Health insurance as gap cover (and so much more) - the hero you need to help cover surprise medical costs!


Jade Poole from I Write Words


When your medical savings run out or when medical aid falls short - health insurance can be used as gap cover (awesome, right?) and so much more!

It’s no fun when you get whacked in the face with medical bills because you either ran out of medical aid savings or there are certain events your medical aid doesn’t cover.

That’s where health insurance comes in to save the day.

Of course, health insurance is also an insurance product in itself and more than gap cover in being able to offer you access to quality, private healthcare when you need it most, and this includes cover for everyday routine care, emergencies and accidents!

But, what many people don’t know is that health insurance can act as gap cover too!

And here’s how…

What is medical aid gap cover?

The simple explanation…

Medical aid gap cover helps to pay for hospital bills that your medical aid doesn’t fully cover.

Gap cover is not a medical aid but is a form of insurance that makes sure you are covered in an event where your medical aid will not cover all of your medical bills.

Let’s get into the definition of gap cover a bit more…

Gap cover is also seen as medical top-up insurance and it is a form of low-cost and high-value insurance that you pay a small fee for every month in case your medical aid does not cover all the costs of a procedure you have done in a hospital or any form of emergency surgery.

But, do I really need gap cover?

YES! Seriously.

A lot of brokers and medical aid providers will suggest you take out some form of gap cover as this can save you from unexpected medical bills that have to come out of your pocket after you leave the hospital.

There are even some specialists who will refuse to operate on you if you don’t have gap cover in fear of not getting paid in full for the procedure.

By having gap cover, you can get the best possible care from specialists and surgeons and not have to worry about the unnecessary costs.

Let’s look at an example of where gap cover comes in handy…

Here’s an example…

Your doctor just booked you into hospital to have your appendix removed.

Your medical aid will cover your stay at the hospital, the doctor’s fees, the costs of an anaesthetist, supplies and medicine.

BUT - your medical aid will only cover a specific percentage of these costs based on your plan, in this scenario, it will cover 100%.

This means that is the doctor and the anaesthetist charge at a rate that is 400%, then you will have the pay in the 300% shortfall.

That’s where gap cover comes in. It will help to cover these unexpected costs and ensure you are not left with a bill that of thousands of rands or more.

How does health insurance work as gap cover?

This is where it gets interesting…

Health insurance is a form of short term insurance.

This means that it helps cover the costs of medical care (from day to day doctor visits and accidents and emergencies) and give you access to private healthcare.

The best part is that health insurance is more affordable than medical aid!

So, when your medical aid falls short - health insurance can be used for you to fall back on!

Our most basic core plan from only R365 a month covers you for the following hospital and emergency events:

Casualty Illness

Up to R4900 for life-threatening emergency illness in casualty units.

Accident Cover

Up to R140 000 per insured event. Up to R280 000 per family per event.

Accident Disability

Up to R180 000 for the duration of the policy.


All of our plans also include ambulance and emergency services with a 24hr medical assistance with an emergency call centre.

Why is health insurance better than gap cover?

Gap cover will only help to cover the costs of hospital stays and procedures in hospital.

But, health insurance is so much more than that and it is still affordable!

From doctor visits, maternity care, dental care and even specialist cover (on our Executive Plan)...

Health insurance is gap cover, levelled up.

So, do the right thing and don’t be left in debt because of medical costs.

Yours in health,


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