Most of us shop for a medical aid first and think about gap cover later, then get a surprise bill that neither one fully covers. So we asked our software to do something simple: look at every 2026 plan and gap policy we have, and put together the pairs that make sense for six kinds of households — with the honest monthly total for both.
These pairings are generated by our AI-assisted system, not by a person. It reads the published 2026 contributions, premiums, limits and benefit wording in our data set and works out combinations it believes fit well together. Every rand figure comes straight from the source documents — but the pairing itself is our software's view, not financial advice, and not a recommendation to buy. Please read the policy documents and chat to an accredited adviser before you sign anything.
One rule we build in: a gap policy only appears next to a medical scheme you could actually buy it with. Discovery Gap Cover, for example, is sold to Discovery Health Medical Scheme members only, so it never gets paired with a Bonitas, Momentum, Fedhealth, Medihelp or Medshield plan, and it is left out of the typical gap premium used in the comparison table further down.
Find the household closest to yours. For each one we picked the plan and the gap policy using a single clear rule — the cheapest option, the widest chronic list, or the biggest shortfall cover — then added the two premiums so you can see the real monthly figure. At the bottom of each card we also show what the same household would pay on the cheapest comprehensive plan, so you can see what you would be giving up.
A single member with no chronic medication who wants the specialist bill covered rather than day-to-day visits.
Same household on Momentum Extender Option, the cheapest comprehensive plan in the data set: R7 939 a month — R6 685 more than this pairing, and it adds day-to-day benefits this pairing does not have. See that plan
Gap cover source brochureA family that needs everyone on one medical scheme and one gap policy priced per family rather than per person.
Same household on Momentum Extender Option, the cheapest comprehensive plan in the data set: R18 630 a month — R15 865 more than this pairing, and it adds day-to-day benefits this pairing does not have. See that plan
Gap cover source brochureRetired members, where gap premiums step up with age and specialist use tends to rise.
Same household on Momentum Extender Option, the cheapest comprehensive plan in the data set: R7 939 a month — R5 600 more than this pairing, and it adds day-to-day benefits this pairing does not have. See that plan
Gap cover source brochureSomeone whose medication list matters more than the hospital ward, and who still faces specialist shortfalls.
Same household on Momentum Extender Option, the cheapest comprehensive plan in the data set: R7 939 a month — R1 982 less than this pairing. See that plan
Gap cover source brochureMembers who want the oncology co-payment shortfall in writing, not assumed.
Same household on Momentum Extender Option, the cheapest comprehensive plan in the data set: R7 939 a month — R2 446 less than this pairing. See that plan
Gap cover source brochurePlanned surgery or a specialist who charges well above the scheme rate.
Same household on Momentum Extender Option, the cheapest comprehensive plan in the data set: R7 939 a month — R5 207 more than this pairing, and it adds day-to-day benefits this pairing does not have. See that plan
Gap cover source brochureIt is the question we get most, so here is the maths for a single member. For each scheme we took its cheapest hospital plan, added a typical gap premium of R426 a month, and put that next to the same scheme's cheapest comprehensive plan. Cheaper does not automatically mean better: a comprehensive plan also pays for GP visits and dentistry, and gap cover never does.
| Scheme | Hospital plan | + gap cover | Cheapest comprehensive | Difference |
|---|---|---|---|---|
| Fedhealth | flexiFEDSavvy Hospital R1 155/m | R1 581/m | maxima EXEC R12 273/m | R10 692 cheaper paired |
| Profmed | ProSelect Savvy R2 477/m | R2 903/m | ProPinnacle Savvy R13 534/m | R10 631 cheaper paired |
| Bonitas | Hospital Standard R3 561/m | R3 987/m | BonComprehensive R12 509/m | R8 522 cheaper paired |
| Discovery Health | KeyCare Core R1 490/m | R1 916/m | Classic Smart Comprehensive R8 576/m | R6 660 cheaper paired |
| Medihelp | MedVital R3 096/m | R3 522/m | MedElite R8 922/m | R5 400 cheaper paired |
| Momentum | Custom Option R2 585/m | R3 011/m | Extender Option R7 939/m | R4 928 cheaper paired |
| Medshield | MediCore R4 278/m | R4 704/m | MediBonus R9 015/m | R4 311 cheaper paired |
| CompCare | HospiCare R5 192/m | R5 618/m | UltraCare R9 014/m | R3 396 cheaper paired |
People usually ask this when one policy has a benefit the other is missing. The cost is easy enough to work out: the two cheapest single-member policies in our 2026 data set would come to R316 a month together — R99 for TRA Basic Cover 300 and R217 for Stratum Benefits Access Optimiser.
The catch is that the second premium does not double what you get back. Gap cover is indemnity insurance — it pays back the shortfall you were actually charged, so the second policy can usually only cover what the first one left behind. Before paying two premiums, look for the "other insurance" clause in both policy documents.
More often than not, that money does more good moving you up one cover level on a single policy. The published cover percentages differ by hundreds of percentage points, and it is that multiple which decides whether a specialist bill is settled. Compare the published cover levels.
Your plan decides which hospitals you may use, and no gap policy can get you into a hospital the plan excludes. Look at the network first, then worry about the premium.
A cover percentage is a multiple of the scheme rate. If your surgeon charges three times that rate, a policy that only goes to 200% will still leave you with a bill.
Gap cover only steps in for in-hospital shortfalls. GP visits, dentistry and glasses come out of your plan's day-to-day benefit, or out of your pocket.
A cheap plan with a pricey gap policy can end up costing more than one mid-range plan. The number that matters is what leaves your account each month, in total.
Your scheme and your gap policy each run their own waiting periods. Starting both in the same month is usually simpler than staggering them.
Gap policies cap individual benefits — casualty visits, co-payments, oncology — inside the overall annual limit. That small print is where claims get declined.
It depends on the numbers for the scheme you are on. Using the median single-member gap premium of R426 a month, 8 of the 8 schemes in our 2026 data set work out cheaper as a hospital plan plus gap cover than as that scheme's cheapest comprehensive plan. The comparison table on this page shows the rand difference for each scheme. Bear in mind the two options do different jobs: a comprehensive plan adds day-to-day benefits, while gap cover only pays in-hospital shortfalls.
Nothing in the products we reviewed stops you buying two, and the cheapest two single-member policies in our 2026 data set would cost R316 a month combined. The catch is that gap cover is indemnity insurance — it reimburses the shortfall you were actually charged, so a second policy can generally only pay what the first one did not. Read the "other insurance" clause in each policy wording before paying two premiums, and speak to an accredited adviser.
Gap cover is sold to members of a registered medical scheme, and every product in our data set requires an active scheme membership. It is not a substitute for a medical scheme and it cannot be bought on its own.
In our 2026 data set the combinations below run from R1 254 to R10 385 a month, depending on household size and whether the plan is hospital-only or comprehensive. Judge a pairing on the combined monthly figure, not on the gap premium alone.
The combinations on this page are put together by our AI-assisted system from published 2026 figures. They are a starting point for your research, not a recommendation, and not a substitute for advice from an accredited financial or healthcare adviser. Premiums, limits and benefits change, and what suits one household can be a poor fit for the next. Always read the scheme and policy documents in full, confirm the numbers with the provider, and get advice about your own situation before you sign up for anything.
Gap cover is not a medical scheme and is not a substitute for medical scheme membership. Premiums and benefits are for 2026 and may change — confirm current terms with the provider before deciding. Information only; not financial advice.