Gov-Gap

This product is a tailor made solution for Government employees who need to optimise their healthcare cover portfolio and premiums covered by Persal. Subject to your Overall Annual limit (OAL) of R150 000. Membership Eligibility: Principal policyholders must be in the full- time employment of The State and be in possession of a valid and current Persal number in order for a Gov-Gap policy documents to be issued. Gov-Gap has a policy cease age of 65. The policy will cease at the end of the benefit year in the year that the policyholder turns 65. Subject to your Overall Annual limit (OAL) of R150 000.

INDIVIDUAL
R255 / mon
FAMILY
R294/ mon

Benefits

Image


Gap Cover:
Will settle claims up to 500% of the 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. Paid to a maximum of R5 000 per claim.
Day Hospital / Clinic and/or In Room Surgical Procedures Cover:
Will settle the Gap portion of claims. Subject to OAL
Emergency Room Cover:
R7 500 sub-limit. Emergency Room – Accident and Trauma Treatment paid up to a maximum of R5 500 as a stated benefit. Emergency Room - Illness Treatment R2 000 per policy for the GAP portion only.
PMB Cover:
R30 000 per claim for the use of Non-DSP facilities for PMB treatments.
Cancer Boost:
Limited to R100 000 per beneficiary and subject to the OAL of this policy. This benefit is restricted to policyholders whose Medical Scheme options has a rand value for Cancer Cover. The Cancer Boost Benefit can only be claimed once your rand limit on your Medical Scheme Oncology benefit has been reached and you need further approved treatment. Terms and conditions apply.
Day To Day Specialist Consultation Fee:
R3 600 sub-limit per policy per annum. R800 per claim, 2 claims per beneficiary per annum for the GAP portion only.
Hospital Account Shortfalls:
R5 000 sub-limit per policy per annum. R1 250 per claim, 2 claims per beneficiary per annum.
Sub-Limit Enhancer:
R45 000 sub-limit. R15 000 per claim, limited to 2 claims per beneficiary per annum. Maximum 3 claims per policy per annum. The Sub-limit Enhancer benefits are limited to MRI Scans, CT Scans and Internal Prosthesis only.

The policy wording supercedes any marketing documentation and all benefits will be payable against the policy wording terms and conditions only.

Value Added Benefits

Image
THESE DO NOT FORM PART OF THE AGGREGATED OAL R150 000 LIMIT.
SPECIFIC WAITING PERIODS APPLY
Gap Cover Premium Waiver:
In event of Death and or Total Permanent Disability of the Premium Payer only. The Premium Waiver is directly linked to your policy premium per month as indicated in your Schedule of Insurance. This benefit is not paid in cash, but held as a credit against the policy for a 6 month period. Should there be any premium adjustments within the 6 month period, the credit balance available for the rest of the waiver period, will be adjusted accordingly.
Medical Scheme Premium Waiver:
Payable in the event of Death and or Total Permanent Disability of the Premium Payer of the Medical Scheme. Sirago will pay the medical scheme premium to the actual amount of the contribution, but not higher than the sub-limit of R2 500 per month for a 4 month period, to the beneficiary for the upkeep of their Medical Scheme contributions. In order to receive the benefit the Gap cover policy and Medical Scheme Membership must remain active during this period. A certificate of membership from your Medical Scheme must be presented monthly for authentication of current membership.
Accidental Death:
R5 000 principal, R5 000 adult dependent, R3 000 per child per policy per life.
Cancer Cover (Initial Diagnosis):
R5 000 upon the initial diagnosis of cancer as defined.
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 31 days of the birth. Subject to availability.
asset-2.png

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.

asset-4.png

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

Follow Us

Copyright © 2019 Sirago Underwriters.

Search

+880 322448500 Beverly Boulevard Los Angeles