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Added Benefits
Accidental Death
Lump sum payment in the event of accidental death of one of the insured persons.
• Principal:
  R7 500
• Adult Depn:
  R5 000
• Child Depen:
  R3 000
Gap Premium Waiver
GapX premiums are waived in the event of death or disability of the premium payer.
12 Month premium waiver when premium payer is forcibly retrenched, becomes totally and permanently disabled or passes away.
Medical Aid
Contribution Cover
Pays towards your contributions of your Medical Scheme in the event of death or disability of the premium payer.
6 Months payment toward your Medical Aid contributions up to R3 000 per month upon the death or total and permanent disability of premium payer.
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Day-to-Day Benefits
Primary Care Benefit
Covers short-payment of consultation fees with a GP, dentist or alternative care provider.
Gap Portion of consultation limited to 3 consultations for:
• General  
  Practitioners
  @ R200 per
  consultation
• Dental
  
Consultations
  @ R200 per
  consultation
• Alternative
  Care
  R300 per  
  consultation
Preventative Care
Covers short-payment by your Scheme for preventative care treatments.
Gap Portion for Preventative treatments limited to
R1 000 per
claim, 3 claims per annum.
Specialist Consultations
Covers short-payment of consultation fees with a specialist doctor.
Gap Portion of consultation @ R1 000 per consultation, 3 claims Per annum
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Cancer Benefits
Cancer Initial Diagnosis
Lump sum payment in the event that one of the insured persons are diagnosed with cancer as defined in the policy wording.
R 10 000
Cancer Shortfall Cover
Covers any short-payment, co-payments or related expenses incurred during treatment of cancer as part of the Scheme oncology treatment plan.
R164 000
per annum for any
Gap or Co-Payment paid from the oncology benefit as part of your oncology treatment plan.
R60 000
Sub-Limit on oncology
Co-Payments.
Cancer Top-Up
Provides additional benefit where your Scheme has imposed a Rand amount limit on your cancer benefit and this limit has been reached.
R50 000 per annum where Rand limit on Medical Aid has been reached.
Reconstructive Benefit
Covers the the short-payment by your Scheme for reconstruction of the effected breast as well as an additional amount for the reconstruction of the non-effected breast.
200% Gap Cover for reconstructive surgery on effected breast and up to R15 000 for reconstruction of unaffected breast.
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Gap Cover
Covers the the short-payment by your Scheme for In-Hospital treatment.
Additional 500%
Co-Payment
Covers the excess amount imposed by your Scheme for undergoing a specific procedure.
Up to R10 000 per admission
Admission Fee
Covers the amount imposed by your Scheme if you are admitted as an in-patient.
Up to R3 000 per admission
Penalty Fee
Covers the penalty fee imposed by your Scheme when you are admitted to a hospital not part of the approved network.
R3 000 per admission,
R6 000 per annum
Appliance Benefit
Provides cover for any short-payment by your Scheme for a list of medical appliances.
R3 000 per annum for selected appliances
ER Benefit
Covers an unexpected event that requires immediate medical attention in an Emergency Room.
R3 000 per annum
Hospital Account
Covers amounts charged by the hospital and not paid by your Scheme.
R1 000 per claim, 3 claims per annum
Day Hospitals
Provides cover for the short-payment by your Scheme for procedures done in a day-hospital that would normally be done in a hospital.
Subject to Overall Annual Limit
Sub-Limit Enhancer
Covers internal prosthesis, MRI and CT scans where you have reached your benefit limit as set by the Scheme.
No Benefit
In-Hospital Benefits
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COMPREHENSIVE
BENEFITS
APPLY
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Added Benefits
Lump sum payment in the event of accidental death of one of the insured persons.
Accidental Death
• Principal: R7 500
• Adult Dependent: R5 000
• Child Dependent: R3 000
GapX premiums are waived in the event of death or disability of the premium payer.
Gap Premium Waiver
12 Month premium waiver when premium payer is forcibly retrenched, becomes totally and permanently disabled or passes away.
Pays towards your contributions of your Medical Scheme in the event of death or disability of the premium payer.
Medical Aid
Contribution Cover
6 Months payment toward your Medical Aid contributions up to R3 000 per month upon the death or total and permanent disability of premium payer.
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Day-to-Day Benefits
Covers short-payment of consultation fees with a GP, dentist or alternative care provider.
Primary Care Benefit
Gap Portion of consultation limited to 3 consultations for:
• General Practitioners @ R200
   per consultation
• Dental Consultations @ R200
   per consultation
• Alternative Care @ R300
  per consultation
Covers short-payment by your Scheme for preventative care treatments.
Preventative Care
Gap Portion for Preventative treatments limited to R1 000 per claim, 3 claims per annum.
Covers short-payment of consultation fees with a specialist doctor.
Specialist Consultations
Gap Portion of consultation @
R1 000 per consultation, 3 claims Per annum
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Cancer Benefits
Lump sum payment in the event that one of the insured persons are diagnosed with cancer as defined in the policy wording.
Cancer Initial Diagnosis
R 10 000
Covers any short-payment, co-payments or related expenses incurred during treatment of cancer as part of the Scheme oncology treatment plan.
Cancer Shortfall Cover
R164 000 per annum for any Gap or Co-Payment paid from the oncology benefit as part of your oncology treatment plan.
R60 000 Sub-Limit on oncology Co-Payments.
Provides additional benefit where your Scheme has imposed a Rand amount limit on your cancer benefit and this limit has been reached.
Cancer Top-Up
R50 000 per annum where Rand limit on Medical Aid has been reached.
Covers the the short-payment by your Scheme for reconstruction of the effected breast as well as an additional amount for the reconstruction of the non-effected breast.
Reconstructive Benefit
200% Gap Cover for reconstructive surgery on effected breast and up to R15 000 for reconstruction of unaffected breast.
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Covers the the short-payment by your Scheme for In-Hospital treatment.
Gap Cover
Additional 500%
Covers the excess amount imposed by your Scheme for undergoing a specific procedure.
Co-Payment
Up to R10 000 per admission
Covers the amount imposed by your Scheme if you are admitted as an in-patient.
Admission Fee
Up to R3 000 per admission
Covers the penalty fee imposed by your Scheme when you are admitted to a hospital not part of the approved network.
Penalty Fee
R3 000 per admission, R6 000 per annum
Provides cover for any short-payment by your Scheme for a list of medical appliances.
Appliance Benefit
R3 000 per annum for selected appliances
Covers an unexpected event that requires immediate medical attention in an Emergency Room.
ER Benefit
R3 000 per annum
Covers amounts charged by the hospital and not paid by your Scheme.
Hospital Account
R1 000 per claim, 3 claims per annum
Provides cover for the short-payment by your Scheme for procedures done in a day-hospital that would normally be done in a hospital.
Day Hospitals
Subject to Overall Annual Limit
Covers internal prosthesis, MRI and CT scans where you have reached your benefit limit as set by the Scheme.
Sub-Limit Enhancer
No Benefit
In-Hospital Benefits
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COMPREHENSIVE BENEFITS
APPLY
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Added Benefits
Lump sum payment in the event of accidental death of one of the insured persons.
Accidental Death
• Principal: R7 500
• Adult Dependent: R5 000
• Child Dependent: R3 000
GapX premiums are waived in the event of death or disability of the premium payer.
Gap Premium Waiver
12 Month premium waiver when premium payer is forcibly retrenched, becomes totally and permanently disabled or passes away.
Pays towards your contributions of your Medical Scheme in the event of death or disability of the premium payer.
Medical Aid
Contribution Cover
6 Months payment toward your Medical Aid contributions up to R3 000 per month upon the death or total and permanent disability of premium payer.
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Day-to-Day Benefits
Covers short-payment of consultation fees with a GP, dentist or alternative care provider.
Primary Care Benefit
Gap Portion of consultation limited to 3 consultations for:
• General Practitioners @ R200
   per consultation
• Dental Consultations @ R200
   per consultation
• Alternative Care @ R300
  per consultation
Covers short-payment by your Scheme for preventative care treatments.
Preventative Care
Gap Portion for Preventative treatments limited to R1 000 per claim, 3 claims per annum.
Covers short-payment of consultation fees with a specialist doctor.
Specialist Consultations
Gap Portion of consultation @
R1 000 per consultation, 3 claims Per annum
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Cancer Benefits
Lump sum payment in the event that one of the insured persons are diagnosed with cancer as defined in the policy wording.
Cancer Initial Diagnosis
R 10 000
Covers any short-payment, co-payments or related expenses incurred during treatment of cancer as part of the Scheme oncology treatment plan.
Cancer Shortfall Cover
R164 000 per annum for any Gap or Co-Payment paid from the oncology benefit as part of your oncology treatment plan.
R60 000 Sub-Limit on oncology Co-Payments.
Provides additional benefit where your Scheme has imposed a Rand amount limit on your cancer benefit and this limit has been reached.
Cancer Top-Up
R50 000 per annum where Rand limit on Medical Aid has been reached.
Covers the the short-payment by your Scheme for reconstruction of the effected breast as well as an additional amount for the reconstruction of the non-effected breast.
Reconstructive Benefit
200% Gap Cover for reconstructive surgery on effected breast and up to R15 000 for reconstruction of unaffected breast.
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Covers the the short-payment by your Scheme for In-Hospital treatment.
Gap Cover
Additional 500%
Covers the excess amount imposed by your Scheme for undergoing a specific procedure.
Co-Payment
Up to R10 000 per admission
Covers the amount imposed by your Scheme if you are admitted as an in-patient.
Admission Fee
Up to R3 000 per admission
Covers the penalty fee imposed by your Scheme when you are admitted to a hospital not part of the approved network.
Penalty Fee
R3 000 per admission, R6 000 per annum
Provides cover for any short-payment by your Scheme for a list of medical appliances.
Appliance Benefit
R3 000 per annum for selected appliances
Covers an unexpected event that requires immediate medical attention in an Emergency Room.
ER Benefit
R3 000 per annum
Covers amounts charged by the hospital and not paid by your Scheme.
Hospital Account
R1 000 per claim, 3 claims per annum
Provides cover for the short-payment by your Scheme for procedures done in a day-hospital that would normally be done in a hospital.
Day Hospitals
Subject to Overall Annual Limit
Covers internal prosthesis, MRI and CT scans where you have reached your benefit limit as set by the Scheme.
Sub-Limit Enhancer
No Benefit
In-Hospital Benefits
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COMPREHENSIVE BENEFITS
Guide
APPLY
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Added Benefits
Accidental Death
Lump sum payment in the event of accidental death of one of the insured persons.
• Principal: R7 500
• Adult Dependent: R5 000
• Child Dependent: R3 000
Gap Premium Waiver
GapX premiums are waived in the event of death or disability of the premium payer.
12 Month premium waiver when premium payer is forcibly retrenched, becomes totally and permanently disabled or passes away.
Medical Aid
Contribution Cover
Pays towards your contributions of your Medical Scheme in the event of death or disability of the premium payer.
6 Months payment toward your Medical Aid contributions up to R3 000 per month upon the death or total and permanent disability of premium payer.
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Day-to-Day Benefits
Primary Care Benefit
Covers short-payment of consultation fees with a GP, dentist or alternative care provider.
Gap Portion of consultation limited to 3 consultations for:
• General Practitioners @
   R200 per consultation
• Dental Consultations @
   R200 per consultation
• Alternative Care @ R300
  per consultation
Preventative Care
Covers short-payment by your Scheme for preventative care treatments.
Gap Portion for Preventative treatments limited to R1 000 per claim, 3 claims per annum.
Specialist Consultations
Covers short-payment of consultation fees with a specialist doctor.
Gap Portion of consultation @ R1 000 per consultation, 3 claims Per annum
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Cancer Benefits
Cancer Initial Diagnosis
Lump sum payment in the event that one of the insured persons are diagnosed with cancer as defined in the policy wording.
R 10 000
Cancer Shortfall Cover
Covers any short-payment, co-payments or related expenses incurred during treatment of cancer as part of the Scheme oncology treatment plan.
R164 000 per annum for any Gap or Co-Payment paid from the oncology benefit as part of your oncology treatment plan.
R60 000 Sub-Limit on oncology Co-Payments.
Cancer Top-Up
Provides additional benefit where your Scheme has imposed a Rand amount limit on your cancer benefit and this limit has been reached.
R50 000 per annum where Rand limit on Medical Aid has been reached.
Reconstructive Benefit
Covers the the short-payment by your Scheme for reconstruction of the effected breast as well as an additional amount for the reconstruction of the non-effected breast.
200% Gap Cover for reconstructive surgery on effected breast and up to R15 000 for reconstruction of unaffected breast.
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Gap Cover
Covers the the short-payment by your Scheme for In-Hospital treatment.
Additional 500%
Co-Payment
Covers the excess amount imposed by your Scheme for undergoing a specific procedure.
Up to R10 000 per admission
Admission Fee
Covers the amount imposed by your Scheme if you are admitted as an in-patient.
Up to R3 000 per admission
Penalty Fee
Covers the penalty fee imposed by your Scheme when you are admitted to a hospital not part of the approved network.
R3 000 per admission, R6 000 per annum
Appliance Benefit
Provides cover for any short-payment by your Scheme for a list of medical appliances.
R3 000 per annum for selected appliances
ER Benefit
Covers an unexpected event that requires immediate medical attention in an Emergency Room.
R3 000 per annum
Hospital Account
Covers amounts charged by the hospital and not paid by your Scheme.
R1 000 per claim, 3 claims per annum
Day Hospitals
Provides cover for the short-payment by your Scheme for procedures done in a day-hospital that would normally be done in a hospital.
Subject to Overall Annual Limit
Sub-Limit Enhancer
Covers internal prosthesis, MRI and CT scans where you have reached your benefit limit as set by the Scheme.
No Benefit
In-Hospital Benefits
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COMPREHENSIVE BENEFITS
APPLY