18 August 2025 – FA News
Tony Singleton, CEO at Turnberry Management Risk Solutions
Medical costs are rising rapidly, and medical inflation is outstripping the ability of medical aid schemes to keep up, even with annual premium increases.
The result is a dramatic escalation in medical expense shortfalls, from doctors and specialists charging many times the scheme rate to increasing co-payments and sub-limits, even on the top-of-the-range plans. Over the years, medical expense shortfalls can add up to significant sums of money that can affect savings and retirement. Protecting your health should never come at the expense of your financial wellbeing, which is why gap cover has become a must in today’s world. Gap cover offers a lifetime of financial protection and peace of mind, with value that only grows stronger as the years go by.
Financial security through life’s health challenges
These days, even the most comprehensive medical aid plans often do not cover the full cost of hospital stays or procedures. It has become increasingly common for specialists to charge significantly above the scheme rate, leaving patients out of pocket when it comes to paying for the shortfalls – unless you have gap cover. With a gap cover policy in place, you are protected against this unanticipated financial burden, which could otherwise put you in debt or force you to use your savings. This in turn can help you to stay on track with long-term goals like education, home ownership or retirement.
When you first join gap cover, there are typically waiting periods and exclusions, but once this period is over, you can enjoy peace of mind that you are covered for most medical expense shortfalls related to hospital stays. If you join when you are younger, it also often means that when you are over retirement age, you can still enjoy the reduced premiums of the younger age bracket, compared to joining when you are over the age of 60, when you will often have a higher, age-adjusted premium.
The growing gap as medical costs rise
There are many reasons why medical aid schemes are no longer able to cover the full cost of treatment for many procedures and conditions. Technological advancements and new treatments lead to improved outcomes, but they also come at a higher cost, so for patients who wish to make use of them, there will often be a co-payment or a sub-limit attached that they would have to pay for. Many hospitals and specialists are also increasing their tariffs, and medical aid schemes simply cannot keep pace while maintaining the affordability of premiums.
Gap cover has also evolved in response to these changes: benefits are reviewed regularly, and the Overall Annual Limit (OAL) increases every year to offer additional protection. Many gap cover providers have also expanded their offerings to include co-payments, oncology shortfalls, casualty visits, and even internal prostheses. There are also a number of flexible plan options that allow you to choose the right option suited to your budget and medical needs.
Cover for every stage of life
Gap cover is not just for retirees or families with young children; it offers lifelong protection through every age and life stage. In your 20s and 30s, accidents or unexpected procedures can come with hefty bills. Gap cover is a cost-effective safety net that covers you for this, as well as co-payments, emergencies, and more. In your 30s, 40s and 50s, gap cover helps you protect your financial stability while you are raising a family and navigating everything from maternity care to childhood illnesses, broken bones and sports injuries to the emergence of chronic illness. In your 60s and beyond, the comprehensive support of gap cover is invaluable as the risk of chronic conditions, surgeries, and specialist visits grows.
Over the course of a lifetime, the financial support a gap cover policy offers is invaluable. In just a few years, one Turnberry client has claimed over R678 000 for 44 treatments related to ureter cancer. Another, dealing with spinal issues, lupus, and GERD, claimed more than R478 000 across 27 incidents. A third client received over R450 000 for 54 claims linked to lung cancer, COPD, and spinal stenosis. Another claimed R448 000 for conditions including benign tumours, epilepsy, and chronic sinusitis. One more client, facing cancer, heart arrhythmia, and spinal issues, received more than R414 000 across 22 claims. These examples show just how powerfully gap cover can support people through complex, long-term medical journeys.
Our clients agree. “I have only been a member of Turnberry gap cover since April 2023. I have had the worst year ever with my health and have been hospitalised three times in the last year. I have needed to claim from Turnberry. I was quite embarrassed having only paid in for such a short time, but they covered everything without a quibble,” says one.
“We have been so impressed with Turnberry! I recently gave birth, and our medical aid did not pay for quite a substantial amount of the bills. We sent through the claims to Turnberry and had impeccable service,” says another.
“It helped make the birth of my daughter far more affordable, and we were able to get the care and surgeons we wanted without bearing the massive fees that medical aids don’t cover,” says a third.
The true value of gap cover
The true value of gap cover comes to life in the experiences of those who have needed it. These stories highlight the very real security that gap cover brings to people navigating not only serious health issues but also joyful occasions like the birth of a child. Gap cover is a smart, long-term investment in your health, that shields you from out-of-pocket expenses that even the best medical aid does not fully cover and adapts to your needs through every stage of life, from early adulthood to retirement. By staying continuously covered, you avoid exclusions and waiting periods and benefit from evolving protection as the healthcare landscape changes. Gap cover is more than just an insurance product; it is essential protection for your health and your financial future.
Invest in gap cover for a lifetime of financial protection and peace of mind
Client Testimonials
Turnberry have been absolutely amazing. Mitze was the consultant on our claim and she went above and beyond to assist us. The first claim was submitted online, thereafter when I tried to submit the form for another claim, the online form was not available. However, all claims were emailed to Mitze who ensured they were processed. If you want exceptional service and a hassel free claim process, use Turnberry.
The service we received Turnberry was outstanding. If I had to rate your company it would be 10plus! The turnaround was less than 5-working days – outstanding and so it goes on. Thank you!!!!! Michael
So far I have been very satisfied with each claim that I have submitted. I have been emailing my claims directly online on the website, and attaching all the relevant documentation. Does everyone need Gap Cover? ‘Do it, you never know when you might need it, trust me you won’t want to be without it!’ Tyrone Swart