Gap cover is an insurance product designed to bridge the shortfall between the amount that medical aids cover and what healthcare providers, particularly specialists, charge for both in-hospital and certain out-of-hospital treatments. Often, medical specialists charge rates significantly higher than what medical aid schemes are willing to pay. This results in a gap, leaving the patient responsible for covering the excess costs.

Gap cover ensures that patients don’t need to worry about these unexpected costs, such as deductibles and co-payments, by covering the difference between the medical aid payout and the full cost of the medical treatment. This additional policy provides financial relief during hospital treatments and eliminates the concern of being underfunded for healthcare services.

Primary healthcare refers to the first level of healthcare aimed at providing essential and basic services to individuals and communities. It includes preventive care, health promotion, diagnosis and treatment of common illnesses, management of chronic conditions, maternal and child health, vaccinations, and basic emergency care.

In contrast, medical aid is a form of health insurance that covers a portion of healthcare expenses incurred by individuals. It typically provides access to a wider range of medical services, including specialist consultations, hospitalisations, surgical procedures, and prescription medications. While primary healthcare focuses on preventive and basic health services, medical aid is designed to protect individuals from high medical costs and ensure they receive comprehensive care when needed.