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 of R2 million
  • 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, family member annual limits for co-payments related to MRI and CT scans is R100, 000.
  • Limited to R50, 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 up to R500,000 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

  • Which are the Top Gap Cover Companies in South Africa?

    There are many companies that offer gap cover, so which are the top gap cover companies in South Africa? Here is a look at four of the best options. Ambledown Ambledown offers 13 options for gap cover. Each option will cover costs at a different level. Gap cover with Ambledown can be purchased from Constantia…

    Read more

  • Zestlife Shortfall Insurance is the SA Leader

    Zestlife Gap Cover Information One of the biggest headaches for health aid members is the shortfall, also known as the gap, which is the difference between what doctors charge and what schemes pay out. Hence, Zestlife shortfall insurance takes steps to cater for the extra costs that arise. The upper limits set by medical aids…

    Read more

  • Medical Gap Cover for Diabetics – Learn More About Gap Cover for Diabetics

    Gap cover and Diabetes – Information for People With Diabetes Diabetes acquired in one’s adult life is lifestyle condition, and it is becoming increasingly common. On the other hand, health covers are paying less for medical expenses frequently. As such you might have questions about medical gap cover and diabetes. Typical diet from the west…

    Read more

Share via
Copy link