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Welcome to Stratum Gap Cover.

Stratum QUOTES MADE EASY

Stratum Gap Cover: Stratum Benefits have been providing individuals, families, and businesses with affordable gap cover plans for over 10 years. We are guaranteed to help you with a wide range of comprehensive gap cover products tailored perfectly to suit your budget.

No Obligation Quotes • Free Broker Services

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 currently belong to a medical aid scheme.

Fill out the quote form provided.

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2023 Brochure About Gap Cover Get Medical Aid

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Page Contents

• Stratum Gap Cover

Disability Or Death Cover
First-time Cancer Diagnosis

• Watch Stratum Video

• Stratum 2025 Updates

• Stratum Benefits

Compact300 Plan
Meridian400 Plan
Elite500 Plan

• Gap Cover Waiting Period

• Stratum Waiting Periods

Stratum Gap Cover

Get individual Gap Cover* from as little as R330 a month!

Stratum Benefits have been offering award-winning Medical Aid Gap Cover for over a decade. For two years running, Stratum has won the FIA’s Product Supplier of the Year award. Visit Stratum Website >

2016 Health Insurance Product Supplier of the Year

2017 Health Insurance Product Supplier of the Year

With a range of affordable products, Stratum offers Gap Cover to suit every budget. No matter what Gap Cover* option you select, your cover will include:

Accidental disability or death

First time cancer diagnosis

Accidental Disability Or Death

You, your spouse and your dependents will be covered in the event of accidental disability or death. Stratum pays out a benefit amount should either of you become permanently disabled or passes away due to an accident.

First-time Cancer Diagnosis

Cancer is unfortunately on the increase and can be life altering should you not have cover. Stratum understands this and includes a payout benefit for members diagnosed with cancer for the first time in their life after taking out a policy.

2025 Updates

STRATUM BENEFITS
GAP COVER SERIES

View Or Download 2025 Brochure

Please note: Benefits and pricing are prone to change.

Stratum Benefits Gap Cover
2025 Updates

Benefits & Rand figures displayed are prone to change without notice, contact us for latest benefits & pricing.

Compact 300

Compact 300
Premium	Up to age 64: Single: R 330 Family: R 399
	Age 65 and over: Single or Family: R 629
	Full time student 26 or younger, may remain on the policy
	even if they are on a different medical aid. Must provide
	proof of studies: online learning and disance learning excluded.


Overall Annual Limit	R 210 580 per person per annum
Cover	300.00%
	Shortfall between the Medical Scheme Rate
	and the private rates (in-hospital) charged
	by the Medical Practioner or Specialist
	up to 300%


Co-Payment Cover	Limited to R 20 000 per policy
	Co-payments for usage of a non-network provider:Limited to R10 000 per policy per year
	Scopes: Subject to admission and procedure co-payment benefit
	MRI, PET and CT scans R3500 per person per event


Sub-limit benefit	Subject to Overall Annual Limit


	R 30 000 per admission for any internal prosthetic device that replaces a body part.
Oncology & biologicals	Subject to Overall Annual Limit
	Cancer top-up R60 000



Additional Benefits
Cover for Day hospital/ clinic or in-room procedure	No benefit
Primary Care	No benefit
Specialist consultant fee	No benefit



Emergency Room Cover - Accident and Emergency	R6000 per policy
Preventative Care	No benefit
Appliance benefit	R30 000 per policy per event
Trauma Counselling	R5000 per policy
Accidental Death	R15 000 principal, R15 000 spouse, R5000 other dependents 1 event per year
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

Meridian 400

Compact 300
Premium	Up to age 35 : Single: R 250
	Age 36-64 Single: R320
	Family 64 and younger R320 Fam and Single over 64 R698
	Full time student 26 or younger, may remain on the policy
	even if they are on a different medical aid. Must provide
	proof of studies: online learning and disance learning excluded.

Overall Annual Limit	R 210 580 per person per annum
Cover	400.00%
	Shortfall between the Medical Scheme Rate
	and the private rates (in-hospital) charged
	by the Medical Practioner or Specialist
	up to 500%


Co-Payment Cover	Admission and procedure co-payments subject to OAL
	Penalty co-payments: 1 co-payment up to R9000 per policy
	Scopes: 2 payments R4000 per policy
	MRI, PET and CT scans R5000 per person per event - sublimit
	MRI, PET and CT 2 Co-payments up to R4000 per co-payment
	per policy per year.
Sub-limit benefit	Internal prosthetic devices: 2 events up to R20 000 per event per year



Oncology & biologicals	R50000 per person for cancer shortfalls on your approved
	oncology plan



Additional Benefits
Cover for Day hospital/ clinic or in-room procedure	Illness benefit out of hospital: R3000: 2 events
Primary Care	No Benefit
Specialist consultant fee	No Benefit



Emergency Room Cover - Accident and Emergency	R9500 per event
Preventative Care	No Benefit
Appliance benefit	R20 000 per policy per event
Trauma Counselling	3 consults R2000 per policy
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

Elite 500

Elite
Premium	Up to age 64: Single: R 481 Family: R 591
	Age 65 and over: Single: R 780 Family: R 954

	Full time student 26 or younger, may remain on the policy
	even if they are on a different medical aid. Must provide
	proof of studies: online learning and disance learning excluded.

Overall Annual Limit	R 210 580 per person per annum
Cover	500.00%
	Shortfall between the Medical Scheme Rate
	and the private rates (in-hospital) charged
	by the Medical Practioner or Specialist
	up to 500%


Co-Payment Cover	Admission and procedure co-payments subject to OAL
	Penalty co-payments: 2 co-payments up to R15 000 per policy
	Scopes: Subject to admission and procedure co-payment benefit
	Robotic surgery: R10 000 pp pa
	MRI, PET and CT scans R5000 per person per event

Sub-limit benefit	Scopes: limited to R6000 per person per event
	Renal dialysis R40 000 per insured perso per event
	Prosthetic top up R10 000 per person
	Internal prosthesis R40 000 per insured person per event
Oncology & biologicals	Subject to Overall Annual Limit
	Cancer top up subject to OAL
	Breast reconstruction 1 event R30 000 per lifetime


Additional Benefits
Cover for Day hospital/ clinic or in-room procedure
Primary Care	No benefit
Specialist consultant fee	4 consults up to R1300 per policy



Emergency Room Cover - Accident and Emergency	R15 000 per policy
Preventative Care	R2000 per policy
Appliance benefit	R40 000 per policy per event ( prosthesis)
Trauma Counselling	R10 000 per policy
Accidental Death	R25000 principal, R25 000 spouse, R5000 other dependents
Child related illness

Gap Premium Waiver	12 months
Medical Aid Premium Waiver	6 months up to R4500 per month
Initial Cancer Diagnosis	No benefit
Hospital account shortfalls	No benefit

Step down or physical rehab	R10 000 physical rehab per person

Stratum Gap Cover Waiting Periods

General 3 Month Waiting Period

You, or your dependents will not be covered during this period, unless you claim for accidental events that occur after your policy start date.

12 Month Pre-existing Waiting Period

There is a 12-month pre-existing waiting period where you, or your dependents, are not covered for medical procedures, surgeries, or treatments. Any illness or medical condition that was diagnosed, received advice for or treatment for within 12 months before the start date of your cover.

Welcome to Stratum Gap Cover.

Stratum QUOTES MADE EASY