Insurance & Medical Aid Brokers

Requirements before submitting a Gap Cover claim

  1. Copy of ID
  2. Proof of having been hospitalised
  3. A hospital pre- authorisation number for the procedure from your medical scheme
  4. Your specialist, ie your surgeon or your anaesthetist, having charged a higher rate than your medical scheme reimbursement rate, ie you have a shortfall
  5. Your medical aid statement showing your shortfall (Due by you)
  6. Gap Cover claim form