Ambledown Gap Cover 200 (🇿🇦 2025)

Overall, Ambledown Gap Cover 200 is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Ambledown Gap Cover 200 Plan starts from R318 ZAR. Ambledown has a trust score of 5.1.      

Ambledown Gap Cover 200 - 7 Key Point Quick Overview

1. ✅ Ambledown Gap Cover 200 Overview
2. ✅ Ambledown Gap Cover 200 Premiums
3. ✅ Ambledown Gap Cover 200 Benefits and Cover Breakdown
4. ✅ Ambledown Gap Cover 200 Exclusions and Waiting Periods
5. ✅ Ambledown Gap Cover 200 vs Other Gap Cover Plans
6. ✅ Our Verdict on Ambledown Gap Cover 200
7. ✅ Ambledown Gap Cover 200 Frequently Asked Questions

Ambledown Gap Cover 200 Overview

The Ambledown Gap Cover 200 is one of seven plans that starts from R318 per month. Ambledown’s Gap Cover 200 has benefits for hospital services, covering up to 300%, lifestyle self-assessment screening, casualty wards, and more. Ambledown offers 24/7 medical emergency assistance.   💙Ambledown Gap Cover has seven plans to choose from:

• • Ambledown Guardian Gap Cover
  • Ambledown Gap Plus Gap Cover
  • Ambledown Supreme Gap Cover
  • Ambledown Select Gap Cover
  • Ambledown LPE Advanced Gap Cover
  • Ambledown Gap 200 Gap Cover
  • Ambledown Gap 100 Gap Cover

Ambledown Gap Cover 200 Premiums

   

Ambledown Gap Cover 200 Benefits and Cover Breakdown

 

Ambledown Gap Cover 200 Exclusions and Waiting Periods

Gap Cover 200 Exclusions

Regarding mental health, accounts related to depression, emotional matters, or mental illnesses are typically not covered by Ambledown’s Gap insurance. This means that expenses related to therapy sessions, counseling, or treatment for such conditions would not be eligible for coverage. Similarly, rehabilitation for drugs or alcohol is generally not covered by a standard health gap plan offered by Ambledown unless it is specifically included in your Prescribed Minimum Benefits (PMB). PMB refers to the minimum level of care that health insurers are legally required to cover. If your policy includes drug or alcohol rehabilitation as part of the PMB, you may be eligible for cover.  

Gap Cover 200 Waiting Periods

  Ambledown applies the following waiting periods: Membership Application:

• ✅ All applications for a new membership with Ambledown will be subject to a 3-month general waiting period.

Exceptions to Waiting Period:

• ✅ The waiting period can be waived if the claims qualify as an accident according to the policy definition.
• ✅ The waiting period can be waived if the client switches gap cover policies within the same insurer (GICL), provided the new policy offers similar benefits.

Pre-existing Clause:

• ✅ A 12-month pre-existing clause will apply, excluding claims for any treatment received for a condition 12 months before the policy’s inception.
• ✅ Benefits for pre-existing conditions will be payable once the membership is over 12 months, regardless of when the illness manifested or the injury occurred.

Upgrade of Cover:

• ✅ If a member upgrades their cover, the benefits obtained will be subject to a 3-month general waiting period and a 12-month pre-existing clause.

  However, the existing benefits enjoyed before the upgrade will not be subject to the waiting periods mentioned.    

Ambledown Gap Cover 200 vs Other Gap Cover Plans

   

Our Verdict on Ambledown Gap Cover 200

According to our research, Ambledown Gap Cover 200 from Ambledown, a reputable South African medical aid provider, offers a variety of benefits and features.  The cover for hospital services, including procedures, chemotherapy, and dialysis, exceeds the medical scheme tariff. In addition, including a casualty ward benefit and medical advice 24 hours a day, 7 days a week through ER24 Virtual Support increases the value. However, it is essential to note that the plan has certain restrictions.    

Frequently Asked Questions

What is Ambledown Gap Cover 200?

Ambledown Gap Cover 200 is a short-term insurance policy designed to cover the ‘gap’ between what your medical aid will pay and what doctors or specialists may charge for specific treatments and procedures. It provides up to three times the Medical Scheme Rate in coverage (300%).  

How much does Ambledown Gap Cover 200 cost per month?

For families with insured members between 18 and 65, the monthly cost begins at R318. The monthly cost for families with individuals aged 66 and older begins at R443.  

What is the cover limit for Ambledown Gap Cover 200?

The annual cover maximum is R210,580 per insured person.  

Are there any waiting periods for Ambledown Gap Cover 200?

Yes, there are waiting periods. But, first, there is a three-month general waiting period during which no benefits are payable for treatment received unless the treatment results from an accident.  Second, a 12-month pre-existing condition clause excludes cover for any treatment or advice received 12 months before the policy’s effective date.  

What does the Medical Scheme Rate (MSR) mean in the context of Ambledown Gap Cover 200?

The Medical Scheme Rate (MSR) is the amount your medical insurance will pay for particular treatments and procedures.  The shortfall or ‘gap’ is the difference between the medical practitioner’s charge and the Medical Aid Tariff (MST) rate for specific in-hospital surgical and out-of-hospital authorized procedures.