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 11 33 22 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 or a family member must let us know within 48 hours after the admission to gain authorisation.
When we give you preauthorisation, we tell you what we pay for, what we do not 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 whether or not you use a network hospital or day clinic, and whether 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 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 cost-effective 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 makes the work of getting ready for a hospital stay a little easier, 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.