The Best Medical Aids
The Best Hospital Plans
Overall, Ambledown Guardian Gap Cover is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Ambledown Guardian Gap Cover Plan starts from R222 ZAR. Ambledown has a trust score of 5.1.
The Ambledown Guardian is one of seven plans that starts from R222 per month. Ambledownβs Guardian has benefits for waiving premiums, online home education, severe illness, sub-limit cover, cancer, and more.
Ambledown Gap Cover has seven plans to choose from:
π Ambledown Plan | π °οΈ Premium for members 18 β 65 | π ±οΈ Premium for Members 66 years> |
βͺοΈ Guardian | R222 | R315 |
π₯ Major Medical Co-payment/Deductible Cover | The co-payment benefit covers the medical schemeβs co-payments or deductibles for in-hospital admissions, listed outpatient procedures, and CT, MRI, and PET scans. Includes a one-time payment per family per year to cover the penalty imposed by a medical scheme for using a non-network hospital. The maximum penalty co-payment is R13,000. |
π§ Sub-limitation Cover | The sub-limitation benefit covers charges that exceed the medical schemeβs defined in-hospital sub-limits. |
π¨ Cancer Cover | The cancer benefit covers the shortfall β either the co-payment or the sub-limitation β for traditional cancer treatment methods or the sub-limitation for cancer treatment with defined biological drugs, immunotherapy, hormone therapy, targeted therapy, photodynamic therapy, or stem cell transplants. |
π© Extended Cancer Cover | Extended Cancer Treatment Cover covers charges above the Medical Scheme sub-limitation for defined biological Cancer drugs for defined oncological conditions or specific sub-groups of: Cancer Immunotherapy Hormone Therapy Targeted Therapy Photodynamic Therapy Stem Cell Transplant |
π¦ Casualty Ward Benefit | Limited to R10,000 per event. Casualty ward benefit covers the cost of a medical or surgical procedure after an emergency in a hospital casualty unit where the medical scheme did not cover such costs. |
πͺ Dread Disease/Severe Illness Benefit | Provides a one-time dread disease benefit, limited to cancer diagnosis. However, the cover ends at the age of 65. The benefit includes the following: All tumors classified histologically as pre-malignant, non-invasive, or cancer in situ Lymphoma with HIV Kaposiβs sarcoma with HIV Skin cancer other than malignant melanoma Non-invasive cancer cells Prostate or breast cancer in its early stages β Stage1 (T1a, N0, M0, G1) Limited to R50,000 per insured person upon diagnosis |
π₯ Premium Waiver Benefit | Pays 6 months of medical scheme contributions and Gap Cover premiums once. Cover ends at the age of 65. |
π§ ER24 Virtual Support | 24/7 medical advice and support, ER24 emergency service, Mental Health self-assessment, and Lifestyle self-assessment screening. |
π¨ Boston Online Home Education | Boston Online Home Education can help your familyβs Social Emotional Learning (SEL) and High School Learning. Social Emotional Learning (SEL) Online Caps support for Grades 10-12 Cambridge International Curriculum discount Career Counseling |
Regarding mental health, accounts related to depression, emotional matters, or mental illnesses are typically not covered by Ambledownβs 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.
Ambledown applies the following waiting periods:
Membership Application:
Exceptions to Waiting Period:
Pre-existing Clause:
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.
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π Provider | π₯ Ambledown Guardian | π₯ Netcare GapCare500+ | π₯ Discovery Health Gap Comprehensive |
π₯ Years in Operation | 19 years | 27 years | 31 years |
π§ Underwriters | Guardrisk Insurance Company Limited | The Hollard Insurance Company Limited | Discovery Insure Ltd |
π¨ Market Share in South Africa | 20% | <5% | >56% |
π© Gap Cover Waiting Period | 3 β 12 months | 3 β 12 months | 12 months |
π¦ Do Exclusions Apply | β Yes | β Yes | β Yes |
πͺ Average Monthly Premium | R222 | R335 | R226 |
π₯ Oncology Benefit | β Yes | β Yes | β Yes |
π§ In-Hospital Benefit | β Yes | β Yes | β Yes |
π¨ Out-of-Hospital Cover | β Yes | β Yes | β Yes |
π© Maternity Benefit | None | β Yes | β Yes |
π¦ Scopes and Scans | β Yes | β Yes | β Yes |
πͺ Co-payment Cover | β Yes | β Yes | β Yes |
π₯ Emergency Room | β Yes | β Yes | None |
π§ Accidental Cover | β Yes | β Yes | None |
π¨ Trauma Counseling | None | β Yes | None |
π© Premium Waiver | β Yes | β Yes | None |
π¦ Non-DSP Co-Payment | β Yes | β Yes | None |
πͺ Prostheses | None | β Yes | None |
π₯ Travel Cover Extender | None | None | β Yes |
π§ Accidental Death/ Permanent Disability | None | β Yes | β Yes |
According to our findings, Ambledown Guardian is a popular and well-established gap cover plan in South Africa, offering comprehensive benefits and coverage options.
With premiums starting at R203 per month, it provides cover for waiving premiums, online home education, severe illness, sub-limit cover, and cancer treatment. We also found that Ambledown Guardian also includes 24/7 medical emergency assistance.
However, while it compares favorably to other providers regarding market share and benefits offered, it has limitations, such as the absence of maternity benefits, trauma counseling, and prostheses coverage.
Ambledown Guardian offers benefits such as waiving premiums, online home education, cover for severe illness, sub-limit cover, and cancer treatment. It also provides 24/7 medical emergency assistance.
Ambledown has operated for 19 years and holds a significant market share. In addition, it offers comparable benefits to other providers, providing cover for oncology, in-hospital and out-of-hospital care, co-payment coverage, and more.
Yes, Ambledown Guardian applies to wait periods ranging from 3 to 12 months for certain benefits.Β However, these waiting periods can be waived in cases of accidents or when switching to a similar gap cover plan within the same insurer.
Ambledown Guardian includes 24/7 medical emergency assistance, which means you can access medical advice and support anytime by contacting the designated emergency service provided by the plan.
Ambledown Guardian has exclusions for mental health-related expenses and rehabilitation for drugs or alcohol unless specifically included in the Prescribed Minimum Benefits (PMB).
We work with leading medical aid companies in South Africa.
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