GapAssist

Self-payment gap on your medical aid keeps increasing? We have a solution for you
Some of the benefits
Trauma Counselling Cover
*R 750 per session covered
Enhanced Cancer Cover
Accidental Dentistry Cover
Accidental Death and Permanent Disability Cover
Medical aid members face the problem of having to pay for their medical expense’s shortfall (self-payment gap). This arises due to specialists charging more than the amount covered by a medical aid scheme.
We cover you with two medical shortfall options:
- Universal GapAssist - comprehensive cover which includes extensive financial protection against a wide range of health risks
- Essential GapAssist - affordable cover for the most frequent medical expense shortfalls which includes additional financial protection for selected health risks
In-hospital cover for doctor and specialist shortfalls
- Out-of-hospital cover for doctor and specialist shortfalls (for approximately 50 out-of-hospital treatments)
- Medical scheme co-payment cover for hospital admissions, scans and certain surgical procedures
- Emergency room cover for accidental injury
Robotic Medical Procedure cover - In addition, Universal GapAssist includes non-network co-payment cover, enhanced cancer cover, internal prosthesis and artificial joint cover as well as in-hospital dentistry cover
Health insurance benefits include:
Trauma counselling cover
- Did you had a traumatic incident in the last 6 months? This includes being a witness of an act of violence or a traumatic accident. We'll cover your counselling for R750 per session for 6 months thereafter
Accidental death and permanent disability cover
- You'll be covered with a lump sum cover of R 50 000
Enhanced Cancer Cover: Lump Sum Pay-out (Universal GapAssist only)
- You'll be covered with a lump sum cover of R 30 000 for first-time diagnosis with stage 2 cancer or stage 1 prostate cancer where the Gleason score is 8 or higher.
Accidental Dentistry Cover (Universal GapAssist only)
- Suffered an accidental blow to the mouth? We'll cover you for R 20 200 per individual per year
Medical scheme and Gap policy premium waiver cover (Universal GapAssist only)
- In the event of accidental death or accidental disability, we’ll pay out a lump sum equal to 12 times your combined
GapAssist and Medical Aid premium up to a limit of R105 000.
See our GapAssist brochure for more information and T&Cs.
Contact us on on (021) 180 4220/0860 009 378 or email [email protected]
Zestlife is a Standard Bank trusted third-party provider
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How it works
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What is covered
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What it costs
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How to claim
Medical aid members face the problem of having to pay for their medical expense’s shortfall (self-payment gap). This arises due to specialists charging more than the amount covered by a medical aid scheme.
We cover you with two medical shortfall options:
- Universal GapAssist - comprehensive cover which includes extensive financial protection against a wide range of health risks
- Essential GapAssist - affordable cover for the most frequent medical expense shortfalls which includes additional financial protection for selected health risks
In-hospital cover for doctor and specialist shortfalls
- Out-of-hospital cover for doctor and specialist shortfalls (for approximately 50 out-of-hospital treatments)
- Medical scheme co-payment cover for hospital admissions, scans and certain surgical procedures
- Emergency room cover for accidental injury
Robotic Medical Procedure cover - In addition, Universal GapAssist includes non-network co-payment cover, enhanced cancer cover, internal prosthesis and artificial joint cover as well as in-hospital dentistry cover
Health insurance benefits include:
Trauma counselling cover
- Did you had a traumatic incident in the last 6 months? This includes being a witness of an act of violence or a traumatic accident. We'll cover your counselling for R750 per session for 6 months thereafter
Accidental death and permanent disability cover
- You'll be covered with a lump sum cover of R 50 000
Enhanced Cancer Cover: Lump Sum Pay-out (Universal GapAssist only)
- You'll be covered with a lump sum cover of R 30 000 for first-time diagnosis with stage 2 cancer or stage 1 prostate cancer where the Gleason score is 8 or higher.
Accidental Dentistry Cover (Universal GapAssist only)
- Suffered an accidental blow to the mouth? We'll cover you for R 20 200 per individual per year
Medical scheme and Gap policy premium waiver cover (Universal GapAssist only)
- In the event of accidental death or accidental disability, we’ll pay out a lump sum equal to 12 times your combined
GapAssist and Medical Aid premium up to a limit of R105 000.
See our GapAssist brochure for more information and T&Cs.
Contact us on on (021) 180 4220/0860 009 378 or email [email protected]
Zestlife is a Standard Bank trusted third-party provider