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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!

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Ambledown Gap Cover

Family cover from as little as R 241 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 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 241.00 p/m

In-Hospital Benefits

  • R177,800 Per insured person per annum
  • 3 x Medical Scheme Tariff
  • Specialists
  • General Practitioners
  • Medical Professionals

66+ y/o – From R 342 p/m per family

T&C Apply

Gap Cover 100 *

Per Family
18 to 65 y/o
From R 347.00 p/m

In-Hospital Benefits

  • R177,800 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 550 p/m per family

T&C Apply

Gap Plus

Per Family
18 to 65 y/o
From R 441.00 p/m

In-Hospital Benefits

  • R177,800 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 601 p/m per family

T&C Apply

Gap Select

Per Family
18 to 65 y/o
From R 520.00 p/m

In-Hospital Benefits

  • R177,800 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 786 p/m per family

T&C Apply

Gap Supreme

Per Family
18 to 65 y/o
From R 562.00 p/m

In-Hospital Benefits

  • R177,800 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 355.00 p/m

In-Hospital Benefits

  • R177,800 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 527 p/m per family

T&C Apply

Guardian

Per Family
18 to 65 y/o
From R 183.00 p/m

In-Hospital Benefits

  • R177,800 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/oFrom R 269 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.

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