Get Cover for Myself
Get Cover For My Employees
Click here to download our benefit fact sheet

Benefits of having Cinagi Gap cover

Gap Cover

If you are admitted to hospital or receive care for approved oncology treatment, your medical scheme may only refund you a portion of what your specialists and surgeons charge for their services. When this happens, we will provide additional cover to pay for these shortfalls.

We cover 3 different categories of shortfalls for oncology. Across all categories, we include cover for modern biological drugs approved by your medical scheme:

  • The 20% co-payment applied on all oncology costs
  • The 25% co-payment applied on Innovative Cancer Medicines
  • Co-payments applied to medicines approved as an ex-gratia benefit by your medical scheme
If your medical scheme has fixed-value upfront payments on MRI/CT/PET scans, in-hospital endoscopes, in-hospital basic dentistry or defined approved surgical procedures, we will cover these in full. We also provide you with cover for co-payments applied as a percentage of medical costs and where you voluntarily make use of a non-network provider.

Should your medical scheme impose a rand limit on internal prosthetic devices (eg, joint replacements, spinal fusions, pacemakers, etc), we will provide additional cover per procedure. Additional cover is also provided for sub-limits on MRI/CT/PET scans, endoscopes and lens implants.

We cover tariff shortfalls on consultations with a gynaecologist or GP during the 2nd and 3rd trimester.

Extender Benefits

For an emergency caused by an accident, we will cover you for x-rays, blood tests, medicines and fees of attending doctors at a casualty facility.

If your treatment at a casualty facility was the result of a sports accident, we will also cover shortfalls on follow-up rehabilitation consultations for physiotherapy or chiropractic treatment.

Covers the excess payable on your international travel insurance for medical emergencies while travelling outside the country.

If you are diagnosed with cancer (stage 2+) for the first time after joining, we will pay you a once-off lump sum to assist with any associated non-medical costs.

If you are admitted to hospital for 3 days or more after an accident we will pay you a lump sum per day for up to 28 days.

If you have a baby that is born 42 days or earlier than your original expected due date, we will pay you a lump sum.

For death/permanent disability of an insured a lump sum is payable - if caused by crime the benefit doubles.

Pays your medical scheme and gap cover for 6 months on accidental death/permanent disability of main member or spouse.

Medical Second Opinion

If you are diagnosed with a serious illness, Mediguide International’s global panel of World Leading Medical Research Centres gives you access to the world’s top medical minds for a diagnosis review.

This ensures that your diagnosis is 100% accurate and your treatment plan is optimally structured for you to achieve the best possible health outcome.

 

 

 

Click here to download our brochure

Submit a Claim

Submitting your claim is seamless. Once you have received the accounts from your specialist and/or hospital you can submit your claim along with your statement from your medical scheme.

Submit a Claim

Claim Optimiser

If you would like to make use of the Co-Payment Claim Optimiser to assist with your upfront payment you can do that here.

Claim Optimiser

Update my details

You can update any of your details here.

Example: banking information, email address, medical scheme information

Update my details

Request a copy of my Benefits

If you would like a copy of your policy documents detailing your waiting periods and benefits.

Request Policy Info

Upgrade my Benefits

If you would like to upgrade your policy to Gap Cover MAX you can submit your request here.

Request Upgrade

Get a Quote

If you would like to join Cinagi you can a quote here.

Get a Quote

How to get in touch with us