Western Gap | Gap Cover
Western Rethink Insurance

This is not a Medical Scheme and the cover is not the same as that of a Medical Scheme.

This Policy is not a substitute for Medical Scheme membership.

Underwritten by Western National Insurance Company Limited (FSP 9465).

What is Gap Cover?

Gap Cover is a short term insurance product that helps you cover certain cost shortfalls that your medical aid does not cover. These medical shortfalls occur when your selected doctor or medical specialist charges rates that are more than what your medical aid will pay for. These shortfalls vary according to the fees charged by a medical specialist and the nature of the procedure required.

Western Gap Cover provides peace of mind with financial cover for in-hospital medical shortfalls and allows you to be able to choose the best medical care for you and your family.

Why Gap Cover is Essential:

Gap Cover is essential due to the high cost of specialist treatments and above-inflation increases, meaning that more people are at risk of being left behind and excluded from the quality medical care they need and deserve.

Many medical disciplines are increasing their charges at a rate much higher than that of inflation, some up to 500% of medical aid rates. Patients and their families are required to meet the cost shortfalls that exist between what their medical aid covers and the actual charge of the specialist.

Western Gap Cover Benefits:

  • Tariff Shortfalls 
  • Co-payments, Penalties & Deductibles
  • Consumables
  • Oncology Co-payments
  • Step Down Facility
  • Dental Reconstruction Benefit
  • Accidental Casualty
  • Child Casualty Illness
  • Maternity Booster
  • Innovative Oncology Medicines
  • In-Hospital Tariff Shortfalls
  • Accidental Death and Disability Benefits
  • Contribution Waiver 

Priority Pass - Gap Cover Claims Process:

Kaelo Gap Claims Step 1 Submit
Kaelo Gap Claims Step 2 Notified
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