Health insurance
Mind the gap your medical aid leaves.
Cover the shortfall between what specialists charge and what your medical aid pays — often hundreds of percent more.
- Specialist shortfalls
- Co-payments
- Sub-limit top-ups
Gap cover pays the shortfall between what your medical aid pays for in-hospital treatment and what specialists actually charge — which can be three to five times the medical-aid rate. Without it, a single operation can leave you with tens of thousands of rands to pay out of your own pocket.
Ample arranges gap cover alongside your medical aid across South Africa's leading providers, closing one of the biggest and most surprising gaps in private healthcare.
What Gap Cover covers
Specialist shortfalls
The difference between specialist bills and your medical aid's rate, for in-hospital care.
Co-payments
Cover for co-payments and deductibles your scheme imposes on certain procedures.
Sub-limit top-ups
Top-ups where your medical aid caps cover for things like scopes or internal prosthetics.
Cancer cover gaps
Help with shortfalls in cancer treatment that exceed your scheme's oncology limits.
Casualty benefits
Cover for emergency casualty visits that don't lead to admission (plan-dependent).
Whole-family option
Cover your dependants under one affordable gap policy.
Who gap cover is for
- Anyone on a medical aid (gap cover complements it)
- Families who use specialists and hospitals
- People facing planned surgery
- Those wanting to avoid surprise medical bills
Gap Cover FAQs
Do I need gap cover if I already have medical aid?
Yes — they do different jobs. Medical aid pays its agreed rate; specialists often charge several times that. Gap cover pays the difference, protecting you from large out-of-pocket bills after an operation.
How big can the 'gap' actually be?
Specialists can charge 300–500% of the medical-aid rate. On a major procedure that can mean tens of thousands of rands you'd otherwise pay yourself. Gap cover is inexpensive relative to that risk.
Is gap cover regulated?
Yes. Gap cover is a short-term insurance product regulated under the Demarcation Regulations, with a legislated annual limit. We'll explain the current limits and what's covered.
Can the whole family be covered?
Yes. Most gap policies let you cover your spouse and children on one plan, usually for a single affordable premium.
This page is general information, not financial advice. Cover varies by policy and provider — your dedicated Ample broker tailors it to your needs.
Get a personalised quote
Let’s prove our reliable insurance cover.
Tell us a little about what you need and your dedicated broker will be in touch — usually within one business day. No bots, no pressure.
- Call us0861 112 466
- Email usinfo@ampleinsurance.co.za
- Office hoursMon–Fri, 08:00–16:30