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    2026 published figures

    TRA gap cover 2026

    4 products taken from TRA's published 2026 documents, underwritten by Auto & General Insurance Company Limited (FSP 40815), administered by Total Risk Administrators (Pty) Ltd. Every figure below links to the source document.

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    The 2026 document we sourced does not restrict this policy to one medical scheme, so it should be available alongside any registered South African medical scheme. Gap cover always requires active medical scheme membership, so confirm your scheme and plan type are accepted before you sign.

    Lowest published premium: R99 a month

    4

    products in the 2026 data set

    R99–R681

    published monthly premium range

    300%, 700%

    cover level of the scheme rate

    3/4

    products stating co-payment cover

    How this compares

    TRA's cheapest published 2026 premium is R99 a month, which is cheaper than 25 of the 27 priced products we hold across 15 providers — the market median is R395 a month.

    • Cheapest that any medical scheme member can buy: Basic Cover 300 — R99/month (lowest premium with no scheme restriction)
    • Best for the highest shortfall multiple: Absolute Cover Plus — 700% (highest published cover level)
    • Best for the highest annual payout ceiling: Absolute Cover Plus — R226 881 (overall annual limit per person)
    • Best for cancer co-payment shortfalls: Absolute Cover Plus — 6 stated oncology benefits (oncology benefit detail itemised in the brochure)
    Compare all 40 products side by side

    Absolute Cover Plus

    Settles shortfalls up to 700% of the scheme rate

    700% cover
    Co-payment cover
    Oncology extender

    Monthly premiums (2026)

    Individual, under 65R681/month
    Individual, 65 and olderR846/month
    Family, under 65R681/month
    Family, 65 and olderR846/month

    Priced per policy, based on the age of the oldest beneficiary. No entry age limit.

    Limits and benefits

    Overall annual limit: R226 881 per insured person per year

    Co-payment cover: Included

    Casualty: Up to R24 255 per policy per year

    Oncology

    • Oncology gap shortfall: unlimited, subject to the annual limit
    • Oncology extender above the scheme limit: unlimited, subject to the annual limit
    • New-tech oncology drugs (e.g. Keytruda, Tagrisso): up to R18 191 per policy per year
    • Breast reconstruction shortfall: up to R38 588 per beneficiary per lifetime of the policy
    • Oncology co-payment (in network): unlimited, subject to the annual limit
    • Oncology co-payment (out of network): 2 per policy per year, combined up to R17 640

    Sub-limits

    • Global fee: Up to R26 460 per policy per year
    • Private ward: Up to R2 205 a day for 3 days
    • Scan sub limit: 2 scans per policy per year, up to R6 615 per scan
    • Premature birth: R20 000 per policy per year
    • Scope sub limit: Up to R24 225 per insured person per year (R6 300 per event)
    • Accidental death: R33 000 insured/spouse, R22 000 dependant
    • Psychiatric care: 21 days
    • Step down facility: R12 000 per insured person per year
    • Contribution waiver: 6 months, up to R7 275 a month
    • Internal prostheses: Unlimited, subject to the annual limit (up to R71 663 per event)
    • Specialist consults: 4 consults per policy per year (max R500 each)
    • Co payment in network: Unlimited, subject to the annual limit
    • Theatre ward consumables: R5 250 per policy per year
    • Co payment out of network: 2 per policy per year, combined up to R17 640
    • Emergency medical services: Unlimited, subject to the annual limit
    • Scan co payment out of hospital: 2 scans per policy per year, unlimited subject to the annual limit

    Waiting periods: No general 3-month waiting period. 10-month condition-specific waiting period for a listed set of conditions and procedures (including pregnancy and childbirth, joint replacements, hernias, cardiac, back and neck procedures, cataracts, ENT and endoscopic procedures). 6-month waiting period on pre-existing conditions. 9-month waiting period on cancer diagnosed before joining (2 years' remission may be accepted with medical evidence).

    Source: TRA Gap Cover 2026 brochure (updated aggregate limit)

    Basic Cover 300

    Settles shortfalls up to 300% of the scheme rate

    From R99 a month
    300% cover

    Monthly premiums (2026)

    Individual, under 65R99/month
    Individual, 65 and olderR394/month
    Family, under 65R197/month
    Family, 65 and olderR394/month

    Priced per policy, based on the age of the oldest beneficiary. No entry age limit.

    Limits and benefits

    Overall annual limit: R226 881 per insured person per year

    Co-payment cover: Not indicated

    Casualty: Up to R3 640 per policy per year (accidents, and children under 8 after hours)

    Oncology

    • Oncology gap shortfall: unlimited, subject to the annual limit

    Sub-limits

    • Dental: Unlimited, subject to the annual limit
    • Accidental death: R7 700 insured/spouse, R4 400 dependant
    • Psychiatric care: 21 days
    • Specialist consults: 1 consult per policy per year (max R500)
    • Theatre ward consumables: R525 per policy per year

    Waiting periods: No general 3-month waiting period. 10-month condition-specific waiting period for a listed set of conditions and procedures (including pregnancy and childbirth, joint replacements, hernias, cardiac, back and neck procedures, cataracts, ENT and endoscopic procedures). 6-month waiting period on pre-existing conditions. 9-month waiting period on cancer diagnosed before joining (2 years' remission may be accepted with medical evidence).

    Source: TRA Gap Cover 2026 brochure (updated aggregate limit)

    Super Cover Plus

    Settles shortfalls up to 700% of the scheme rate

    700% cover
    Co-payment cover
    Oncology extender

    Monthly premiums (2026)

    Individual, under 65R417/month
    Individual, 65 and olderR626/month
    Family, under 65R417/month
    Family, 65 and olderR626/month

    Priced per policy, based on the age of the oldest beneficiary. No entry age limit.

    Limits and benefits

    Overall annual limit: R226 881 per insured person per year

    Co-payment cover: Included

    Casualty: Up to R14 335 per policy per year

    Oncology

    • Oncology gap shortfall: unlimited, subject to the annual limit
    • Oncology extender above the scheme limit: up to R38 588 per policy per year
    • New-tech oncology drugs (e.g. Keytruda, Tagrisso): up to R9 040 per policy per year
    • Breast reconstruction shortfall: up to R19 845 per beneficiary per lifetime of the policy
    • Oncology co-payment (in network): up to R66 150 per policy per year
    • Oncology co-payment (out of network): 1 per policy per year, up to R5 513

    Sub-limits

    • Global fee: Up to R13 230 per policy per year
    • Private ward: Up to R550 a day for 3 days
    • Scan sub limit: 1 scan per policy per year, up to R3 969
    • Premature birth: R15 000 per policy per year
    • Scope sub limit: Up to R14 333 per policy per year (R3 780 per event)
    • Accidental death: R22 000 insured/spouse, R8 800 dependant
    • Psychiatric care: 21 days
    • Step down facility: R8 000 per insured person per year
    • Contribution waiver: 6 months, up to R6 060 a month
    • Internal prostheses: Up to R12 128 per policy per year
    • Specialist consults: 3 consults per policy per year (max R500 each)
    • Co payment in network: Up to R66 150 per policy per year
    • Theatre ward consumables: R3 150 per policy per year
    • Co payment out of network: 1 per policy per year, up to R5 513
    • Scan co payment out of hospital: 1 MRI/CT/PET scan per policy per year, up to R13 230

    Waiting periods: No general 3-month waiting period. 10-month condition-specific waiting period for a listed set of conditions and procedures (including pregnancy and childbirth, joint replacements, hernias, cardiac, back and neck procedures, cataracts, ENT and endoscopic procedures). 6-month waiting period on pre-existing conditions. 9-month waiting period on cancer diagnosed before joining (2 years' remission may be accepted with medical evidence).

    Source: TRA Gap Cover 2026 brochure (updated aggregate limit)

    Vital Cover Plus

    Settles shortfalls up to 700% of the scheme rate

    700% cover
    Co-payment cover

    Monthly premiums (2026)

    Individual, under 65R394/month
    Individual, 65 and olderR591/month
    Family, under 65R394/month
    Family, 65 and olderR591/month

    Priced per policy, based on the age of the oldest beneficiary. No entry age limit.

    Limits and benefits

    Overall annual limit: R226 881 per insured person per year

    Co-payment cover: Included

    Casualty: Up to R9 700 per policy per year

    Oncology

    • Oncology gap shortfall: unlimited, subject to the annual limit
    • Oncology co-payment (in network): up to R14 333 per policy per year

    Sub-limits

    • Accidental death: R11 000 insured/spouse, R6 060 dependant
    • Psychiatric care: 21 days
    • Contribution waiver: 6 months, up to R4 850 a month
    • Internal prostheses: Up to R5 775 per policy per year
    • Specialist consults: 2 consults per policy per year (max R500 each)
    • Co payment in network: Up to R14 335 per policy per year
    • Theatre ward consumables: R1 050 per policy per year

    Waiting periods: No general 3-month waiting period. 10-month condition-specific waiting period for a listed set of conditions and procedures (including pregnancy and childbirth, joint replacements, hernias, cardiac, back and neck procedures, cataracts, ENT and endoscopic procedures). 6-month waiting period on pre-existing conditions. 9-month waiting period on cancer diagnosed before joining (2 years' remission may be accepted with medical evidence).

    Source: TRA Gap Cover 2026 brochure (updated aggregate limit)

    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.