefits
(Covered, subject to medical aid review).
Treatment for accidents in a casualty unit up to R23 100 per annum.
In network hospital co-payments Unlimited (subject to the aggregate annual limit per insured person per annum.
Out of network hospital co-payments 2 co-payments/deductibles per policy per annum to a combined maximum of R16 000.
Sub-limit benefit: Internal prostheses Unlimited but subject to the aggregate annual limit per insured person per annum. Up to R42 000 per event.
Sub-limit benefit: MRI/CT/PET Scans 2 MRI/CT/PET scans per policy per annum up to R5 500 per scan.
Dental Treatment benefit Unlimited (subject to the aggregate annual limit per insured person per annum).
Global fee benefit up to R25 200 per annum.
Oncology Benefits
Oncology Gap Benefit Unlimited (subject to the aggregate annual limit per insured person per annum).
In-network oncology co-payment Unlimited (subject to the aggregate annual limit per insured person per annum). Up to R42 000 per event.
Out of network oncology co-payment 2 Co-payments per policy per annum up to a combined limit of R16 800.
Oncology extender benefit Unlimited but subject to the aggregate annual limit per insured person per annum.
Oncology “New tech” benefit Up to R17 325 per policy per annum.
Please download the brochure for more detailed information.
Get your Medical Gap Insurance quote in minutes, click below to complete the online application.