The Best Medical Aids
The Best Hospital Plans
Overall, Ambledown Gap Select is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Ambledown Gap Select Plan starts from R627 ZAR. Ambledown has a trust score of 5.1.
🔎 Provider | 🥇 Ambledown Gap Select |
🟥 Years in Operation | 19 years |
🟧 Market Share in South Africa | 20% |
🟨 Gap Cover Waiting Period | 3 – 12 months |
🟩 Do Exclusions Apply | ✅ Yes |
🟦 Average Monthly Premium | R627 |
🟪 Oncology Benefit | ✅ Yes |
🟥 In-Hospital Benefit | ✅ Yes |
🟧 Out-of-Hospital Cover | ✅ Yes |
🟨 Maternity Benefit | None |
The Ambledown Gap Select is one of seven plans that starts from R627 per month. Ambledown’s Gap Select has benefits for dread disease and severe illness, oncology, medical or surgical procedures after an emergency, non-network hospital co-payments, 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:
🔎 Ambledown Plan | 🅰️ The premium for members 18 – 65 | 🅱️ The premium for Members 66 years> |
↪️ Gap Select | R627 | R912 |
🟥 Gap Cover | Gap Cover covers hospital services, listed outpatient procedures, cancer chemotherapy and radiotherapy, and kidney dialysis above the medical scheme tariff. Gap Cover provides 600% coverage. Limited to R185,837 per year. |
🟧 Major Medical Co-payment/Deductible Cover | The co-payment benefit covers the medical scheme’s 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. |
🟨 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. |
🟩 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 Kaposi’s sarcoma with HIV Skin cancer other than malignant melanoma Non-invasive cancer cells Prostate or breast cancer in its early stages – Stage1 (T1a, N0, M0, G1) Limited to R50,000 per insured person upon diagnosis |
🟦 ER24 Virtual Support | 24/7 medical advice and support, ER24 emergency service, Mental Health self-assessment, and Lifestyle self-assessment screening. |
🟪 Boston Online Home Education | Boston Online Home Education can help your family’s 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 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.
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.
Read more about the 5 Best Hospital Plans for Foreign Nationals
🔎 Provider | 🥇 Ambledown Gap Select | 🥈 Zestlife Universal Gap Cover | 🥉 Cura Administrators Gap Advanced Plus |
🟥 Years in Operation | 19 years | 3 years | 26 years |
🟧 Market Share in South Africa | 20% | >15% | <5% |
🟨 Gap Cover Waiting Period | 3 – 12 months | 3 – 12 months | 3 – 12 months |
🟩 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
🟦 Average Monthly Premium | R627 | R506 | R437 |
🟪 Oncology Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟥 In-Hospital Benefit | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Out-of-Hospital Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟨 Maternity Benefit | None | None | ✅ Yes |
🟩 Scopes and Scans | ✅ Yes | ✅ Yes | ✅ Yes |
🟦 Co-payment Cover | ✅ Yes | None | ✅ Yes |
🟪 Emergency Room | ✅ Yes | ✅ Yes | ✅ Yes |
🟥 Accidental Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟧 Trauma Counseling | None | ✅ Yes | ✅ Yes |
🟨 Premium Waiver | None | ✅ Yes | ✅ Yes |
🟩 Non-DSP Co-Payment | ✅ Yes | ✅ Yes | ✅ Yes |
🟦 Prostheses | None | ✅ Yes | ✅ Yes |
🟪 Travel Cover Extender | None | None | ✅ Yes |
🟥 Accidental Death/ Permanent Disability | None | ✅ Yes | ✅ Yes |
In our experience, Ambledown’s Gap Select Plan offers a comprehensive range of benefits, providing a safety net for major medical expenses and emergencies. In addition, including additional services like 24/7 virtual support is a significant advantage.
However, the absence of cover for maternity, prostheses, accidental death/disability, travel cover, trauma counseling, or premium waiver may be a drawback for some.
The plan’s limitations on mental health cover and the cessation of dread disease/severe illness benefit at age 65 also warrant consideration.
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Ambledown Gap Select primarily covers hospital-based treatments and procedures. It does not cover daily procedures or general outpatient benefits, but certain outpatient procedures on the list may be covered.
No, Ambledown Gap Select does not include travel coverage as part of its benefits.
Ambledown Gap Select’s cover limit is R185,837 per year for hospital services, listed outpatient procedures, cancer chemotherapy and radiotherapy, and kidney dialysis.
The premiums for Ambledown Gap Select are R627 per month for members aged 18-65 and R912 per month for members aged 66 and above.
The major medical co-payment cover in Ambledown Gap Select helps cover the medical scheme’s co-payments or deductibles for in-hospital admissions, listed outpatient procedures, and CT, MRI, and PET scans. It also includes a one-time payment per family per year to cover penalties imposed by a medical scheme for using a non-network hospital, with a maximum penalty co-payment of R13,000.
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