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 means 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.
- 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
- 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
All info was correct at time of publishing