Zestlife offers affordable gap cover products that pay for the portion of a claim that is not covered by your medical aid scheme. This registered financial services provider was established in 2008, and has an experienced management team at its helm.
Medical gap cover policies are underwritten by Guardrisk Insurance Company and, as a member of the Direct Marketing association of South Africa Zestlife markets and distributes its products countrywide.
Zestlife has designed its policies in such way that they not only offer financial cover for authorised claims in and out of hospital; they protect you and your family from the monetary consequences of accidental death, disability, illness and injury.
With Zestlife, you’ll be protected through the following benefits:
- cover of up to 500 percent of the Medical Scheme Tariff (MST) for doctor and specialist treatments in hospital
- outpatient cover for MRI, CT, PET scans, kidney dialysis, colonoscopy, cataract removal, vasectomy, childbirth in a non-hospital setting, and dozens of other procedures, up to 500 percent of the MST and with no overall annual limit, and
- co-payment cover for designated service provider (DSP) and non-DSP hospital admissions, scans, and specified surgical procedures.
Opt for the top-tier gap cover policies, and the bouquet of benefits extend to:
- internal prosthesis
- accidental dentistry
- accidental death and disability
- medical premium waivers.
Zestlife medical gap cover policies
Zestlife has built its gap cover products for the wider South African public.
Low-income earners benefit from cover for basic funding shortfalls in the entry-level Core product, while the top-tier Universal medical gap cover product has a comprehensive array of benefits proportionate to the monthly premium. In addition, there’s optional extended cover for cancer and dentistry.
Core is Zestlife’s low cost, entry-level gap cover product. It offers basic cover for:
- GP and specialist consultations in-hospital, up to 500 percent of the MST
- more than 35 defined procedures conducted out of hospital, at up to 500 percent of the MST, and with no annual maximum claim limits
- unlimited co-payments at DSP hospitals and limited co-payments of one claim per year, up to R8000 at non-DSPs.
Prescribed Minimum Benefits (PMBs) are not covered under the Core option. PMBs include approximately 300 hospital procedures, including emergency procedures, that a medical scheme is obliged to cover in full unless you do not use the network specialists appointed by the medical scheme.
The Standard gap cover policy combines basic gap cover for procedures conducted in and out of hospital, with co-payment benefits in both DSP and non-DSP hospitals. It offers:
- a lump sum of R25 000 for a first time cancer diagnosis
- co-payment benefits for cancer treatment, limited to a co-payment of 20% once a scheme threshold has been reached
- cosmetic breast reconstruction cover of R20 000
- joint prosthesis benefit of up to R30 000 per policy per year.
Zestlife’s comprehensive gap cover product, Universal, offers the same in and out of hospital gap cover and benefits as the Standard option, plus the following:
- accidental tooth fracture cover of R14 000 per individual per annum
- benefit for treatment in a hospital casualty facility up to a maximum of R5000
- accidental death or disability benefit of R25 000 for beneficiaries under 65 years
- emergency transport maximum of R25000
- life support equipment maximum of R25000
- trauma counselling up to R750 per visit with an annual limit of R25000
- an automatic gap cover and medical premium waiver benefit, up to R5600 per month, for three months, for members under the age of 65 years.
Optional extended cover
In addition to its standalone gap cover product portfolio, Zestlife has designed optional extender policies that provide enhanced cover for cancer and dentistry.
These policies are compatible with all Zestlife gap cover products. They provide the following lump sum benefits:
- extended cancer cover of either R75 000 or R175 000 for the first time diagnosis of cancer and/or
- extended dentistry cover for emergency, accidental and specialised dentistry for the entire family.
Why choose Zestlife as your gap cover provider?
Advantages of Zestlife gap cover:
- all options cover the gap in and out of hospital, up to 500 percent of the MST
- you can reduce your monthly premiums by applying an optional claims excess of R1500 to your policy
- no general waiting periods apply
- policies are backed by a subsidiary of the Momentum Metropolitan Insurance (MMI) company
- benefits are paid within 15 working days.
- optional extender policies enhance gap benefits for cancer and dentistry
- Zestlife gap cover products can be used in conjunction with any medical aid scheme in South Africa.
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