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NetcarePlus GapCare
GapCare banner GapCare banner - mobile
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NetcarePlus GapCare

From

R299

per month

NetcarePlus GapCare

More
cover when your medical aid runs out

Because medical aid alone won’t always be enough to get you the quality care you need, or to take care of unexpected expenses and shortfalls. You need gap cover that makes more of your medical aid.

This is not a medical scheme, and the cover is not the same as that of a medical scheme. This insurance product is not a substitute for medical scheme membership.

How GapCare makes more of your medical aid

Discover more about NetcarePlus GapCare and why you need gap cover.

Why NetcarePlus GapCare? Why gap cover?
Specialist cover Hospitals and
specialists Emergency
treatment Pregnancy, childbirth
and more

500% more
cover for specialists, both in and out of hospital

You'll be covered for any approved admissions in a day clinic or hospital, plus against shortfalls for specialist consultations, treatment and procedures when you're not admitted to hospital.

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

700%
600%
500%
400%
300%
200%
100%
0%
500%
Medical aid GapCare

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

Hospitals and specialists Hospitals and specialists

Access to world-class treatment

With NetcarePlus GapCare, you get access to all of Netcare's facilities, plus access to any other hospital, so you can get the care you need without worrying about medical aid network limitations.

Emergency cover for injuries and illnesses, 24/7

NetcarePlus GapCare covers you against shortfalls for injuries and illnesses in an emergency department, 24/7.

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

100%
80%
60%
40%
20%
0%
Weekdays
Weekends
Competitors NetcarePlus GapCare

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

More
cover for maternity shortfalls

NetcarePlus GapCare covers you against shortfalls during pregnancy, childbirth and after your baby is born.

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

Hover over the graphs to see how our cover goes beyond medical aid limits.

Tap on the graphs to see how our cover goes beyond medical aid limits.

R25 000
R20 000
R15 000
R10 000
R5 000
R0
Consultations
Complications
Pregnancy
Gynacologist
Private ward cover
Anaesthetist
Paediatrician
Childbirth
Paediatrician
Immunisations
Post pregnancy
Medical aid NetcarePlus GapCare

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

What is
gap cover Why do you
need gap cover? How does it
work? How it helped
Lindiwe
What is gap cover What is gap cover

What is gap cover?

Gap cover is basically top-up insurance for your medical aid. It bridges the gap between medical expenses and what your medical scheme covers.

Why do you need gap cover Why do you need gap cover

Why do you need gap cover?

  • Specialists often charge more than the amount covered by your medical aid
  • The hospitals and specialists you want to use may fall outside of your medical aid network
  • You could reach the limit of your medical aid's benefits
  • Hospitals can also charge co-payments for certain procedures

Without gap cover, you'll have to pay for these expenses out of your own pocket.

How does it work How does it work

How does it work?

Medical aids set an annual rate that is paid to specialists for every procedure. Based on your medical aid option, you can be covered for up to 300% of the medical aid rate.

Specialists usually charge more than what your medical aid covers, causing a shortfall between their rate and what your medical aid covers.

This is when gap cover kicks in, protecting you against unexpected expenses.

Meet Lindiwe

01

Lindiwe is unsure of which specialist to see to have her wisdom teeth removed, so she gets a recommendation from her dentist.

Lindiwe finds a specialist

02

The specialist who Lindiwe is referred to does not practise at a hospital in her medical aid network.

She sees the specialist

03

For her own peace of mind, Lindiwe decides to book an appointment with the recommended specialist.

Lindiwe is covered

04

If Lindiwe did not have gap cover, she would've had to pay R10 002 out of her pocket for a simple day surgery.

With NetcarePlus GapCare, not only are you covered against shortfalls in your medical aid, but you also have the freedom to choose specialists and hospitals based on your needs.

Total cost Medical aid payout Gap cover
Hospital R 6 120 R 4 896 R 1 224
Specialist R 9 567 R 3 189 R 6 378
Anaesthetist R 3 600 R 1 200 R 2 400
Total R 19 287 R 9 285 R 10 002

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

Meet Lindiwe Meet Lindiwe

Lindiwe, 35

Wisdom teeth removal

With NetcarePlus GapCare, not only are you covered against shortfalls in your medical aid, but you also have the freedom to choose specialists and hospitals based on your needs.

Total cost Medical aid payout Gap cover
Hospital R 6 120 R 4 896 R 1 224
Specialist R 9 567 R 3 189 R 6 378
Anaesthetist R 3 600 R 1 200 R 2 400
Total R 19 287 R 9 285 R 10 002

All examples shown are for illustrative purposes only. Claims covered by GapCare will depend on your medical aid payouts and the benefits available as part of your GapCare policy.

What are the benefits?

With NetcarePlus GapCare, you'll be covered for the following benefits and more.

GP icon

In-hospital
specialist fees

You'll be covered for specialist shortfalls for any approved admission in a hospital or in a day clinic. Plus, we'll also take care of consultations while you're admitted in hospital.

Payment icon

Upfront
co-payments

You'll be protected against upfront co-payments for certain day procedures, like scopes or scans performed in hospital or a day clinic.

Oncology icon

Comprehensive cancer
treatment

You'll be covered for co-payments for cancer treatments beyond the limits of your medical aid's oncology benefit. Plus, shortfalls when using providers outside of your medical aid network.

GP location icon

Unlimited admissions in
any Netcare facility

You'll get unlimited cover for co-payments when you use a Netcare hospital outside of your medical aid network.

Caduceus icon

Cover in
an emergency department

You'll receive emergency medical treatment for injuries and emergency illnesses, beyond the cover of your medical aid.

Hospital icon

Out-of-hospital
specialist shortfalls

Your medical specialist shortfalls will be covered for consultations and treatment, when you are not admitted to hospital.

Stethoscope icon

Day-to-day
medical costs

You'll be covered for specialist consultations if referred by your GP, including cover for radiology, pathology, as well as basic and specialised dentistry once you've reached your day-to-day limits.

Pregnancy icon

Extended
maternity benefits

You'll be protected against maternity costs beyond medical aid limits, even if your pregnancy is high-risk. Plus, we take on shortfalls for prenatal consultations, private ward costs, and baby's first hearing screening and immunisations.

Plus

Out-of-network hospital co-payments

An extended stay in a mental health facility

Charges above medical aid sub-limits

Shortfalls in trauma counselling

Quick turnaround time on claims

Premium waiver

What are my options?

Choose from three levels of cover based on your needs and budget.

Download brochure

GapCare

Cover for in-hospital and other common shortfalls up to an additional 500% of the medical aid tariffs.

Perfect for employer groups and students.

From

R299

per month
Cover level

500%

Out-of-hospital
Day-to-day costs beyond
medical aid limits Maternity costs Out-of-hospital
specialist shortfalls

Day-to-day costs beyond medical aid limits

If you don’t have medical savings left or you’ve reached the limits of your day-to-day benefits, we'll make more of your medical aid by covering:

  • Specialist consultations if referred by your GP
  • Basic dentistry (fillings and extractions)
  • Specialised dentistry (root canals, X-rays, pulp removal, reconstructive dentistry)
  • Specialised radiology or pathology

Maternity costs

You'll be covered for shortfalls for prenatal consultations with your gynaecologist or obstetrician. Plus, when you’ve run out of medical aid savings or if you've reached your day-to-day benefit sub-limit, you'll be covered for:

  • Prenatal testing for high-risk pregnancies, up to R25 000 for each pregnancy
  • Your baby's first immunisations

Out-of-hospital specialist shortfalls

You'll be covered against shortfalls for specialist consultations, treatment and procedures when you're not admitted to hospital.

In-hospital
In-hospital
specialist shortfalls Co-payments and
deductibles Out-of-network
hospital co-payments Charges above medical
aid sub-limits

In-hospital specialist shortfalls

You'll be covered for specialist shortfalls for any approved admission in a hospital or in a day clinic. Plus, we'll also take care of consultations while you're admitted in hospital.

Co-payments and deductibles

You'll be covered for co-payments for certain scopes and scans performed in hospital or at a day clinic. And if you've settled a co-payment from your medical savings, we'll reimburse you for the cost.

Out-of-network hospital co-payments

You'll have unlimited cover for co-payments when admitted to a Netcare hospital, outside of your medical aid network. Plus, you'll get one hospital stay up to R10 000 per annum at any hospital outside of your medical aid network.

Charges above medical aid sub-limits

You'll be protected against shortfalls for certain in-hospital procedures, for prosthetic devices, a stay in a mental health institution, rehab, step-down or sub-acute facility – up to a maximum of R35 000 per annum – once your medical aid's sub-limits have been reached.

Cancer treatment
Shortfalls in
cancer treatment Co-payments for
cancer treatment

Shortfalls in cancer treatment

You'll be protected against shortfalls in cancer treatment when you use a provider outside of your medical aid's network.

Co-payments for cancer treatment

You don't have to worry about co-payments applied by your medical aid, because you'll be covered for that too – even when you reach the limits of your medical aid's oncology benefit.

Emergency treatment
Emergency treatment
for injuries and illnesses Emergency booster

Emergency treatment for injuries and illnesses

When you need emergency medical treatment, we'll make more of your medical aid by covering:

  • Shortfalls between what the doctor charges and what your medical aid covers (limited to 300% or 500% of your medical aid tariff)
  • Shortfalls in medical aid sub-limits or co-payments for tests, scans or appliances
  • Covers these costs when you have run out of savings or reached your benefit limit:
    • Doctor's consultation fees
    • Facility fees
    • Basic radiology, specialised radiology and pathology
    • Medical appliances
    • Medication

Emergency booster

You'll be covered for the cost of emergency medical treatment in the emergency department of a hospital, including:

  • Doctor's consultation fees
  • Facility fees
  • Basic radiology, specialised radiology and pathology
  • Medical appliances
  • Medication administered during the event
Premium waiver
GapCare premiums Medical aid contributions

GapCare premiums

Should you pass away or become totally and permanently disabled due to an accident, we'll take care of your NetcarePlus GapCare premiums for six months, up to a maximum of R5 000 per month.

Medical aid contributions

Should you pass away or become totally and permanently disabled due to an accident, we'll take care of your medical aid contributions for six months, up to a maximum of R5 000 per month.

Trauma counselling
Trauma counselling

Trauma counselling

You'll be covered for counselling with a registered counsellor, psychologist or psychiatrist when you have run out of medical aid savings or if you've reached your day-to-day benefit sub-limit.

GapCare 300+

Cover for in-hospital and other common shortfalls PLUS out of hospital shortfalls, up to an additional 300% of the medical aid tariffs.

Perfect if you belong to a comprehensive medical scheme.

From

R355

per month

300%

GapCare 500+

Cover for in-hospital and other common shortfalls PLUS out of hospital shortfalls, up to an additional 500% of medical aid tariffs.

Perfect if you belong to a medical scheme with network limits.

From

R390

per month

500%

How much will it cost?

Complete the questions below to get an online quote.

GapCare is only available if you have medical aid. Our EmergencyCare covers you for injuries and emergency illnesses, without medical aid.

0

People to be covered

Your quote

All prices shown are based on the information provided by you. Waiting periods may be applied once we process your application.

Below is more information on the range of gap cover products available from NetcarePlus.

GapCare

Cover for in-hospital and other common shortfalls up to an additional 500% of the medical aid tariffs.

Perfect for employer groups and students.

From

R285

per month
Get cover now
Cover level

500%

Out-of-hospital
Day-to-day costs beyond
medical aid limits Maternity costs Out-of-hospital
specialist shortfalls

Day-to-day costs beyond medical aid limits

If you don’t have medical savings left or you’ve reached the limits of your day-to-day benefits, we'll make more of your medical aid by covering:

  • Specialist consultations if referred by your GP
  • Basic dentistry (fillings and extractions)
  • Specialised dentistry (root canals, X-rays, pulp removal, reconstructive dentistry)
  • Specialised radiology or pathology

Maternity costs

You'll be covered for shortfalls for prenatal consultations with your gynaecologist or obstetrician. Plus, when you’ve run out of medical aid savings or if you've reached your day-to-day benefit sub-limit, you'll be covered for:

  • Prenatal testing for high-risk pregnancies, up to R25 000 for each pregnancy
  • Your baby's first immunisations

Out-of-hospital specialist shortfalls

You'll be covered against shortfalls for specialist consultations, treatment and procedures when you're not admitted to hospital.

In-hospital
In-hospital
specialist shortfalls Co-payments and
deductibles Out-of-network
hospital co-payments Charges above medical
aid sub-limits

In-hospital specialist shortfalls

You'll be covered for specialist shortfalls for any approved admission in a hospital or in a day clinic. Plus, we'll also take care of consultations while you're admitted in hospital.

Co-payments and deductibles

You'll be covered for co-payments for certain scopes and scans performed in hospital or at a day clinic. And if you've settled a co-payment from your medical savings, we'll reimburse you for the cost.

Out-of-network hospital co-payments

You'll have unlimited cover for co-payments when admitted to a Netcare hospital, outside of your medical aid network. Plus, you'll get one hospital stay up to R10 000 per annum at any hospital outside of your medical aid network.

Charges above medical aid sub-limits

You'll be protected against shortfalls for certain in-hospital procedures, for prosthetic devices, a stay in a mental health institution, rehab, step-down or sub-acute facility – up to a maximum of R35 000 per annum – once your medical aid's sub-limits have been reached.

Cancer treatment
Shortfalls in
cancer treatment Co-payments for
cancer treatment

Shortfalls in cancer treatment

You'll be protected against shortfalls in cancer treatment when you use a provider outside of your medical aid's network.

Co-payments for cancer treatment

You don't have to worry about co-payments applied by your medical aid, because you'll be covered for that too – even when you reach the limits of your medical aid's oncology benefit.

Emergency treatment
Emergency treatment
for injuries and illnesses Emergency booster

Emergency treatment for injuries and illnesses

When you need emergency medical treatment, we'll make more of your medical aid by covering:

  • Shortfalls between what the doctor charges and what your medical aid covers (limited to 300% or 500% of your medical aid tariff)
  • Shortfalls in medical aid sub-limits or co-payments for tests, scans or appliances
  • Covers these costs when you have run out of savings or reached your benefit limit:
    • Doctor's consultation fees
    • Facility fees
    • Basic radiology, specialised radiology and pathology
    • Medical appliances
    • Medication

Emergency booster

You'll be covered for the cost of emergency medical treatment in the emergency department of a hospital, including:

  • Doctor's consultation fees
  • Facility fees
  • Basic radiology, specialised radiology and pathology
  • Medical appliances
  • Medication administered during the event
Premium waiver
GapCare premiums Medical aid contributions

GapCare premiums

Should you pass away or become totally and permanently disabled due to an accident, we'll take care of your NetcarePlus GapCare premiums for six months, up to a maximum of R5 000 per month.

Medical aid contributions

Should you pass away or become totally and permanently disabled due to an accident, we'll take care of your medical aid contributions for six months, up to a maximum of R5 000 per month.

Trauma counselling
Trauma counselling

Trauma counselling

You'll be covered for counselling with a registered counsellor, psychologist or psychiatrist when you have run out of medical aid savings or if you've reached your day-to-day benefit sub-limit.

GapCare 300+

Cover for in-hospital and other common shortfalls PLUS out of hospital shortfalls, up to an additional 300% of the medical aid tariffs.

Perfect if you belong to a comprehensive medical scheme.

From

R325

per month
Get cover now

300%

GapCare 500+

Cover for in-hospital and other common shortfalls PLUS out of hospital shortfalls, up to an additional 500% of medical aid tariffs.

Perfect if you belong to a medical scheme with network limits.

From

R355

per month
Get cover now

500%

desktop mobile

Thank you for your application,
Jane Doe

You have successfully completed your application for NetcarePlus GapCare 300+. Your policy documents will be sent within 48 hours to this email address: WY********GMAIL.COM

What's next?

Accept your DebiCheck

Why do I need to do this?
How to accept your DebiCheck

A DebiCheck request may be sent to you by SMS within the next 5 working days.

Other ways to accept:

  • Screen check icon

    Via internet banking

  • Smartphone icon

    In your mobile banking app

  • Map pin icon

    By visiting a branch of your bank

  • Screen check icon

    At an ATM

Further
information

Need help or have questions?

Email our team at [email protected] or contact us on 0860 101 151

FAQ Terms & Conditions
Hollard logo

Underwritten by The Hollard Insurance Co. Ltd, a Licensed Non-Life Insurer and Auth.FSP. NetcarePlus is an Auth.FSP.

There will be scheduled downtime due to website maintenance on the 18th March from 23:00. We'll be back online on the 19th March at 04:00. Thank you for your patience.

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More about GapCare

Watch the video to learn more about GapCare and how it benefits you.

More-Cover-For-Employees More-Cover-For-Employees

More cover for your employees

Add value to your employees' lives and attract new talent, by offering gap cover that makes more of their medical aid and gives them access to Netcare's world-class specialists and hospitals.

Need more ways to access quality care?

R435all incl.

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Prepaid Healthcare Vouchers

Get the daily care you need with access to Netcare's world-class doctors, dentists and optometrists.

Further
information

Need help or have questions?

Email our team at [email protected] or contact us on 0860 101 151

FAQ Terms & Conditions

Underwritten by The Hollard Insurance Co. Ltd, a Licensed Non-Life Insurer and Auth.FSP. NetcarePlus is an Auth.FSP.

As part of our annual price increase, please note our new prices will take effect from 1 January .