GAP and Shortfall Cover
Get an online quote using our live chat at the bottom of the page or email us for a full spectrum benefit comparison of top-up health insurance to cover the most expensive shortfalls and co-payments which we all face on medical aid today:
- Tariff differences in-hospital, as most contracted out surgeons and anaesthetists charge 3 – 7 x more than the medical aid rates your medical aid plan pays
- Shortfalls on prostheses and other sub-limits
- Co-pays on MRI and CT scans, gastroscopies and endoscopies
- Cancer limit and co-pay top ups
- Specialised & biological drugs
- Out of DSP hospital network benefit
Prices vary from R113 for basic tariff Gap cover (<65 age) to R525 per family for comprehensive cover over the age of 65. Some feature “cash back” features, which added to the premium rate.
We match your medical aid, needs to the right plan and provide you with a comparison of covers to make an informed decision about what is right for you, and your pocket. Some medical aid co-pays are percentages, which are not covered by many Gap products.
Our team guide you on the standard terms applied to all Gap products (R150,000 per person annual limit, 1 year waiting period on pre-existing conditions if not currently on Gap cover for individuals. We negotiate preferential immediate cover terms and lower premiums for groups.)
Be delighted by expert after-sales service to assist medical aid clients in picking up claims shortfalls, claiming them and ensuring prompt settlement and best care.
SPG (Self Payment Gaps)
There are no insurances for SPG, but there are funding vehicles (savings cards, accounts) and we provide free guidance to medical aid clients on how to keep your SPG as small as possible.
Additional Health Insurances
Click on the link above to view other products available, including
- Network plan top-ups: excluded procedures on KeyCare/BonCap
- Additional day-to-day GP, dental and optical network benefits
- Accidental hospital plans
Our premier custom program for groups, extends cover beyond individual plans, to include pathology, radiology, day-to-day and family care, including rehabilitation and recovery and some elements of SPG.
HOLD ALL can integrate cover of EAP, Wellness, GPA and benefit programs to deliver best care to staff, disabilities and pensioners without duplication and unnecessary forms.