Gap Cover Insurance

Aon has contracts with Gap cover providers

Gap Cover has been designed to reduce your risk of out of pocket expenses when you are hospitalised. Typical out of pocket expenses is the shortfall you may experience:

  • Tariff Shortfall - difference between a provider’s fee for in-hospital treatment and your medical scheme benefit;
  • Co-payments or Deductibles – these can range from around R1, 000 up to as much as R11 000 and more depending on your medical scheme plan and in-hospital procedure;
  • Annual Sub-Limits - limitations imposed on certain in-hospital items, e.g. prosthesis used for joint replacements;
  • Oncology Co-payments – 20% of Oncology treatment above a certain threshold;
  • Medical Scheme Contribution Waiver – which continues to pay your medical scheme contributions for the dependants after the death of the principal member, up to a period of 6 months
  • Daily cash benefit for prolonged in hospital care, normally pays after your third day in hospital. However this does not pay retrospective to day 1.

Aon prides itself in guiding, educating and protecting our clients and for this reason we believe you need to be aware of the shortfalls and risks you may be exposed to.

It is important to know the rules of your medical scheme to understand the gaps in cover of your medical scheme option and possible out-of-pocket exposure. It is also important to understand what gap does not cover, such as Prescribed Minimum Benefits, procedures declined by your medical scheme and specific exclusions.

Gap must under no circumstances be considered as a replacement to your medical scheme.

We strongly advise you to speak to one of our knowledgeable consultants.

Gap Cover

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For a comprehensive quotation, Contact Us or Call the Aon Resolution Centre (ARC) on 0860 835 272 should you not be able to get hold of the branches.

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