Hospital Authorisation

Your approved hospital admission is covered from the Scheme's Major Medical Benefits (MMB).

Some hospital benefits are subject to clinical protocols and managed care measures. This means that certain treatments may need to be reviewed before cover can be approved.

Please note that Scheme exclusions apply to hospital benefits.

You will have full cover when you see a specialist or general practitioner in hospital if they are part of the SABMAS network.

You will have full cover if you use a hospital that is in the SABMAS network.

If you do not use healthcare professionals or hospitals that are in the network, we will pay them up to the Scheme Rate and if the provider charges more than the Scheme Rate , you will be responsible to pay the difference

Find out more about hospital cover for your option by referring to our guides.