Gap Cover

Your whole policy has an Overall Annual Limit (OAL) of R150 000 per beneficiary to utilise.

INDIVIDUAL, UNDER 65
R231 / mon
FAMILY, UNDER 65
R249/ mon
FAMILY, 65+
R354/ mon

Benefits

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Gap Cover:
We will settle claims up to 500% of your Medical Scheme rate. Limited to a maximum of 600% or at the stated benefit value
Co-pay Cover:
R40 000 sub-limit per policy per annum. Limited to R10 000 per claim.
Admission Fee Cover:
Paid to a maximum of R3 000 per admission. A maximum of 3 claims per policy per annum. Including the use of a Partial Cover Network Hospital as determined by your Medical Scheme.
Day Hospital / Clinic and/or In Room Surgical Procedures Cover:
We will settle the Gap portion of claims.
Emergency Room Cover:
R4 000 sub-limit. Emergency Room – Accident and Trauma Treatment R2 000. Emergency Room - Illness Treatment R2 000 per policy for the Gap portion only.
PMB Cover:
Limited to R30 000 per claim for the use of Non-DSP facilities for PMB treatments.
Cancer Benefit:
A R100 000 limit per policy applies once your Medical Scheme Oncology benefit limit has been reached and a percentage co-payment is applied. Limited to R15 000 per claim for Cancer co-payments. Cancer Cover incorporates Co-payment cover and biological drugs. In order to access this benefit you need to be on a registered treatment plan with your Medical Scheme.
Hospital Account Shortfalls:
R1 500 sub-limit per policy per annum. Maximum of R500 per claim. Maximum 3 claims per beneficiary per policy per annum.
 
The policy wording supercedes any marketing documentation and all benefits will be payable against the policy wording terms and conditions only.

Value Added Benefits

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THESE DO NOT FORM PART OF THE AGGREGATED OAL R150 000 LIMIT

Sira-Go’ Baby:
A branded Sirago Welcome Pack will be couriered to your physical address as per your application form upon receipt of the instruction to add the newborn child to the policy within 30 days of the birth. Subject to availability.
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Sirago Underwriting Managers (Pty) Ltd is an Authorised Financial Services Provider (FSP:4710).
Underwriting Agency for GENRIC Insurance Company Limited (FSP:43638).
GENRIC is an Authorised Financial Services Provider and Registered Short-term Insurer.

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Contact

Tel: 010 599 1163

Fax: 086 508 2292

Email: info@sirago.co.za

Address: Midrand Business Park, Building 3, 563 Old Pretoria Main Road, Midrand, 1685

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