2024 CURA GAP STUDENT COVER
Our Gap Student Cover is for Individuals between the ages of 18 and 27 and offers financial cover for health-related expenses at an affordable price for those who have become too old to stay on their parent’s policy but do not necessarily fit the Medical Scheme’s definition of a student. The insured will receive a benefit Benefits mainly covers in-hospital costs with additional extensive cover for those unplanned medical emergencies.
This is not a medical scheme, and the cover is not the same as that of a medical scheme. This policy is not a substitute for medical scheme membership.
What does Cura Student Cover entail?
| cover | annual limit | Benefit description |
|---|---|---|
|
Overall Annual Limit (OAL) of R201 000 per Insured (Limits are subject to regulatory amendments) |
||
| Gap Cover | No penalty shortfalls will be covered under this policy. |
The shortfall that arises after your medical aid has processed your account, as a result of the service providers charging above scheme tariff for authorised in-hospital procedures. The benefit pays up to 400% of medical scheme tariff less the higher of the amount paid by the scheme or the scheme tariff for in-hospital procedures or treatment. You must belong to a registered South African medical scheme to qualify for Gap Cover. |
| Cover for all Prescribed Minimum Benefits (PMB’s) |
R201 000.00 per Insured per annum. |
A set of defined benefits, as per the Medical Schemes Act, in terms of which all medical schemes must cover the costs related to the diagnosis, treatment and care of any emergency medical condition; a limited set of 270 medical conditions; and 27 chronic conditions. |
|
In-hospital Co-payments / Deductibles (Includes out-of-hospital MRI and CT scans) |
R15 000 per incident, subject to OAL | A co-payment or deductible is an upfront amount that needs to be paid to the hospital/day clinic/radiologist before undergoing certain procedures, as specified by your Medical Scheme. When you experience a co-payment for a procedure or scan (as specified by your Medical Scheme) you would need to pay for the co-payment up-front and then claim the amount back from your Cura Gap Policy. If your Medical Scheme pays for co-payments from your day-to-day benefits, you may still claim the amount. This benefit includes out-of-hospital MRI/CT scans. |
| Casualty Benefit | R15 000 per Policy per annum |
The cost of emergency medical treatment or a surgical procedure performed in the hospital casualty unit, should such cost not be covered by the medical scheme. Emergency Triage Index applies. (Include: Orange and Red triage). “Emergency” means the sudden and, at the time, unexpected onset of a health condition that requires immediate medical treatment and/or an operation. If the treatment is not available, the emergency could result in weakened bodily functions, serious and lasting damage to organs, limbs or other body parts, or death. The determination of an Emergency will be done through diagnosis (through classification by the attending Medical Practitioner and / or the Casualty Unit) and not on symptoms presented. Emergency Triage Index applies (Orange and red triage). Excluding medical appliances such as crutches, braces, wheelchairs, and take-home medication. |
| Dental Procedures | R3 000 per Policy per annum | The cost of emergency medical treatment or a surgical procedure due to accidental impact resulting in severe physical injury or due to cancer. Implants are not included as part of this benefit. |
Waiting periods:
- 3-month general waiting period.
- 12-month waiting period for pre-existing conditions.
- 9-month waiting period on pregnancy.
Maximum Entry Age:
The maximum entry age is age 26 (as at insured’s last birthday).
Premium:
| Entry Age | Monthly Premium |
|---|---|
| Between the ages of 18 and 27 | R182.00 per month |
Premiums (incl. VAT) are for a single person. Premiums are reviewed and may be adjusted annually.
Terms and conditions apply in terms of exclusions and claim procedures.
