This benefit will cover your Gap Cover portion for any day hospital/clinic and/or in-room procedures including acute hospitals in the event that a policyholder elects to have the treatment that would normally be performed on an in-patient basis, performed as an out-patient, by a registered medical professional.


Ultimate Gap | Plus Gap | Gap Assist | Gap Lite | Gap Only | Exact with Gap and Copay | Corporate Comprehensive | Corporate Base

Exact Cover

Benefit description:

This benefit provides cover for surgical procedures that can be performed in hospital but are elected to be performed in the doctors’ rooms. or in a day hospital.

Important points to consider:

  • Your medical aid still needs to process their medical aid (first 100%) scheme rate / tariff per line in order for us to review the Gap component. 
  • Examples of procedures includes wisdom teeth removal, childbirth, gastroscopy and arthroscopies.