Covers the shortfall between what your medical scheme pays and what specialists or hospitals actually charge — sold via Mzansi Insure, since a medical scheme may not sell gap cover itself.
Pays the gap when a specialist charges more than your medical scheme rate covers.
Available to members of Mzansi Health or any other registered medical scheme.
Optional add-on to cover scheme co-payments on MRI, CT and certain procedures.
| Cover feature | Detail |
|---|---|
| Annual cover limit | Up to R200,000 per family |
| Co-payment cover | Optional add-on |
| Waiting period | 3 months general, 12 months for pre-existing conditions |
| Works with | Any registered South African medical scheme |
| Claims payment | Paid directly to you or your service provider |
No — Gap Cover from Mzansi Insure is available to members of any registered South African medical scheme.
Medical schemes are restricted by law from selling gap cover directly, which is why it's offered as a separate short-term insurance product through Mzansi Insure.
Gap Cover doesn't cover scheme exclusions entirely — it covers the difference between the scheme rate and the actual charge for procedures your scheme already covers.
An adviser at Mzansi Advisors can review your medical scheme option and recommend the right level of Gap Cover — at no extra cost.
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