Oneplan Gap Cover

With Oneplan Gap Cover, you know exactly what you're covered for. There is no complicated jargon, confusing benefits, long claims processes or high monthly premiums.

WHAT IS GAP COVER?


Gap cover is a handy add-on to your medical aid that provides financial assistance when you have run out of your Medical Scheme Savings or if you have reached your day-to-day benefit sub-limit. Oneplan Gap Cover includes Out- and In-Patient benefits such as in-hospital shortfalls, co-payments, and other deductibles at an affordable monthly premium.


WHY DO I NEED GAP COVER?


While medical aids cover a significant portion of expenses, they often have limits on procedures and specialist fees. Gap health cover acts as a supplementary layer, filling the GAP between what your medical aid covers and the actual costs of treatment, especially when specialists charge above medical aid rates. This additional cover helps protect you against unexpected medical bills so you can get the best health care possible without worrying about significant out-of-pocket expenses.

WHY CHOOSE ONEPLAN GAP COVER?

No sub-limits. We double or quadruple the scheme payout. No fuss, no complications.

Cover from a trusted brand that delivers what we promise.

We pay shortfalls and co-payments, even when you are within your MSA Savings Threshold.

Cover for mental health conditions when not related to a self-inflicted injury

Added Cancer cover. All cancers are covered, no questions asked (subject to like-for-like and pre-existing waiting periods)

Accidental Death Cover and HIV Treatments at no extra premium



Oneplan Insurance has an average rating of 4.53
from 16 658 reviews | 10/10 Trust Index

JULIANNA

2024-05-11 10:04:00

Oneplan amazing gesture with outstanding hospital bills.

"I am a Oneplan Health insurance member, I have been for a number of years. The company as amazed me and my family with the extended financial help for my late husband’s hospital bills. The staff Ronald and Renee literally held my hand in helping me with the shortfall for my latest husband hospital bills. I have been previously with other medical aids and never experience such compassion and financial aid from a medical scheme. I was holding my head with the bills that I had to pay When Renee called me to say they will handle my bills. I am writing this with tears in my eyes as no one has helped as much as ONEPLAN. Love the company and what they stand for."

Sanelisiwe

2023-10-31 16:02:00

Best healthcare insurance provider

"I have had the privilege of being a policyholder with an outstanding medical insurance provider for the past four years. Throughout this time, my experience has been nothing short of exceptional. From general practitioner consultations to comprehensive maternity coverage, the services provided have consistently surpassed my expectations. I hold only positive feedback for the quality and reliability of this insurance."

Jeanett M

2023-06-22 10:04:00

First time using Oneplan health insurance

"First time using Oneplan health insurance and when I needed to consult for medical check up, I simply put my claim through via their app and in less than 20min my claim was approved, funds were loaded into my Oneplan card hassle and stress free.First time using Oneplan health insurance and when I needed to consult for medical check up, I simply put my claim through via their app and in less than 20min my claim was approved, funds were loaded into my Oneplan card hassle and stress free. One of the Best decisions I've made this year was to take up a cover with Oneplan."

Kobus K

2023-06-02 08:57:00

I’ve been on Oneplan ...

"I would like to write a review about Oneplan Insurance. Oneplan Health is the best, they go out of their way for clients, I spoke to a consultant this morning and to Anele on WhatsApp. They are fast to respond and always try to assist, I have had a few medical emergencies this year and I am safe knowing I am on Oneplan health ... you guys are amazing and will recommend you to everyone."

Caroline M

2022-06-22 09:018:00

I would like to writ...

"I would like to write a review about Oneplan Insurance. Oneplan Health is the best, they go out of their way for clients, I spoke to a consultant this morning and to Anele on WhatsApp. They are fast to respond and always try to assist, I have had a few medical emergencies this year and I am safe knowing I am on Oneplan health ... you guys are amazing and will recommend you to everyone."

Melinda T

2022-07-01 10:14:00

I received fast and ..."

"I received fast and efficient service from Busisiwe Motha this morning on uploading my health claim invoice which was finalised within 15 minutes."

Dominique

2024-07-02 13:02:00

Outstanding service

"I'm thrilled to be celebrating my one-year anniversary with the Oneplan family! The professionalism and expertise of the consultants I've worked with continue to impress me. A special shoutout to Mapula Khakhathiba for her exceptional guidance and patience in addressing my queries. Her dedication to ensuring I had all the information I needed was truly appreciated. Thank you, Mapula, and the entire Oneplan team, for an outstanding experience!"

Helene

2024-03-22 13:19:00

It has been an amazing experience from start to finish

"It has been an amazing experience from start to finish. The service that we get from Oneplan and that I got from Sibusiso is phenomenal. They always try to help and assist you. My husband and I are so grateful for affordable and high quality health care. We have recently moved from medical aid to Oneplan health insurance and the benefits are way more than we are used to and our premium is so affordable. Keep it up with the amazing service and quality health care Oneplan. We will continue to tell everyone we know about you."

Beryl G

2024-06-03 14:26:00

They are always so helpful

"They are always so helpful. My husband was admitted to hospital recently and I can say that we had absolutely no issues at all at the hospital with them accepting Oneplan. Thank you Oneplan. It’s great to have peace of mind should you need to go to hospital."

Daniel

2023-07-07 14:36:00

Excellent Service, Again

"I am a double amputee and recently slipped with my prosthetic legs and broke my right femur (multiple fractures). I was transported by ambulance to Mediclinic casualty and received surgery soon thereafter. Oneplan covered my entire accident, from the emergency ambulance care to the day I was discharged from hospital. I am so impressed and relieved. Thank you so much!"

FIND YOUR PLAN

Core Plan
from
R220
per month
Executive Plan
from
R285
per month
Core Plan
from
R220
per month
Executive Plan
from
R285
per month

HOW TO CLAIM


To submit a claim to your GAP Cover policy, simply WhatsApp (083 794 5452) or e-mail (gapclaims@oneplan.co.za) the payment statement from your Medical Scheme after the Insured event. You may need to send supporting documentation like proof, medical evidence, or information in writing as reasonably requested by the Insurer. All claims are processed within 7 days from the date of receiving ALL required documents, considering the latest document’s submission date if provided separately.


ANSWERS TO YOUR FREQUENTLY ASKED QUESTIONS (FAQs)


Do I have to have medical aid cover to have GAP Cover?


Yes. GAP Cover helps you to claim in the event you have exhausted your medical aid savings or encounter situations where your medical aid cover is insufficient, which means you can only get a GAP Cover policy if you have proof of an existing medical aid policy. If you are interested in getting medical cover that’s more affordable than medical aid, you can head over to Oneplan Health Insurance to see our range of comprehensive, affordable healthcare plans here.


Can I cover my children or spouse only or must it be the whole family?


You have the option to get cover for yourself only, or for a family, or only certain members of your family. You have the option to cover a family up to four on the Oneplan Core or Executive GAP Cover Plans.


Is gap cover an insurance or medical aid benefit?


Medical Aids are regulated by the Medical Schemes Act, whereas gap cover is short-term insurance product which, together with your medical aid, provides top-up health cover up to certain limits. The purpose of cover is to provide additional financial protection to medical scheme members who receive in-hospital treatment and care so that they are not saddled with large out-of-pocket expenses following a hospital event.

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