Penalty Fee Cover

Modified on Wed, 11 May 2022 at 04:36 AM

Co-payment cover is for the co-payments, excesses or deductibles imposed by a medical scheme for specified procedures, cover for hospital admission fees, scans, or surgical procedures. Co-payments related to cancer are catered for in the Cancer Benefit.


Ultimate Gap | Plus Gap | Gap Assist | Gap Lite | Corporate Comprehensive | Corporate Base

Gap Only | Exact Cover | Exact with Gap and Copay |

Benefit description:

This benefit provides cover for the penalty fee imposed by your Medical Scheme when making use of an out-of-network hospital (non-DSP). 

Important points to consider:

  • Only covers fees imposed by your Scheme, co-payments levied by a provider directly are not covered.
  • Penalty fees are paid to the hospital upfront and then claimed back from Sirago.

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