Get an Instant Quote (2022)

Simply fill out the short, no-obligations form below to instantly see how affordable Gapwise cover can be.
For plans that commence in 2022 and valid for the remainder of 2022 only. Click here for 2023 quotes.

"*" indicates required fields

Personal & Contact Details*

Your premium will be displayed instantly - you won't have to wait for an email or phone call.

First Name*

Surname*

Cell Number*

Email*

Contact Preference*

Time to Contact*

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Cover & Plan

Cover & Plan Details*

Here you can select your level of cover and the plan you wish to receive a quote on.

Single or Family?*

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Dependants

Number of Dependants per Age Group*

You may add only dependants that are on your medical aid scheme.
If you have no dependants in an age group, simply leave the field blank.
Ensure that the respective age group selections are correct for the month when you would want cover to start (this month, next month or the month after next).
NOTE: Dependants only - the Principal Insured should not be counted here.

0 to 18

Dependants 0 to 18

Please enter a number greater than or equal to 0.

19 to 24

Dependants 19 to 24

Please enter a number greater than or equal to 0.

25 to 34

Dependants 25 to 34

Please enter a number greater than or equal to 0.

35 to 44

Dependants 35 to 44

Please enter a number greater than or equal to 0.

45 to 54

Dependants 45 to 54

Please enter a number greater than or equal to 0.

55 to 64

Dependants 55 to 64

Please enter a number greater than or equal to 0.

Over 64

Dependants over 64

Please enter a number greater than or equal to 0.

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Principal

Age Group of the Principal Insured*

Age Group of Principal Insured*

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C 18 to 24

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C 25 to 34

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C 35 to 44

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C 45 to 54

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C 55 to 64

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C Over 64

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Principal Rate - Comprehensive

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U 18 to 24

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U 25 to 34

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U 35 to 44

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U 45 to 54

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U 55 to 64

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U Over 64

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Principal Rate - Ultra

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Comprehensive Policy Fee

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Ultra Policy Fee

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Dependants Rate - Comprehensive

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Dependants Rate - Ultra

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Total Rate Comprehensive

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Total Rate Ultra

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Monthly Premium - Comprehensive

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Monthly Premium - Ultra

Name

This field is for validation purposes and should be left unchanged.

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