General FAQ's

What is Gap Cover?
Healthcare providers are free to charge what they like and sometimes charge in excess of what your Medical Scheme will pay for a procedure, leaving you with...
Tue, 23 Jun, 2020 at 3:53 PM
Who can be covered on GapX?
Any person who is a member of a registered South African Medical Scheme can be covered on gap cover.
Tue, 23 Jun, 2020 at 3:55 PM
Do I need an active Medical Aid to have Gap Cover?
Yes. Gap Cover, requires that all dependants be covered on a South African medical scheme registered with the Council of Medical Schemes.
Tue, 23 Jun, 2020 at 3:55 PM
Do all dependants need to be on the same Medical Aid as the principal?
No, dependants can be covered on different medical aids. All dependants must be covered on a registered South African Medical Scheme, but it doesn'...
Tue, 23 Jun, 2020 at 4:04 PM
What does Overall Annual Limit(OAL) mean?
The Overall Annual Limit (OAL) is a an aggregated Rand limit for all claims that may be paid per dependant per annum. This amount is determined by law and e...
Tue, 23 Jun, 2020 at 4:05 PM
What does 100% of Scheme Rate mean?
Each registered Medical Scheme in South Africa has a predefined rate that they will pay for a given procedure called the Scheme Rate. Medical providers can ...
Tue, 23 Jun, 2020 at 4:07 PM