Gap Supreme
About this plan
Gap Supreme is Ambledown's flagship gap cover plan, offering the broadest protection for specialist fee shortfalls, hospital co-payments, cancer treatment, sub-limit benefits, casualty ward treatment, and selected severe illness benefits. It is designed for members seeking the highest level of financial protection alongside their medical scheme.
Monthly premium
From
R821
per month
What's covered
Hospital cover
Savings account
Day-to-day
Chronic cover
Dental
Optical
Maternity
Mental health
Waiting periods
- General
- 3 months
- Pre-existing conditions
- 12 months
Gap Supreme
Ambledown Gap Supreme (🇿🇦 2025)
Overall, Ambledown Gap Supreme is a trustworthy short-term insurance product designed to provide extra protection for those with medical aid. The Ambledown Gap Supreme Plan starts from R748 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 | R748 |
| 🟥 Oncology Benefit | ✅ Yes |
| 🟧 In-Hospital Benefit | ✅ Yes |
| 🟨 Out-of-Hospital Cover | ✅ Yes |
Ambledown Gap Supreme - 6 Key Point Quick Overview
- ✅ Ambledown Gap Supreme Overview
- ✅ Ambledown Gap Supreme Benefits and Cover Breakdown
- ✅ Ambledown Gap Supreme Exclusions and Waiting Periods
- ✅ Ambledown Gap Supreme vs Other Gap Cover Plans
- ✅ Our Verdict on Ambledown Gap Supreme
- ✅ Ambledown Gap Supreme Frequently Asked Questions
Ambledown Gap Supreme Overview
The Ambledown Gap Supreme is one of seven plans that starts from R748 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:
Ambledown Gap Supreme Benefits and Cover Breakdown
| 🟥 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 R210,580 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 R15,000. |
| 🟨 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 R11,000 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. |
Ambledown Gap Supreme Exclusions and Waiting Periods
Gap Supreme 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.💙Women might consider making use of our free Ovulation Calculator
Gap Supreme 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.
- ✅ 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.
- ✅ 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.
💙READ more about How to recon Medical Aid Credits
Ambledown Gap Supreme vs Other Gap Cover Medical Aid Plans
| 🔎 Provider | 🥇 Ambledown Gap Supreme | 🥈 GapCover® Combined | 🥉 Liberty Optimal Gap Cover |
| 🟥 Years in Operation | 21 years | N/A | 68 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 | R748 | R370 | R253 |
| 🟥 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 |
💙Poll: 5 Best Medical Aids Covering Glasses & Optometry
Our Verdict on Ambledown Gap Supreme
In our experience, the Ambledown Gap Supreme, priced from R748 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
