Medical aid shortfall cover from Ambledown

More often than not, people are shocked when their medical aid cover fails to pay all the costs. Ambledown medical aid shortfall cover treats the shock.

They bridge the gap and protect your savings by paying the shortfall for you.

Usually, health care plans have set limits to what they will pay out. Doctors impose rates higher than the medical tariffs, and so, patients end up paying more.

Medical aid shortfall cover for unexpected extras

Extra costs can be huge and could leave you and your family financially drained. Further, some health experts charge up to five times what schemes will pay out. Which medical aid shortfall covermeans you have to pay the bulk of the bill! So don’t get caught off-guard and suffer financial ruin.

Get medical aid shortfall cover and enjoy peace of mind, knowing that your savings are safe.

What gap Cover can Do

Ambledown gap Cover offers;

  • Hospital treatments
  • Outpatient cancer treatment
  • Outpatient dialysis

There are Limits to the Cover

  • Ambledown provides an annual limit
  • The cover caters for up to five times the Medical Scheme Tariff limits
  • The cover does not include hospital bills
  • It does not contain prosthesis, medication, and material costs.
  • It includes consultancy fees during hospital treatment.
  • Also, there are family member annual limits for co-payments related to MRI and CT scans.
  • Limited amount per each household member.
  • Further, members should talk to their gap cover provider about claims before the time and must use a listed hospital/doctor.

Cancer patients

  • Insured cancer patients get an amount per treatment sequence
  • The insurance co-payments and deductibles
  • Sub-limitations imposed by medical plans are not included
  • Covers some cancers and includes in-hospital expenses and medication
  • The cover includes out-patient treatment but also excludes consultation fee with specialists.

The casualty benefit caters for medical emergencies treated in a hospital, but the limit per family is R100, 000.

Further, there is also a premium waiver benefit: in the event of disability or death of the main member, Ambledown pays health premiums for six months.

Medical Aid Shortfall Cover pays for 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.
  • Internal nerve stimulators
  • Bunionectomy
  • Arthroscopy
  • Varicose vein removal and treatment of other skin disorders.

Further, this gap cover only pays a maximum of 500% of the health plan rates and has an annual limit of R2million.

So get a FREE gap cover quote. Just fill in and send us the form.
Note: Gap cover is for members of legitimate South African medical aids only

Published:

Updated:

Latest posts

  • Get Medical Aid Shortfall Cover with Ambledown Today – Stay Covered

    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…

    Read more

  • Making a Gap Cover Claim from Sanlam

    If you have a gap cover from Sanlam, you might be required to be making a gap cover claim from Sanlam following a hospital visit. But what is gap cover? While making a hospital visit is not something you will want to consider, it’s not something that we expect to happen. Hence, only a few…

    Read more

  • Gap Cover for the Primary Medical Aid Member – Stay Covered

    The Main Medical Aid Member Should Consider Gap Cover The last you want to see is a pile of unpaid bills after visiting the hospital during recovery. As such, that is why you require a gap cover for primary health aid members and their dependents. Ten or twenty years ago, one could have been completely…

    Read more

Share via
Copy link