How does the Agility Gap & CoPay Cover protect me from in-hospital shortfalls and procedure co-payments?

The Agility Gap & CoPay Cover pays up to 500% of medical aid rate payments for in-hospital shortfalls, covers penalties for using non-network hospitals, and offers unlimited cover for procedural co-payments. It also includes extensive emergency, maternity, and PMB cover, plus benefits like private room upgrades and robotic-assisted surgery. This means you can avoid unexpected medical bills without upgrading your medical aid, ensuring peace of mind during hospital stays.

What options does Agility offer to suit different budgets and medical needs?

Agility provides two main Gap/Top Up options: 1) Comprehensive specialised shortfall cover plans with 200% to 500% cover for specialist fee shortfalls, and 2) Combined Gap and CoPay plans that cover both shortfalls and co-payments for procedures, including MRI and CT scans. These flexible plans let you choose the best cover level for your budget and medical requirements, ensuring comprehensive protection against high medical costs.

Why is joining a Gap and CoPay plan essential despite having medical aid?

Medical aids often do not cover full hospital bills, with doctors and specialists charging up to 5 times the medical aid rate and co-payments increasing for expensive procedures. Without Gap and CoPay cover, you risk paying large out-of-pocket expenses. Joining a Gap/Top Up plan today bridges this gap, protecting you from costly shortfalls and co-payments, so you can stay stress-free and financially secure.

What additional benefits does the Agility Combined Range include beyond basic gap cover?

The Agility Combined Range offers full cover for in-hospital short payments, co-payments for MRI & CT scans, and procedural admissions with options covering 200%, 400%, and 500% of medical aid rates. Higher plans include cover for sub-limits, robotic-assisted surgery shortfalls, private room upgrades, oncology shortfalls, premature birth, outpatient consultations, maternity scans, emergency room visits, and trauma counselling - comprehensive protection.

How can I get started with the best Gap/Top Up plan for my needs and budget?

Investigate the Agility Gap & CoPay plans with cover from 200% to 500% of medical aid rates. Join now and get financial protection against hospital shortfalls and co-payments. Don't wait for unexpected medical bills - contact us today and enjoy peace of mind with extensive cover and valuable benefits tailored just for you.

Gap/Top Up insurance | An Excellent Top Up Insurance to Join

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A Gap/TopUp Insurance Plan pays in-hospital shortfalls and procedure co-payments

Have you ever had hospital bills short-paid?

Or a co-payment charged for a specific treatment or procedure?

Private doctors and specialists can charge what they want, often up to 5 times what your medical aid pays!
Medical aids are increasingly charging co-payment for expensive procedures.
Procedures like knee replacement surgery, colonoscopies, or using hospitals outside of your medical aid’s network.

The only way to address the threat of you having to pay these high medical expenses is to join a Gap and CoPay plan today.

Many medical aid members have already done this and are stress-free medical aid members.

The Agility Gap & CoPay Cover gives you:

More in-hospital medical cover (up to 500% of medical aid rate payments), without needing to upgrade your current medical aid.
Pays the penalty if you use non-network hospitals
Unlimited cover for procedural co-payments across all the options
Extensive medical emergency cover
Maternity cover
PMB cover
Gap and medical scheme premium waiver benefits
A Hospital Booster Benefit (which covers private room upgrades, in-hospital sub-limits & robotic-assisted surgery)

Through a variety of cover levels, Agility offers you a choice of options to best suit your needs and budget.

comprehensive medical aid gap and top up There are 2 main options:

1. The Agility Range of comprehensive, highly specialised mediocal aid shortfall cover plans are suitable for all budgets.

Guaranteed to cover the difference between your medical scheme rate and what your doctor or hospital charges for an in-hospital procedure.

There is a choice of 200% to 500% cover for in-hospital specialist fee shortfalls, exceeding your medical aid’s limits.

2. The Agility Combined Range of integrated Gap and CoPay benefits.

Covers benefit shortfalls, where your doctor or hospital charges more for an in-hospital procedure than what your medical scheme will cover, as well as any out-of-pocket contributions that you may need to pay towards an in-hospital procedure.

They include full cover for in-hospital professional fee short payments, co-payments related to MRI & CT scans, as well as procedural admissions to hospital across a range of 200%, 400% & 500% of medical aid rates.

The Combined 400, Combined 500 and Ultra options include cover for in-hospital sub-limits, robotic-assisted shortfalls and private room upgrades.

Other benefits are:

Oncology Shortfall Benefit
Premature Birth Cover
Extensive out-patient cover including emergency room benefits, physiotherapy consultations and more
Procedures performed as an in-patient or as an out-patient (specified list of procedures), as well as MRI, CT, and Ultrasound scans.
Outpatient Benefits - Comprehensive cover for out-of-hospital in-room procedures, consultations, including GP, Specialist, Dentist, Physio & Psychology Consultations
Maternity benefits during pregnancy - Lump-sum benefit activated after first trimester, 2D, 3D, 4D Scans (in-and-out-of-hospital)
Emergency Room Benefit - covers all beneficiaries on the policy without age limitations or reasons for emergency visits. All treatments and consultations for Trauma, Accident & Illness will be covered up to the annual benefit per policy, regardless of any payment by the medical aid.
Trauma Counselling Benefit - Cover in the event of an unplanned traumatic incident, including accidents or events of violence leading to physical injury or psychological trauma. This benefit provides consultations with registered psychologists, psychiatrists, or counsellors.

agility gap benefits

No medical aid member can afford to be without Gap/Top up cover.

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You must consult the schemes/company product brochures and rules for comprehensive benefit descriptions.

083 655 2164

You must consult the schemes/company product brochures and rules for comprehensive benefit descriptions.

Medical aid pays healthcare costs.
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Your Trusted and Qualified Financial Advisor

Peter Pyburn - Authorised Financial Services Provider has been fully licensed to provide expert financial services since 1991.
Based in Sandton, Johannesburg, Gauteng, we specialise in comprehensive financial planning including: Death and Disability Cover, Retirement Planning, Investment Strategies, Medical Aid, Estate Planning
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Important Disclaimer: This content is for informational purposes only and does not constitute financial or healthcare advice.
Medical aid benefits are subject to change. Please consult the medical aid brochure and speak to me before making any decisions.

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Last verified: November20, 2025

Gap/Top Up insurance

An Excellent Gap Plan to Join