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Bloom Gap Options

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    Gap Options Benefits

    Bloom Gap cover is a way to ensure that you’re covered for medical expense shortfalls. Gap cover works in conjunction with your medical aid to provide you with better financial support when you need it.

    We’ve partnered with Cinagi to offer our members affordable gap healthcare solutions for the South African market. There are two gap category plans available and each plan provides a wide range of benefits.

    Gap Core Gap Max
    A quick comparison of our Gap Cover benefits
    Tariff Shortfalls
    Overall Annual Limit (OAL) for Gap Cover Benefits R198,660 pppa R198,660 pppa
    We cover medical specialists for treatment or surgery provided in hospital We cover medical oncologists
    for treatment provided in or out of hospital
    Benefit Enhancement up to 600% Benefit Enhancement up to 600%
    We cover medical specialists for out-patient procedures that would attract a co-payment if performed in
    hospital
    Subject to OAL Subject to OAL
    We cover gynaecologist or GP consultations during the 2nd and 3rd trimester of pregnancy R600 per consult
    R24,400 per pregnancy
    R600 per consult
    R24,400 per pregnancy
    Oncology Co-Payments
    We cover the 20% co-payment applied after reaching the oncology threshold Subject to OAL Subject to OAL
    We cover the 25% and 50% co-payments applied to approved precision medicines R12, 500 per claim Subject to OAL R15, 000 per claim Subject to OAL
    If your medical scheme approves ex-gratia benefits for oncology medicines, we will provide additional
    cover for your portion of the costs
    R12, 500 per claim/ R25, 000per
    medicine cycle Subject to OAL
    R15,000 per claim/ R30, 000per
    medicine cycle Subject to OAL
    Upfront Payments
    We cover fixed rand value upfront payments for MRI/CT/PET scans, in-hospital endoscopes, in-hospital
    basic dentistry and defined medical procedures
    Subject to OAL Subject to OAL
    We cover other upfront payments (including robotic surgery) R14,000 per event R22,000 per event
    We cover upfront payments for voluntary use of non-network hospital/day clinic R12,000 per event max 1 pa R18,000 per event max 2 pa
    Limit Extender
    We cover shortfalls when a sub-limit applies to internal prosthetic devices R44,000 per event R64,000 per event
    We cover shortfalls when a sub-limit applies to MRI/CT/PET scans, endoscopes and intra-ocular lenses R5,800 per event R7,000 per event
    Gap Core Gap Max
    Extender Cover
    Casualty Cover
    Cover for emergency treatment at a casualty facility resulting from an accident R14,000 per event | max 2 pa R18,000 per event | max 2 pa
    If the accident was a sports injury, we will also cover shortfalls on rehabilitation consultations R460 per consult | max 6 pe R680 per consult | max 6 pe
    Travel Cover
    Cover for the excess on your international travel insurance for medical emergencies R2,400 per departure R3,400 per departure
    Cancer Diagnosis
    For a first lifetime cancer diagnosis made after inception of the policy and waiting periods. R30,000 Lump Sum R40,000 Lump Sum
    If after diagnosis you upgrade your medical scheme benefit option at the first upgrade opportunity, we
    will provide a waiver for the additional contributions *
    R14,000 per event R4,000 pm for 12 Months
    Extra Cover
    For an admission resulting from an accident and where the admission is 3 days or longer Daily Lump Sum
    Payable: Tier 1 pays from day 1 to 7 and Tier 2 pays
    from day 8 to 28
    Tier 1 = R110 per day
    Tier 2 = R1,100 per day
    Tier 1 = R160 per day
    Tier 2 = R1,600 per day
    For a premature Birth that is 42 Days or more earlier
    than the expected due date
    R15,000 per event R20,000 per event
    Accident Cover
    In the event of accidental death or permanent disability caused by an accident R44,000 per event R64,000 per event
    If the event was a direct result of a proven crime, an additional benefit is payable R5,800 per event R7,000 per event
    Waiver Cover
    In the event of accidental death or permanent disability
    of the principal member or spouse, we will cover the
    cost of the medical scheme contributions and gap
    cover premiums
    R44,000 per event R64,000 per event

    In partnership with Cinagi

    By joining forces with Cinagi, Bloom Financial Services strengthens its ability to meet the healthcare and insurance needs of our valued customers. Together, we will distribute a range of high-quality, relevant, and fairly-priced products to as many South Africans as possible. With our shared values of honesty, integrity, hard work, fairness, and customer-centricity, we are a perfect match to deliver exceptional healthcare solutions to the South African market.

    We are thrilled to have Cinagi as our partner in this journey. With their expertise and our unwavering commitment to our customers, we are poised to become market leaders in the healthcare industry.

    Experience the power of our partnership for quality healthcare. Contact us today to explore the wide range of products and services we offer. Together, let’s unlock a healthier future for South Africa.

    Your journey to quality healthcare starts here.

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    Momentum Health4Me is not a medical scheme product, and is not a substitute for medical scheme membership. The information provided on this website does not constitute advice in terms of the Financial Advisory and Intermediary Services Act. Momentum is a division of Momentum Metropolitan Life Limited, an authorised financial services provider (FSP 6406) and a wholly owned subsidiary of Momentum Metropolitan Holdings Limited.

    Bloom Gap Cover is not a medical Scheme. Products that are offered are not the same as that of a medical scheme.

    © Bloom Financial Services 2023. Bloom Financial Services (Pty) Ltd is an authorised financial services provider (FSP 50140). Bloom Gap is underwritten by Infiniti Insurance Limited a licensed non-life insurer and an authorised financial services provider (FSP No.35914)

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