Gap cover pays the shortfall between what your medical scheme settles for in-hospital treatment and what your specialist actually charges. Asking which one is best only really works once you say best at what — so we ran the 2026 products against one published figure at a time: cheapest single premium, cheapest family rate, highest shortfall multiple, most detailed oncology benefit. Every number below comes from the provider's own brochure, linked on the row it sits on.
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products in our 2026 data set
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providers covered
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lowest published premium
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highest cover level
Premium is the last thing to look at, not the first. These are the five checks that decide whether a policy actually pays when you hand in the claim — each one maps to a column in the table further down.
A cover level is a multiple of the medical scheme rate. If your anaesthetist charges four times the rate and the policy settles to 200%, you still pay the difference. Ask your specialist what multiple they bill.
Every policy caps individual benefits inside the overall annual limit. 0 of the 0 products in our data set state cover for scheme co-payments and penalties, and 0 itemise an oncology benefit.
Premiums step up at 65, and some policies price children separately while others charge one family rate. Compare the premium for your household shape, not the headline 'from' price.
General waiting periods, condition-specific waiting periods and maternity exclusions differ by product and are set out in the policy wording, not the brochure summary.
Gap cover only works alongside an active medical scheme membership. Confirm the policy accepts your scheme and plan type before you sign anything.
A cheap medical aid with an expensive gap policy can cost more than one mid-range plan. We do that arithmetic for you on the combination cover page.
Gap cover is sold as accident-and-health insurance, and the total it may pay out per insured person per year is capped by regulation. Providers call this the Overall Annual Limit (OAL) or Overall Policy Limit (OPL), and every brochure in our data set states it.
1 January – 31 March 2026
R219 845
per insured person per year
1 April 2026 – 31 March 2027
R223 000
per insured person per year
Sub-limits sit inside this cap. A policy may, for example, cap penalty co-payments at R16 000 per claim even though the annual limit is far higher — so read the sub-limits on each product page.
Options worth comparing include the products below. Where a provider does not publish a premium we show "Not published" rather than an estimate.
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There is no single best product for everyone, because the winner changes with what you are solving for. On published 2026 figures the cheapest single-member premium, the cheapest family premium, the highest shortfall multiple and the most detailed oncology benefit are four different products — each one is named in the picks section on this page, with the figure that won it.
No. Discovery Gap Cover is only sold to Discovery Health Medical Scheme members. Its 2026 sales aid prices every option by Discovery Health plan type and requires everyone on your Discovery Health plan to be on the gap policy too, so it cannot be paired with a Bonitas, Momentum, Fedhealth, Medihelp or Medshield plan. That matters when you compare premiums, because Discovery's entry option is one of the cheapest figures on this page and most people are not eligible for it.
Everything on this page is published for comparison. Where we can arrange a quote, the product is marked as a quote partner.
Work in this order: check that the policy is actually available to you (some are sold only to members of one medical scheme, or only through an employer group), check your age band, compare the cover percentage against what your specialists actually charge, read the sub-limits for co-payments, casualty and oncology, then check the waiting periods. Only then compare premiums — the cheapest policy with the wrong sub-limits is the expensive one at claim time.
Premiums vary by provider, age band and whether the policy is priced per person or per family. Every published figure we could verify is in the comparison table on this page.
Gap cover is a short-term insurance policy that pays the shortfall between what your medical scheme pays for in-hospital treatment and what the doctor or specialist actually charges. It is not a medical scheme and only active medical scheme members can buy it.
Gap cover payouts are capped by regulation. The limit is R219 845 per insured person per year from 1 January 2026 to 31 March 2026, and R223 000 per insured person per year from 1 April 2026 to 31 March 2027. Providers state this limit in their brochures as the OAL or OPL.
It is the multiple of the medical scheme rate up to which the policy will settle a shortfall. A 500% policy settles claims up to five times the scheme rate, subject to the overall annual limit and any sub-limits.
Every figure is taken from the provider's own published 2026 brochure or policy document, and each plan links to the exact source PDF. Where a provider does not print a premium, we leave it blank rather than estimate it.
Gap cover is not a medical scheme and is not a substitute for medical scheme membership. Premiums and benefits are for 2026 and may change — confirm current terms with the provider before deciding. Information only; not financial advice.