South Africa
GapAssist: Gap cover
Self-payment gap on your medical aid keeps increasing? We have a solution for you
Some of the benefits
Co-payment Cover
Cover for co-payments that your medical aid charge for hospital admissions, CT, PET and MRI scans and specified medical procedures.
Enhanced Cancer Cover
Benefit of R30 000 to cover the unexpected costs in the event of first-time diagnosis with stage 2 cancer.
Accidental Dentistry Cover
Suffered an accidental blow to the mouth? We’ll cover you for R 24 000 per individual per year.
Accidental Death and Permanent Disability Cover
A benefit of R50 000 to cover the unexpected costs.
How it works
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 three 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
- Optimal GapAssist – high levels of cover and affordability to match the needs of individuals younger than 35.
What is covered
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 have 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 R840 per session for 6 months thereafter
Accidental death and permanent disability cover
- This benefit of R50 000 is to cover the unexpected costs in the event of accidental death or accidental permanent disability.
Enhanced Cancer Cover
- Receive a benefit of R 30 000 to cover unexpected costs for first-time diagnosis with stage 2 cancer or stage 1 prostate cancer where the Gleason score is 8 or higher (Only on GapAssist Universal option)
Accidental Dentistry Cover
- Suffered an accidental blow to the mouth? We'll cover you for R22 500 per individual per year
Medical scheme and Gap policy premium waiver cover
- To cover the loss incurred in the event of accidental death or accidental disability, you will receive a benefit equal to 12 times your combined GapAssist and Medical Aid premium up to a limit of R116 000.
See our GapAssist brochure for more information and T&Cs.
What it costs
Let us call you back and give you a personalised obligation-free quote
How to claim
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
-
What is covered
-
What it costs
-
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 three 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
- Optimal GapAssist – high levels of cover and affordability to match the needs of individuals younger than 35.
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 have 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 R840 per session for 6 months thereafter
Accidental death and permanent disability cover
- This benefit of R50 000 is to cover the unexpected costs in the event of accidental death or accidental permanent disability.
Enhanced Cancer Cover
- Receive a benefit of R 30 000 to cover unexpected costs for first-time diagnosis with stage 2 cancer or stage 1 prostate cancer where the Gleason score is 8 or higher (Only on GapAssist Universal option)
Accidental Dentistry Cover
- Suffered an accidental blow to the mouth? We'll cover you for R22 500 per individual per year
Medical scheme and Gap policy premium waiver cover
- To cover the loss incurred in the event of accidental death or accidental disability, you will receive a benefit equal to 12 times your combined GapAssist and Medical Aid premium up to a limit of R116 000.
See our GapAssist brochure for more information and T&Cs.
Let us call you back and give you a personalised obligation-free quote
Contact us on on (021) 180 4220/0860 009 378 or email [email protected]
Zestlife is a Standard Bank trusted third-party provider
We also offer
Salary Protection
Apply for the amount of cover you need to pay your bills and cover your expenses if you can't work due to illness or injury.
Personal accident plan
Give your family the financial security of a lump-sum payout in the event of your death or permanent disability due to an accident.