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Overall, Ambledown Gap Supreme is a trustworthy short-term insurance product designed to provide extra protection for those who already have medical aid. The Ambledown Gap Supreme Plan starts from R677 ZAR. Ambledown has a trust score of 5.1.
🔎 Provider | 🥇 Ambledown Gap Supreme |
🟥 Years in Operation | 19 years |
🟧 Underwriters | Guardrisk Insurance Company Limited |
🟨 Market Share in South Africa | 20% |
🟩 Gap Cover Waiting Period | 3 – 12 months |
🟦 Do Exclusions Apply | ✅ Yes |
🟪 Average Monthly Premium | R677 |
🟥 Oncology Benefit | ✅ Yes |
🟧 In-Hospital Benefit | ✅ Yes |
🟨 Out-of-Hospital Cover | ✅ Yes |
The Ambledown Gap Supreme is one of seven plans that starts from R677 per month. Ambledown’s Gap Supreme has benefits for extended cancer cover, premium waivers, casualties, sub-limits, major co-payments, deductibles, and more.
Ambledown Gap Cover has seven plans to choose from:
🟥 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. |
🟨 Sub-limitation Cover | The sub-limitation benefit covers charges that exceed the medical scheme’s defined in-hospital sub-limits. |
🟩 Cancer Cover | The cancer benefit covers the shortfall — either the co-payment or the sub-limitation — 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. |
🟦 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 |
🟪 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 |
🟧 Premium Waiver Benefit | Pays 6 months of medical scheme contributions and Gap Cover premiums once. Cover ends at the age of 65. |
🟨 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.
Women might consider making use of our free Ovulation Calculator
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.
READ more about How to recon Medical Aid Credits
🔎 Provider | 🥇 Ambledown Gap Supreme | 🥈 GapCover® Combined | 🥉 Liberty Optimal Gap Cover |
🟥 Years in Operation | 19 years | N/A | 66 years |
🟧 Underwriters | Guardrisk Insurance Company Limited | Western National Insurance Company Limited | Guardrisk Life Limited (FSP 76) |
🟨 Market Share in South Africa | 20% | <1% | >25% |
🟩 Gap Cover Waiting Period | 3 – 12 months | 3 – 12 months | 12 months |
🟦 Do Exclusions Apply | ✅ Yes | ✅ Yes | ✅ Yes |
🟪 Average Monthly Premium | R677 | R292 | R239 |
🟥 Oncology Benefit | ✅ Yes | None | None |
🟧 In-Hospital Benefit | ✅ Yes | None | ✅ Yes |
🟨 Out-of-Hospital Cover | ✅ Yes | None | ✅ Yes |
🟩 Maternity Benefit | None | None | None |
🟦 Scopes and Scans | ✅ Yes | None | ✅ Yes |
🟪 Co-payment Cover | ✅ Yes | ✅ Yes | ✅ Yes |
🟥 Emergency Room | ✅ Yes | ✅ Yes | None |
🟧 Accidental Cover | ✅ Yes | None | ✅ Yes |
🟨 Trauma Counseling | None | None | ✅ Yes |
🟩 Premium Waiver | ✅ Yes | None | ✅ Yes |
🟦 Non-DSP Co-Payment | ✅ Yes | None | ✅ Yes |
🟪 Prostheses | None | None | ✅ Yes |
🟥 Travel Cover Extender | None | None | None |
🟧 Accidental Death/ Permanent Disability | None | None | ✅ Yes |
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In our experience, the Ambledown Gap Supreme, priced from R613 p/m, offers comprehensive cover, including 600% cover on gap insurance and a host of unique benefits, such as extended cancer cover and major medical co-payment/deductible cover.
Notably, it lacks maternity benefits, trauma counseling, and a travel cover extender. However, its premium waiver and non-DSP co-payment features stand out. The well-regarded Guardrisk Insurance Company backs it and holds a 20% market share in South Africa.
Despite a waiting period of 3-12 months, Ambledown Gap Supreme offers robust cover for both in-hospital and certain out-of-hospital treatments.
Sharpen your knowledge with a better understanding of Medical Aids in South Africa
Ambledown Gap Supreme is a gap cover policy that provides up to 600% coverage on medical expenses that exceed what your medical aid scheme covers.
It also offers unique benefits such as extended cancer coverage, major medical co-payment, and deductibles. However, the policy does not include maternity benefits, trauma counseling, and travel cover extender.
Guardrisk Insurance Company, a reputable insurance company in South Africa, underwrites Ambledown Gap Supreme.
The Ambledown Gap Supreme policy starts from R677 per month.
Yes, Ambledown Gap Supreme provides robust cover for both in-hospital and certain out-of-hospital treatments.
There is a general 3-month waiting period during which no benefits are payable for treatment received, except for accidents. For pre-existing conditions, a 12-month waiting period applies. After the 12 months, all benefits are payable regardless of when the illness or injury occurred
We work with leading medical aid companies in South Africa.
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