More often people are shocked when health insurance covers fail to foot the entire hospitalisation costs. However, you can learn about Ambledown medical shortfall plan that helps bridge the gap.
Ordinarily, health covers have set limits and pay out accordingly. However doctors impose rates higher than the medical tariffs, and consequently, patients end up suffering more. Such unforeseen costs can turn out to be way too high. These costs can also have a significantly huge effect on your budget and savings.
More About Ambledown Medical Aid Shortfall Cover
What Gap Cover Can Do
That’s where Gap plans come in, with Ambledown paying the shortfall between medical rates and what you are required to pay.
What Ambledown medical shortfall Cover offers:
- Hospital treatments
- Outpatient chemotherapy and radiotherapy
- And also outpatient dialysis
Limits to the cover
- Ambledown provides an annual limit of R2 million
- The cover caters for up to five times the MST limits
- The cover does not include hospital bills
- The does not contain prosthesis, medication, and material costs.
- It includes consultancy services during hospital treatment.
- Family member annual limits for co-payments related to MRI and CT scans is R100, 000.
- The cover limits sub-limitation plan.
- Also, members should get authorization beforehand and must use a preferred network hospital.
Cancer patients
- Insured cancer patients get a payout per treatment sequence
- The insurance co-payments and deductibles
- This gap cover does not include sub-limitations that medical plans impose
- Covers some cancers and includes in-hospital expenses and medication
- The cover includes out-patient treatment but also excludes consultation fee with specialists.
Casualty benefit of Ambledown Medical Shortfall plan
The casualty benefit caters for medical emergencies treated in a hospital
The admission to casualty is covered if not settled by a medical plan, but the limit per family is R100, 000.
Premium waiver benefit: in the event of permanent disability or death of a leading family member, Ambledown pays medical premiums for six months.
Gap listed procedure covers the following:
- Dentistry reconstructive procedures caused by trauma, and functional nasal surgery.
- Treatment or spinal surgeries
- Replacement of joints, not limited to hips, shoulders, knees and elbows.
- Treatment, devices and processors for cochlear and auditory brain implants.
- Also internal nerve stimulators
- Bunionectomy
- Arthroscopy
- Varicose vein removal and treatment of other skin disorders such as lipomas.
This gap cover only pays a maximum of 500% of the medical plan rates, and an annual limit of R2million.
If you belong to a legitimate medical aid, for a FREE gap cover quote simply enter your details into the form provided and click the GET A QUOTE button!
