How to Choose a Gap Cover Provider

gap cover choice

Gap cover has become an important protection for South Africans. It's designed to cover the funding shortfall between what medical aids pay and what specialists actually charge.

In South Africa, several registered short term insurers offer gap cover policies aimed at different income groups. Monthly premiums and benefits don't differ that markedly from one provider to another. So the big question is, how do I choose a gap cover provider?

FSB compliant

First and foremost, it’s essential to sign up with a legitimate short-term insurance company registered with the Financial Services Board (FSB). Information about the provider's FSB registration should be readily available on the company website, or on request.

If the company is not FSB compliant, walk away and don’t look back. Unfortunately, there are rogue companies out there, conducting illegitimate and unregulated business deals.

Credit ratings

Credit ratings are independent indicators that point to an insurance company’s ability to pay claims quickly and in full. A high credit rating suggests that a company has plenty of cash at hand to meet its obligations.

Zestlife gap cover policies, for example, are underwritten by Guardrisk, a company that happens to be the highest-rated insurer in South Africa. It currently enjoys ratings of AA+ and Aaa from Fitch and Moody’s, respectively.

Another safe bet is Sirago. This gap cover provider is the underwriting agency for Genric Insurance, an FSB-accredited short term insurer that boasts an A- global credit rating.

Independent consumer reviews: the good, the bad, the ugly

To ensure you're signing up with a gap cover provider that pays out the benefits it says it will, it’s a good idea to read independent consumer reviews.

Websites such as hellopeter.com are popular platforms that focus on customer service complaints and commendations. Using this type of site, you can quickly ascertain whether the service you're about to pay for is up to scratch. This information is free and easy to access.

Once you’ve narrowed the choices to one or two gap cover providers, you can get down to the nitty gritty of selecting the right policy for your individual needs.

Medical aid scheme rate

If the medical aid plan you're subscribed to pays out only major medical benefits at 100 percent of the scheme rate, it's ideal to invest in top-tier gap cover. This is because medical specialists can charge up to five times more, leaving you with a significant funding gap.

Opt for any of the gap cover policies by Stratum Benefits or Zestlife, and you’ll automatically enjoy an extra 500 percent of cover to bridge the gap.

Family history

Family history is a good indicator of potential healthcare risks. For example, if people in your family have suffered from heart disease, diabetes, certain types of cancer or other inheritable conditions, there’s a greater possibility that you or your children may be affected too.

The leading providers of gap cover, such as Stratum Benefits, Zestlife and Sirago, offer extra benefits that increase in scale according to the monthly premium. Examples are oncology benefits, cover for specialist out-patient procedures and cover for CT and MRI scans.

Ask the professionals

If you're looking for a reliable way to choose a gap cover provider, consult the professionals.

Our independent medical brokers have all the facts and figures available at their fingertips. They’ll be able to assess your healthcare funding requirements, and recommend a gap cover provider that has the financial muscle and policy selection to suit your needs.