Avoid unexpected hospital costs
Getting care in hospital is only part of preparing for a hospital stay; you also have to get ready to go to hospital. Let us know about your planned visit on 0860 00 21 33, at least 48 hours before you have to go to hospital, and carefully read your preauthorisation letter to find out how we will pay for your hospital stay. We pay for your hospital stay from the Hospital Benefit.
If you do not get preauthorisation, we only pay 70% of the Scheme Rate for your claims. You have to pay the rest yourself. In an emergency you don't need to get preauthorization, but you do have to let us know that you're in hospital.
When we give you preauthorisation, we tell you what we pay for, what we don't pay for, and how much you have to pay yourself. If your doctor called us for preauthorisation, make sure they send you all the preauthorisation details.
Having preauthorisation does not mean that we will pay all the costs related to your hospital stay in full.
What preauthorisation means
Preauthorisation means that that your treatment meets our conditions for cover. It does not mean we pay for every part of your hospital stay or operation.
Your cover depends on if you use a network hospital or day?clinic, and if all the doctors who treat you (like the surgeon and anaesthetist) are part of our network.
As part of preauthorisation, we show you what cover you will have if you use the healthcare providers you or your treating doctor chose. You might have to go to another healthcare provider, day?clinic or hospital to get the most cover possible. Contact us if you are unsure.
Read your letter carefully even if your doctor called us
Some doctors call us for you to get approval for your hospital stay. While this minimizes the work of getting ready for a hospital stay, you still have to make sure you ask the doctor for the preauthorisation letter and read it carefully.
When you use the authorisation number at the hospital, it tells us that you read and accepted the cover we approved, and that you are willing to pay part of the cost, if you do not have full cover.
Don't be caught by surprise costs when you check out of hospital! Read your preauthorisation letter and call us on 0860 00 21 33 if you have any questions.