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
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 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.
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 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.
Contact us on on (021) 180 4220/0860 009 378 or email [email protected]
Zestlife is a Standard Bank trusted third-party provider