Home » Discovery Gap Cover
Welcome to Discovery Gap Cover.
Discovery QUOTES MADE EASY
Discovery Gap Cover: Most Discovery Health members have received unexpected medical bills, and are unaware that Discovery offers Gap Cover protection. To avoid these out-of-pocket expenses, Informed Healthcare contracted with Discovery Gap Cover to help members make an informed decision when taking out Gap Cover.
Free Broker Services & No Obligation Quotes
By simply filling in the form provided one of our Gap Cover Experts will contact you via phone or email. Should you take out a Gap Cover policy, you will receive our market leading brokerage services free of charge.
- You must be a member of Discovery Health Medical Aid.
- Fill in the Gap Cover quote form provided.
- One of our consultants will contact you right back!
Gap Cover From Discovery
Get covered for as little as R157 a month!
Discovery offers some of the most affordable premium to benefit products on the market. In line with this, Discovery takes the individual member’s circumstances in account when working out their monthly premiums. Visit Discovery Website >
- Gap Cover premiums start at as little as R157 PM, depending on certain criteria.
- You can add Supplementary Illness Benefit from as little as R 100 PM for complete cover.
Gap Cover Benefits
Get covered for medical aid shortfalls on approved in-hospital specialist claims & specific out-of-hospital costs relating to approved hospital admission & more.
Supplementary Illness Benefit
Provides premium protection & lump-sum payouts. Discovery’s Illness Benefit also includes up to 25% annual payback of your premiums. Download Brochure
2025 Updates
DISCOVERY
GAP COVER SERIES
Please note: the brochure still has to be updated for 2025.
We will update as soon as Discovery has updated their website.
Discovery Gap Cover Products
Brochures, Benefits & Rand figures displayed are prone to change without notice, contact us for latest benefits & pricing.
Gap Cover Core (Essential Plans)
| Gap Cover Core For Essential Plans | |
|---|---|
| Premium | 0-54 Single R291 Family R525 |
| 55-64 Single:R659 Family R1089 | |
| 65+ Single: R988 Family R1742 | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 250% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Extra gap cover for R7500 for shortfalls on approved specialist | |
| claims in-hospital over and above your Gap Cover | |
| Co-Payment Cover | No Benefit |
| Sub-limit benefit | No Benefit |
| Oncology & biologicals | Limited to R 75 000 per person per annum. |
| Additional Benefits | R7 500 Hospital Admission Benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No Benefit |
| Specialist consultant fee | No Benefit |
| Emergency Room Cover - Accident and Emergency | No Benefit |
| Preventative Care | No Benefit |
| Appliance benefit | No Benefit |
| Trauma Counselling | No Benefit |
| Accidental Death | No Benefit |
| Child related illness | No Benefit |
| Gap Premium Waiver | No Benefit |
| Medical Aid Premium Waiver | No Benefit |
| Initial Cancer Diagnosis | No Benefit |
| Hospital account shortfalls | No Benefit |
| Step down or physical rehab | No Benefit |
Gap Cover Core (Executive & Classic Plans)
| Discovery Gap Cover Core For Executive and Classic Plans | |
|---|---|
| Premium | 0-54 Single R157 Family R271 |
| 55-64 Single:R281 Family R335 | |
| 65+ Single: R326 Family R491 | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 250% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Extra gap cover for R7500 for shortfalls on approved specialist | |
| claims in-hospital over and above your Gap Cover | |
| Co-Payment Cover | No Benefit |
| Sub-limit benefit | No Benefit |
| Oncology & biologicals | Limited to R 75 000 per person per annum. |
| Additional Benefits | R7 500 Hospital Admission Benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No Benefit |
| Specialist consultant fee | No Benefit |
| Emergency Room Cover - Accident and Emergency | No Benefit |
| Preventative Care | No Benefit |
| Appliance benefit | No Benefit |
| Trauma Counselling | No Benefit |
| Accidental Death | No Benefit |
| Child related illness | No Benefit |
| Gap Premium Waiver | No Benefit |
| Medical Aid Premium Waiver | No Benefit |
| Initial Cancer Diagnosis | No Benefit |
| Hospital account shortfalls | No Benefit |
| Step down or physical rehab | No Benefit |
Gap Cover Core (Coastal Plans)
| Discovery Gap Cover Core For Coastal Plans | |
|---|---|
| Premium | 0-54 Single R319 Family R749 |
| 55-64 Single:R724 Family R1089 | |
| 65+ Single: R1086 Family R1742 | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 250% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Extra gap cover for R7500 for shortfalls on approved specialist | |
| claims in-hospital over and above your Gap Cover | |
| Co-Payment Cover | No Benefit |
| Sub-limit benefit | No Benefit |
| No Benefit | |
| Oncology & biologicals | Limited to R 75 000 per person per annum. |
| Additional Benefits | R7 500 Hospital Admission Benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No Benefit |
| Specialist consultant fee | No Benefit |
| Emergency Room Cover - Accident and Emergency | No Benefit |
| Preventative Care | No Benefit |
| Appliance benefit | No Benefit |
| Trauma Counselling | No Benefit |
| Accidental Death | No Benefit |
| Child related illness | No Benefit |
| Gap Premium Waiver | No Benefit |
| Medical Aid Premium Waiver | No Benefit |
| Initial Cancer Diagnosis | No Benefit |
| Hospital account shortfalls | No Benefit |
| Step down or physical rehab | No Benefit |
Gap Cover Comprehensive (Executive & Classic Plans)
| Discovery Gap Cover Comprehensive For Executive and Classic Plans | |
|---|---|
| Premium | 0-54 Single R248 Family R420 |
| 55-64 Single:R420 Family R641 | |
| 65+ Single: R538 Family R889 | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 500% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Extra gap cover for R15 000 for shortfalls on approved specialist | |
| claims in-hospital over and above your Gap Cover | |
| Co-Payment Cover | On the benefit extender the member is covered |
| for co-payments or deductibles for endoscopies | |
| related to an authorised hospital admission | |
| Provides cover for the co-payment for MRI | |
| and CT scans out of hospital. | |
| Sub-limit benefit | No Benefit |
| No Benefit | |
| Oncology & biologicals | Limited to R 100 000 per person per annum. |
| Additional Benefits | R15 000 Hospital Admission Benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No Benefit |
| Specialist consultant fee | No Benefit |
| Emergency Room Cover - Accident and Emergency | No Benefit |
| Preventative Care | No Benefit |
| Appliance benefit | No Benefit |
| Trauma Counselling | No Benefit |
| Accidental Death | No Benefit |
| Child related illness | No Benefit |
| Gap Premium Waiver | No Benefit |
| Medical Aid Premium Waiver | No Benefit |
| Initial Cancer Diagnosis | No Benefit |
| Hospital account shortfalls | No Benefit |
| Step down or physical rehab | No Benefit |
Gap Cover Comprehensive (Essential Plans)
| Discovery Gap Cover Comprehensive For Essential Plans | |
|---|---|
| Premium | 0-54 Single R426 Family R748 |
| 55-64 Single:R780 Family R1633 | |
| 65+ Single: R1036 Family R2147 | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 500% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Extra gap cover for R15 000 for shortfalls on approved specialist | |
| claims in-hospital over and above your Gap Cover | |
| Co-Payment Cover | On the benefit extender the member is covered |
| for co-payments or deductibles for endoscopies | |
| related to an authorised hospital admission | |
| Provides cover for the co-payment for MRI | |
| and CT scans out of hospital. | |
| Sub-limit benefit | No Benefit |
| No Benefit | |
| Oncology & biologicals | Limited to R 100 000 per person per annum. |
| Additional Benefits | R15 000 Hospital Admission Benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No Benefit |
| Specialist consultant fee | No Benefit |
| Emergency Room Cover - Accident and Emergency | No Benefit |
| Preventative Care | No Benefit |
| Appliance benefit | No Benefit |
| Trauma Counselling | No Benefit |
| Accidental Death | No Benefit |
| Child related illness | No Benefit |
| Gap Premium Waiver | No Benefit |
| Medical Aid Premium Waiver | No Benefit |
| Initial Cancer Diagnosis | No Benefit |
| Hospital account shortfalls | No Benefit |
| Step down or physical rehab | No Benefit |
Gap Cover Comprehensive (Coastal Plans)
| Discovery Gap Cover Comprehensive For Coastal Plans | |
|---|---|
| Premium | 0-54 Single R468 Family R1069 |
| 55-64 Single:R857Family R1633 | |
| 65+ Single: R1139 Family R2147 | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 500% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Extra gap cover for R15 000 for shortfalls on approved specialist | |
| claims in-hospital over and above your Gap Cover | |
| Co-Payment Cover | On the benefit extender the member is covered |
| for co-payments or deductibles for endoscopies | |
| related to an authorised hospital admission | |
| Provides cover for the co-payment for MRI | |
| and CT scans out of hospital. | |
| Sub-limit benefit | No Benefit |
| No Benefit | |
| Oncology & biologicals | Limited to R 100 000 per person per annum. |
| Additional Benefits | R15 000 Hospital Admission Benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No Benefit |
| Specialist consultant fee | No Benefit |
| Emergency Room Cover - Accident and Emergency | No Benefit |
| Preventative Care | No Benefit |
| Appliance benefit | No Benefit |
| Trauma Counselling | No Benefit |
| Accidental Death | No Benefit |
| Child related illness | No Benefit |
| Gap Premium Waiver | No Benefit |
| Medical Aid Premium Waiver | No Benefit |
| Initial Cancer Diagnosis | No Benefit |
| Hospital account shortfalls | No Benefit |
| Step down or physical rehab | No Benefit |
Gap Active (Executive & Classic Plans)
| Discovery Gap Active For Executive & Classic Plans | |
|---|---|
| Premium | 0-30 Single R49 Family R140 |
| 31 - 40 Single:R99 Family R175 | |
| 41+ Single: R267 Family R318 | |
| Still subject to FSCA approval | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 100% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Covered for the procedural deductible incurred under the | |
| Active Smart plan up to a max of R7500 per event | |
| Co-Payment Cover | No benefit |
| for co-payments or deductibles for endoscopies | |
| related to an authorised hospital admission | |
| Provides cover for the co-payment for MRI | |
| and CT scans out of hospital. | |
| Sub-limit benefit | No benefit |
| No Benefit | |
| Oncology & biologicals | No benefit |
| Additional Benefits | No benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No benefit |
| Specialist consultant fee | No benefit |
| Emergency Room Cover - Accident and Emergency | No benefit |
| Preventative Care | No benefit |
| Appliance benefit | No benefit |
| Trauma Counselling | No benefit |
| Accidental Death | No benefit |
| Child related illness | No benefit |
| Gap Premium Waiver | No benefit |
| Medical Aid Premium Waiver | No benefit |
| Initial Cancer Diagnosis | No benefit |
| Hospital account shortfalls | No benefit |
| Step down or physical rehab | No benefit |
Gap Active (Essential Plans)
| Discovery Gap Active For Essential Plans | |
|---|---|
| Premium | 0-30 Single R49 Family R200 |
| 31-40 Single R99 Family R300 | |
| 41+ Single R400 Family R661 | |
| Still subject to FSCA approval | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 100% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Covered for the procedural deductible incurred under the | |
| Active Smart plan up to a max of R7500 per event | |
| Co-Payment Cover | No benefit |
| for co-payments or deductibles for endoscopies | |
| related to an authorised hospital admission | |
| Provides cover for the co-payment for MRI | |
| and CT scans out of hospital. | |
| Sub-limit benefit | No benefit |
| No Benefit | |
| Oncology & biologicals | No benefit |
| Additional Benefits | No benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No benefit |
| Specialist consultant fee | No benefit |
| Emergency Room Cover - Accident and Emergency | No benefit |
| Preventative Care | No benefit |
| Appliance benefit | No benefit |
| Trauma Counselling | No benefit |
| Accidental Death | No benefit |
| Child related illness | No benefit |
| Gap Premium Waiver | No benefit |
| Medical Aid Premium Waiver | No benefit |
| Initial Cancer Diagnosis | No benefit |
| Hospital account shortfalls | No benefit |
| Step down or physical rehab | No benefit |
Gap Active (Coastal Plans)
| Discovery Gap Active For Coastal Plans | |
|---|---|
| Premium | 0-30 Single R75 Family R300 |
| 31 - 40 Single:R120 Family R400 | |
| 41+ Single: R688 Family R1035 | |
| Still subject to FSCA approval | |
| Overall Annual Limit | R 210 580 per person per annum |
| Cover | 100% over and above your scheme rate. |
| Shortfall between the Medical Scheme Rate | |
| and the private rates (in-hospital) charged | |
| by the Medical Practioner or Specialist | |
| over and above your medical scheme rate. | |
| Covered for the procedural deductible incurred under the | |
| Active Smart plan up to a max of R7500 per event | |
| Co-Payment Cover | No benefit |
| for co-payments or deductibles for endoscopies | |
| related to an authorised hospital admission | |
| Provides cover for the co-payment for MRI | |
| and CT scans out of hospital. | |
| Sub-limit benefit | No benefit |
| No Benefit | |
| Oncology & biologicals | No benefit |
| Additional Benefits | No benefit |
| Cover for Day hospital/ clinic or in-room procedure | on the hospital admission benefit extender |
| Primary Care | No benefit |
| Specialist consultant fee | No benefit |
| Emergency Room Cover - Accident and Emergency | No benefit |
| Preventative Care | No benefit |
| Appliance benefit | No benefit |
| Trauma Counselling | No benefit |
| Accidental Death | No benefit |
| Child related illness | No benefit |
| Gap Premium Waiver | No benefit |
| Medical Aid Premium Waiver | No benefit |
| Initial Cancer Diagnosis | No benefit |
| Hospital account shortfalls | No benefit |
| Step down or physical rehab | No benefit |
Gap Cover Waiting Periods
3-Month General Waiting Period
When you sign up, there is an automatic 3-month waiting period for all medical services and treatments, except for authorised emergency hospital admissions.
12-Month Pre-existing Waiting Period
There is an automatic 12-month waiting period for any claims directly or indirectly related to the treatment of (click to open):
- Pregnancy and childbirth,
- Endometrial ablations,
- Hysterectomy,
- Joint replacements,
- Minimally invasive scopes, endoscopes, hysteroscopes and arthroscopes,
- Cataracts,
- Cholecystectomy,
- Wisdom teeth,
- Orthognathic surgery,
- Dental implants,
- Tonsillectomy,
- Grommets,
- Adenoidectomy,
- Nasal procedures,
- Hernia procedures,
- Reflux surgery.
