The Best Medical Aids
The Best Hospital Plans
Overall, Ambledown Gap LPE Advanced is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Ambledown Gap LPE Advanced Plan starts from R420 ZAR. Ambledown has a trust score of 5.1.
π Provider | π₯ Ambledown Gap LPE Advanced |
π₯ Years in Operation | 19 years |
π§ Underwriters | Guardrisk Insurance Company Limited |
π¨ Market Share in South Africa | 20% |
π© Gap Cover Waiting Period | 3 β 12 months |
π¦ Do Exclusions Apply | β Yes |
πͺ Average Monthly Premium | R420 |
π₯ Oncology Benefit | β Yes |
π§ In-Hospital Benefit | β Yes |
π¨ Out-of-Hospital Cover | β Yes |
The Ambledown Gap LPE Advanced is one of seven plans that starts from R420 per month. Ambledownβs Gap LPE Advanced has benefits for in-hospital procedures, accidents, casualty wards, ER24 virtual support, and more.
Ambledown offers 24/7 medical emergency assistance and has a trust rating of 2.7, according to the Trust Index.
Ambledown Gap Cover has seven plans to choose from:
π Ambledown Plan | π °οΈ The premium for members 18 β 65 | π ±οΈ The premium for Members 66 years> |
βͺοΈ Gap LPE Advanced | R420 | R623 |
π₯ LPE Advanced | Provides a benefit equal to the cost of in-hospitalization and associated medical expenses (as defined) for one of the listed procedures less the medical scheme optionβs cover. The Listed Procedures mentioned below are limited to the actual costs incurred, calculated at the Medical Scheme Rate, and subject to a specific limitation of R100,000 in aggregate per insured person per annum. The defined listed procedures covered include: In-hospital dentistry for impacted teeth for minors under 18 or reconstructive plastic surgery due to an accident during the cover Rhinoplasty Oesophageal reflux and hiatus hernia surgery. Neck and back surgery Joint replacements, including but not limited to hips, knees, shoulders, and elbows Cochlear implants, auditory brain implants, and internal nerve stimulators, including procedures, devices, and processors. Bunionectomy Arthroscopy. Varicose vein removal Lipomas and benign growths |
π§ Gap Cover 100 | Gap Cover covers hospital services, listed outpatient procedures, cancer chemotherapy and radiotherapy, and kidney dialysis above the medical scheme tariff. Gap Cover 100 provides 600% coverage. Limited to R185,837 per year. |
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. |
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:
However, the existing benefits enjoyed before the upgrade will not be subject to the waiting periods mentioned.
π Provider | π₯ Ambledown Gap LPE Advanced | π₯ iWYZE Gap Cover | π₯ Cura Administrators Gap Basic |
π₯ Years in Operation | 19 years | 13 years | 26 years |
π§ Underwriters | Guardrisk Insurance Company Limited | Old Mutual Insure Limited | GENRIC Insurance Company Limited |
π¨ Market Share in South Africa | 20% | 15%> | <5% |
π© Gap Cover Waiting Period | 3 β 12 months | 3 β 12 months | 3 β 12 months |
π¦ Do Exclusions Apply | β Yes | β Yes | β Yes |
πͺ Average Monthly Premium | R420 | Variable | R182 |
π₯ Oncology Benefit | β Yes | β Yes | None |
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 | None |
π¦ Scopes and Scans | β Yes | β Yes | β Yes |
πͺ Co-payment Cover | β Yes | β Yes | None |
π₯ Emergency Room | β Yes | β Yes | β Yes |
π§ Accidental Cover | β Yes | β Yes | β Yes |
π¨ Trauma Counseling | None | None | None |
π© Premium Waiver | None | 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 | None |
π§ Accidental Death/ Permanent Disability | None | β Yes | None |
You might consider advancing your healthcare knowledge about Economical Health Insurance companies in SA
In our experience, Ambledown Gap LPE Advanced offers a comprehensive range of benefits designed to fill the gaps left by medical aid schemes. According to our research, the plan also includes cover for out-of-hospital treatments, including scans and scopes, and co-payments and non-DSP co-payments.
While Ambledown Gap LPE Advanced provides several valuable benefits, it does have certain limitations.Β Some notable exclusions include mental health-related treatments, rehabilitation for drugs or alcohol, and elective cosmetic procedures.
Yes, certain elective cosmetic procedures, such as lipomas and benign growths, may not be covered under this plan.
Gap Cover 100 covers up to R185,837 per year for hospital services, listed outpatient procedures, cancer chemotherapy, radiotherapy, and kidney dialysis above the medical scheme tariff.
Ambledown Gap LPE Advanced imposes a general waiting period of 3 months for new memberships.
No, Ambledown Gap LPE Advanced typically does not cover expenses related to therapy sessions, counseling, or treatment for mental illnesses.
Yes, Ambledown Gap LPE Advanced offers a casualty ward benefit, which 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. The benefit is limited to R10,000 per event.
We work with leading medical aid companies in South Africa.
π Report a bug or outdated data to be updated to [email protected]
Β© Medicalaid.com | All rights Reserved |
Copyright 2024
Top 5 Medical Aids
Top 5 Gap Cover Plans