Vital Cover Plus is our second entry level product which is sufficient in providing for Gap Cover, Casualty cover and Oncology Gap.

Benefits: Vital Cover Plus*

The Vital Cover Plus option covers up to 700% above medical aid scheme tariff. This means that if your service provider charges anything up to 7 times what your medical aid will cover, TRA will provide for this gap, subject to the annual limit.*

*Annual Limit: The Basic Gap, Casualty and Oncology Gap benefits are subject to the aggregate gap cover annual limit of R150 000 per insured person per annum. (This limit may change due to regulatory amendment).

Casualty

  • Sometimes emergencies occur and you need to rush to casualty.
  • Your medical aid does not always cover the total costs in full. Whether payment comes from your medical scheme savings account or day-to-day benefit, the gap will be covered.
  • Sometimes, your medical aid will not account for anything regarding this casualty visit, leaving you to cover the bill in full. This benefit will cover you for up to R5 000 per policy per annum (subject to the annual limit*) EVEN IF YOUR MEDICAL AID COVERS NOTHING.

Oncology Gap

  • Unfortunately, cancer statistics show that cancer diagnoses are increasing dramatically every year.
  • With an early start to treatment, one can recover. But, the costs for cancer treatments are rising too. Specialists are also charging more than medical aids are obliged to cover, creating a substantial gap.
  • You will receive up to an aggregate of R150 000* per insured person per annum to assist where your service provider has charged more than the rate at which your medical aid reimburses, provided it is treatment which has been approved by your medical aid, and it is within your annual scheme limit.

Accidental Death

  • Accidents happen! Unfortunately, some severe accidents may even result in death. The situation is made worse if that person was the main breadwinner. Costs can run into the thousands and often funds are tied up to an estate.
    This benefit will provide an amount of R3 000 in the event of death of the insured and / or spouse, and R1 500 in the event of the death of the dependant, caused by violent, accidental, external, or visible means.

Policy Extender

  • We often hear of cases where one of our policyholders passes away, leaving their loved ones to pick up the pieces. They are left with the challenge to make sure that the gap cover they were used to is funded for a period of time.
  • This benefit will provide for your gap cover contributions for a period of 6 months after the death of the original policyholder.

TRA ASSIST powered by ER24 ASSIST

  • Benefits: Home Drive, Panic Button, Nurse Line.

*Subject to the aggregate gap cover annual limit of R150 000 per insured person per annum.

TERMS AND CONDITIONS:
A full list of terms and conditions can be viewed here.

GAP COVER EXAMPLES: TONSILLECTOMY AND ADENOIDECTOMY – 2018

Attending Doctor Private Rate Medical Aid Tariff *Gap Cover Your Share
Ear, Nose and Throat Surgeon R8 311.30 R2 599.52 R5 711.78 NIL
Specialist Anaesthesiologist R3 056.75 R1 012.19 R2 044.56 NIL
TOTAL R11 368.05 R3 611.71 R7 756.34 NIL

 

*Cover provided by all 4 Gap products.

PARTIAL KNEE REPLACEMENT
2018

Attending Doctor Private Rate Medical Aid Tariff *Gap Cover Your Share
Orthopaedic Surgeon R54 818.59 R17 009.47 R37 809.12 NIL
Specialist Anaesthesiologist R10 369.46 R 6 319.08 R 4 050.38 NIL
TOTAL R65 188.05 R23 328.55 R41 859.50 NIL

 

*Cover provided by all 4 Gap products.

*Subject to Product Option benefits and Imposed Waiting Periods.
*Subject to the aggregate gap cover annual limit of R150 000 per insured person per annum.
(This may change due to regulatory amendment).