Covers shortfalls on approved in-hospital specialist claims, specific out-of-hospital costs related to an approved hospital admission, and co-payments on approved cancer-related claims, depending on the option you choose
Reasons to get Discovery Gap Cover
You do not need to submit a separate Discovery Gap Cover claim to us.
By providing consent to access your claims information, we will automatically identify any potential gap cover claims, and then pay according to your
Discovery Gap Cover benefits
You will also receive a claims statement where you will see how your policy has covered any shortfalls.
In-hospital Specialist Gap Cover
When you are admitted to hospital, your specialist may charge more than the amount covered by your medical scheme. Our gap cover pays for tariff shortfalls on your approved specialist claims in hospital.
Hospital Admission Benefit Extender
You will receive up to R20 000 extra gap cover for shortfalls still remaining on specialist claims in-hospital, over and above what is covered by your In-hospital Specialist Gap Cover, and for specified out-of-hospital expenses related to your authorized hospital admission.
You will receive up to R10 000 extra gap cover for shortfalls still remaining on specialist claims in-hospital, over and above what is covered by your In-hospital Specialist Gap Cover.
Oncology Benefit Extender
Once you are registered on your scheme's oncology benefit, and you have reached the oncology threshold, the Oncology Benefit Extender will help you cover co-payments for cancer-related expenses approved by your medical scheme. You will receive up to R100 000, depending on the Discovery Gap Cover option you choose, to cover shortfalls on approved cancer-related claims once you have reached your scheme's oncology threshold.