Gap Max
Bloom’s Gap Max cover is the premium and comprehensive answer to unexpected medical expenses. This option covers the shortfall between what your medical aid covers and what hospitals and specialists charge, with many added benefits.
If you want a more affordable cover, head to our Gap Core offering.

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Features of Bloom Gap Cover
In-Hospital Cover
Comprehensive protection against shortfalls in your medical scheme cover – for medical specialists and surgeons
Oncology Cover
Our oncology cover offers you the most comprehensive industry-leading protection against oncology co-payments and tariff shortfalls
Casualty Cover
Provides cover for emergency treatment at a casualty facility for accidents plus an additional rehabilitation benefit for sports injuries
Upfront Payments
Full cover for upfront payments or deductibles on diagnostic and surgical procedures
Affordable Premiums
Starting at just R217 for Gap MAX and R188 for Gap CORE, you get industry-leading protection at competitive premiums
Medical Second Opinion
When serious illness strikes you have access to a second opinion from the world’s leading medical minds to make sure you have the right diagnosis and treatment plan
Travel Cover
We will cover the excess payable on your travel insurance policy for claims on medical emergencies whilst travelling internationally
Claim Optimiser
Don’t be out of pocket – our Claim Optimiser will guarantee upfront payments to providers, meaning no out-of-pocket costs for you
What does the Gap Max Option cover? | ||||||||
Tariff Shortfalls
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Oncology Co-Payments
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Upfront Payments
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Limit Extender
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EXTENDER COVER | ||||||
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EXTENDER COVER | ||||||
Casualty Cover
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Travel Cover
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Cancer Diagnosis
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Extra Cover
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Accident Cover ¥
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Waiver Cover
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Your Monthly Premiums Explained
Bloom premiums are structured on the entry age of the oldest person joining the policy as well as the family size.
Our integrated Cover Pay Level (CPL) structure also recognises if you are on a richer medical scheme benefit option. If your benefit option covers medical specialists for in-hospital treatment at 200% or more of scheme tariff, then the CPL-200 premiums will apply to your cover. If the in-hospital medical specialist cover is at 100% of scheme tariff, then the CPL-100 premiums will apply.
Your Monthly Premiums Explained
Important to know
- The Cover Pay Level (CPL) is the percentage of the medical scheme tariff level at which your benefit option covers in-hospital medical specialists.
- Your premium and benefit calculations depend on the CPL
- Only your spouse and/or children are eligible as dependents on this policy and you must all be covered under the same medical scheme membership
- You or your spouse can be the principal member on your Bloom Gap policy
- A spouse dependent will be charged adult premiums
- Child dependents will be charged child premiums until they turn 24
and a maximum of two children will be charged per family - From 24 years, all children are charged adult premiums
- The Entry Age category is determined by the oldest person covered under your policy
- Premiums include VAT, broker commission and administration fees
- Premiums are adjusted on 1 January of each year in line with medical inflation
- Premiums are deducted in advance by debit order on the 1st working day of each month
- Corporate accounts are underwritten on a group basis and premiums may differ from those above.
- If you are a member of a corporate account, please contact us at bloom.insure/contact-us to confirm your premium