Introducing you to
Dis-Chem Health Gap Cover
When 100% is not enough?

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Gap Cover from R190 – Adults | R18 – Children
Dis-Chem Health: Gap Plans
Base
Base is our Standard Gap Cover plan that covers tariff shortfalls up to 500%, sub-limits, dental reconstruction as well as Family and Hospital booster benefits. It starts from R190 per month.
Summit
Summit is our Comprehensive Gap Cover plan which has all the benefit amounts as well as cover for oncology tariff shortfalls, sub-limits, co-payments and so much more. From R235 per month.
Base - price table
Principal | Adults | Children | |
---|---|---|---|
< 18 | R18 | ||
18 - 39 | R190 | R65 | R25 (Child up to 25) |
40 - 49 | R220 | R85 | |
50 - 59 | R265 | R110 | |
> 60 | R300 | R155 |
Summit - price table
Principal | Adults | Children | |
---|---|---|---|
< 18 | R25 | ||
18 - 39 | R235 | R95 | R35 (Child up to 25) |
40 - 49 | R275 | R120 | |
50 - 59 | R315 | R150 | |
> 60 | R385 | R215 |

Compare our Gap Cover plans
The below outlines a sub-set of summarised benefits included in our Gap Cover plans. View the Policy Packs
Base | Summit |
---|---|
Tariff Shortfalls up to 500%: Shortfalls on Specialist Account | Tariff Shortfalls up to 500%: Shortfalls on Specialist Account |
Sub-limit: Surgical Procedures or the shortfall of internal prosthesis | Sub-limit: Surgical Procedures or the shortfall of internal prosthesis |
Dental Reconstruction Benefit, limited to R45 700 | Dental Reconstruction Benefit, limited to R49 900 |
Hospital Booster: Daily lump sum benefit in the event of an accident or a premature birth limited to R25 760 | Hospital Booster: Daily lump sum benefit in the event of an accident or a premature birth limited to a maximum of R27 690 |
See Policy Docs for full list | Oncology shortfalls |
Family Booster of R 15 000 for premature birth | |
Accidental Casualty up to R16 500 | |
Co-payments: Upfront payments for certain procedures | |
Innovative Oncology Medicines | |
Child Casualty Illness | |
See Policy Docs for full list |
Gap Benefits
The below outlines a sub-set of summarised benefits included in our Gap Cover plans. To view the full Policy with detailed services and benefits as per your preferred plan, or to view the policy terms and conditions, please download the full policy document or contact us directly for more information.
In-Hospital Benefits
Limited to an additional five times (500%) that of the medical scheme tariff. Examples of in-hospital events:
- Childbirth
- Dentistry (basic)
- Tonsillectomy (Tonsil removal)
- Broken bones
- Gynaecological procedures
- Scopes: gastroscopies & colonoscopies
- Orthopaedic surgery
- Cardiac surgery
Sub-Limits *Summit Plan only:
Medical Schemes often put limits on certain procedures. This means, they will only pay up to a defined rand value, however, your treatment may cost more. We will cover you up to a limited amount per year.
Examples of such procedures:
- Internal Prosthetics
- Pacemakers
- Implants
- Joint replacements
Co-payments on Listed Treatments: These are defined amounts that you need to pay upfront (as per your Medical Scheme) to the hospital, which you can claim back from Gap cover. This pertains to:
- Scopes
- Wisdom tooth extractions
- Back and neck treatment
- Reflux surgery
Penalties may be applied for using a hospital outside of your Medical Scheme network, we cover these penalty co-payments up to a rand limit per annum
For more information on the full policy benefits and limits for your preferred plan option – click here
Out-of-Hospital Treatment Benefits
Diagnostic radiology to find the problem:
- MRI Scans
- CT Scans
- Arthroscopy
Other treatments include but not limited to:
Defined Medical Procedures | |
---|---|
Conservative Back and Neck Treatment | In-patient Basic Dentistry |
Myringotomy | Endometrial Ablation |
Tonsillectomy | Hernia Repair |
Adenoidectomy | Varicose Vein Surgery |
Facet Joint Injections | Percutaneous Radiofrequency Ablations |
Arthroscopy | Rhizotomies |
Functional Nasal Procedures | Circumcision |
Non-Malignant Hysterectomy | Hymenotomy |
Laparoscopy | Nissen Fundoplication |
Confinement | Spinal Fusion or Major Joint Replacement |
Hysteroscopy |
Oncology (Cancer) Benefits
Oncology (Cancer Treatments): We cover a variety of cancer related treatments (when your treatment plan has been reviewed and approved by your Medical Scheme):
- 20% Co-payment applied when you reach your cancer limit defined in your Medical Scheme plan
- The difference between what your cancer specialist charges and what your Medical Scheme pays
- A lump sum payment when you are first diagnosed with cancer and your treatment plan has been approved, up to the age of 66 years
For more information on the full policy benefits and limits for your preferred plan option – click here
Accidental Death & Disability Cover
- Accidental Death and Disability: If you, or one of your dependants pass away or becomes permanently disabled as a result of an accident, we will pay R20 000 for children under 6 years old and between R28 000 and R30 000 for all other people covered on the policy.
- Contribution Waiver: If the main member of your Medical Scheme passes away as a result of an accident, we will cover your Medical Scheme contributions for a limited period and amount. We will also waive your Gap Cover premium for 6 months.
For more information on the full policy benefits and limits for your preferred plan option – click here

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