What are Dis-Chem Health Gap Cover products all about?
Gap Cover provides short-term insurance products that help you cover certain cost shortfalls between what your medical provider charges and what your medical aid pays.

Fill in your details on this page indicating that you would like Gap Cover. A broker will call you back, run you through a quote and talk you through the two Gap Cover options. Policies are bought over the phone, and your policy documents will be mailed to you.

Your spouse and children (up to age 26) may be added as dependants onto your policy.

A minimum of 31 days’ notice is required in order to cancel your policy.

The waiting periods for Dis-Chem Health Gap Cover are as follows:

• 3-month general waiting period – does not apply to claims resulting from an accident
• 12-month Condition Specific waiting period – applies to any pre-existing conditions
• If you are transferring your Gap Cover from another provider, your waiting periods will be reviewed and possibly waived. Proof of previous cover is required

They occur when your surgeon or anaesthetist charges more than what your medical aid pays for a procedure or specific code. This is called a ‘tariff’ shortfall.
Do all specialists charge more than the medical aid tariff?
A lot of them do and the charges vary from 1.5 times above what the medical scheme covers up to as much as 5 times more than the medical aid tariff.

Tariff shortfalls vary according to the fees charged by your medical specialist and also the severity of the procedure. Typically, the shortfalls on minor procedures are several thousand rands and can be anywhere between R20,000 and R40,000 on large procedures.

Yes, they can also occur if your medical scheme imposes co-payments or deductibles on certain procedures, e.g. MRI/CT scans or diagnostic scopes while in hospital.

It all depends on your medical plan and on the type of procedure, but they range from around R2,000 up to as much as R15,000 per case.

The policy does contain some exclusions, please refer to your policy document for the detailed list.

These are optional benefits that you can include in your Gap Cover plan for an additional R55. Lifestyle Benefits unlock Dis-Chem extraRewards – the only rewards programme that could cover the cost of your premium. Save up to R600 per month with an instant 20% off on many products at Dis-Chem (in-store and online). Your extraRewards discount is valid on existing special offers too, so you save even more.

 

Other Lifestyle Benefits focus on improving mental wellness such as family counselling, children and teenager support as well as financial and legal advice.

 

For more information on Lifestyle Benefits, click here.

Dis-Chem Health Gap Cover processes claims daily and payable benefit payments to members also made daily. Claims take 7-14 working days to finalise once all required documents are received by Dis-Chem Health.

You can visit the website and either download a claim form or complete the online claim form.

The minimum documents required are: a fully completed claim form, a copy of the doctor’s invoice, a copy of the hospital account and a copy of your medical scheme statement showing the shortfall.