It might come as a shock to know that your medical aid plan will not cover all your costs in the hospital? Ambledown medical shortfall insurance helps you recover from the shock.
Healthcare firms set out a tariff on how much they are willing to pay for each procedure when you are in the hospital. However, if the hospital charges you more than your healthcare tariff rate, you have to pay the rest.
These “extra” expenses can come at a time when you don’t have the strength to deal with them. And this is not a couple of hundred bucks either. With a hospital stay, you are looking at thousands of Rand.
Ambledown medical shortfall insurance picks up the extra cost
You have two choices – either prepare, or never get ill. Needless to say, the former is a lot easier than the latter.
Fortunately, you can now insure against having to pay expensive medical bills by taking out gap cover from Ambledown.
Why Ambledown medical shortfall insurance
can save your life
Gap cover pays the portion of the account that your medical aid doesn’t. If you see any doctor who charges above medical aid rates, the gap cover comes into play.
You don’t need to worry about getting care at a second-rate hospital because that is all your medical aid will pay for. Gap cover can cover the whole family.
Get healthcare The Ambledown way and Rest easy
Ambledown medical shortfall insurance is simple and effective. With an annual limit of R2 000 000 and a maximum of five times the standard medical tariffs, this cover is hard to beat.
With the Gap series, you will have cover for:
- Procedures conducted in a hospital
- Radiotherapy or chemo and dialysis treatments on an out-patient basis
- The fees for doctors that treat you while in the hospital
The Exclusions to the Plan are as Follows:
- Costs related to medication, prosthesis and materials
- The plan will not pay for hospital fees
The sub-limits are as follows:
- CT and MRI scans are limited to R100 000 per annum per family
- Sub-limitation of R50 000 for the whole family per annum
Furthermore, you are expected to use a hospital that is one of the network providers. You must also get pre-authorisation before being admitted.
For Those with Cancer
- You have a limit of R500 000 for each treatment cycle
- If you exceed your medical aid’s sub-limits, you may claim on the gap cover
- You may claim deductibles and co-payments
- The plan pays for cancer treatment, along with medication and expenses during a hospital stay
- You may claim for treatments conducted on an out-patient basis
- The plan does not pay specialist’s fees
Ambledown’s casualty Benefit
This benefit comes into play when you need to go to casualty in the hospital.
- The cover includes any admission fees that your medical aid does not pay. This is limited to R10 000 annually, per family
The Premium waiver Benefit
Should the main member die or become disabled, the premium will be waived for a period of 6 months.
This policy comes with a range of different benefits. It is a good idea to familiarise yourself with the terms and conditions of cover from Ambledown so that you know exactly what cover you have.
To get a FREE gap cover quote, please fill in the form on this page
All info was correct at time of publishing