Welcome to Ambledown Medical Aid Gap Cover.
Ambledown QUOTES MADE EASY
Ambledown is one of the leading health insurance providers for all South African medical aid scheme members. Offering a variety of gap cover products to suit your specific needs & budget.
No Obligation Quotes & Free Broker Services
By simply filling in the form provided, one of our Gap Cover Experts will contact you via phone or email. Should you take out a Gap Cover policy, you will receive our market leading brokerage services free of charge.
- You must be a medical aid member.
- Fill in the form provided.
- We will contact you right back!
GET A QUOTE TODAY!
Ambledown Gap Cover
Family cover from as little as R 263 PM
As a private Medical Aid Scheme member, you would think that an in-hospital procedure would be covered in full, unfortunately this is not so. Consequently, most Medical Aid Schemes will only cover in-hospital services rendered by a Medical Specialist at the Medical Scheme Rate. Visit Ambledown Website >
- Medical Scheme Rate (MSR) is the amount your medical aid are prepared to pay for specific treatments and procedures.
- A Shortfall (Gap) is the difference medical practitioner’s charge above the Medical Aid Tariff (MST) rate for authorised in-hospital surgical and specific out of hospital procedures.
- The Gap is defined as services rendered by a Medical Practitioner who charges above the MST.
To sum up, when you are insured by Ambledown Gap Cover you will receive a benefit to cover the Gap for any authorised in-hospital procedures, subject to specified limitations.
In conclusion, the Gap Cover Series offer affordable Insurance Products that provide shortfall cover for you and your immediate family.
Ambledown Financial Services
2024 Product Launch Video
Ambledown Financial Services, recently announced its 2024 product offering at a virtual event hosted in partnership with Business Day. Read BusinessDay Article >
2023 Updates
AMBLEDOWN
GAP COVER SERIES
Please note: the brochures in the comparison tables below still have to be updated for 2024.
We will update the links as soon as Ambledown has updated their website.
Ambledown Products Compared
Benefits & Rand figures displayed are prone to change without notice, contact us for latest benefits & pricing.
Gap Cover 200
Per Family
18 to 65 y/o
From R 263.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- 3 x Medical Scheme Tariff
- Specialists
- General Practitioners
- Medical Professionals
66+ y/o – From R 366 p/m per family
T&C Apply
Gap Cover 100 *
Per Family
18 to 65 y/o
From R 422.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- 5 x Medical Scheme Tariff
- Co-payment Cover
- One penalty Co-payment
- Casualty Ward Benefit
66+ y/o – From R 639 p/m per family
T&C Apply
Gap Plus
Per Family
18 to 65 y/o
From R 532.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- 5 x Medical Scheme Tariff
- Gap 100 *
- Sub Limit Cover
- Cancer Cover
- Dread Disease Benefit
66+ y/o – From R 698 p/m per family
T&C Apply
Gap Select
Per Family
18 to 65 y/o
From R 627.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- 5 x Medical Scheme Tariff
- Gap 100 *
- Sub Limit Cover
- Cancer Cover
- Dread Disease Benefit
66+ y/o – From R 912 p/m per family
T&C Apply
Gap Supreme
Per Family
18 to 65 y/o
From R 677.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- 5 x Medical Scheme Tariff
- Gap 100 *
- Sub Limit Cover
- Cancer Cover
- Dread Disease Benefit
- Premium Waiver Benefit
66+ y/o – Not available
T&C Apply
LPE Advanced
Per Family
18 to 65 y/o
From R 420.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- 5 x Medical Scheme Tariff
- Gap 100 *
- Casualty Ward Benefit
- Medical expenses for 10 defined procedures
66+ y/o – From R 623 p/m per family
T&C Apply
Guardian
Per Family
18 to 65 y/o
From R 222.00 p/m
In-Hospital Benefits
- R198,660 Per insured person per annum
- Co-payment Cover
- One penalty Co-payment
- Casualty Ward Benefit
- Sub Limit Cover
- Cancer Cover
- Dread Disease Benefit
- Premium Waiver Benefit
- Stand-alone policy
66+ y/o– From R 315 p/m per family
T&C Apply
Ambledown Gap Cover Waiting Periods
3-Month General Waiting Period
There is a general 3-month waiting period where no benefits will be payable for treatment received. During this three-month period, you will be covered for treatment as a result of an accident.
12-Month Pre-existing Waiting Period
During the first 12 months, a pre-existing clause applies. This clause excludes claims for any treatment or advice that has been received in the 12 months prior to the start of the policy. After the membership has exceeded 12 months, then all benefits are payable regardless of the date the illness or injury occurred.
