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Hospitalisation and essential care

Because Medihelp understands what really matters when life happens, all our plans have been designed to ensure quality care.

A solid foundation of essential care

All Medihelp’s plans give you access to –

  • quality care at private hospitals with no overall annual limit;
  • unlimited cover for ambulance services and the treatment of medical emergencies; and
  • comprehensive cover and treatment for 270 serious medical diagnoses, including 26 specific chronic conditions.

Cover for private hospitalisation is non-negotiable. Medihelp applies a standard pre-authorisation process for all planned hospital procedures or admissions, but this is not required for emergency admissions. By authorising admissions, we can confirm your benefits and ensure that you know exactly what your cover entails, and we can verify that members who enrolled on network plans are admitted to network hospitals. We also offer you alternatives to hospitalisation such as subacute care or nursing services to ensure post-hospital recovery.

Some Medihelp plans offer you a choice between using any hospital or a network hospital when you join the network version of the plan at a considerably lower premium, which is made possible by negotiating tariffs with efficient networks of hospitals and day procedure facilities. Click here to search for a network hospital and network day procedure facility or download a list.

Elect plans – network hospitals

Any hospital

Should you need a scan

Your doctor may require a CT scan or MRI to confirm a diagnosis, and Medihelp’s plans provide cover for unlimited scans during hospitalisation. If you opt for a plan offering more comprehensive cover or a larger savings account, you will also enjoy cover for scans while not in hospital. View the plans’ out-of-hospital and core benefits for more detail.

Why is pre-authorisation important?

By pre-authorising planned procedures or treatment, you and your healthcare providers will know exactly what cover you will receive, and you will know beforehand if there are any additional expenses to make provision for. In case of an emergency requiring immediate hospital admission, a family member or the hospital need only phone Medihelp on the first workday following the admission to obtain authorisation.

All the Medihelp’s plans cover the diagnosis, treatment and care of 270 serious medical diagnoses known as prescribed minimum benefits (PMB) as well as 26 specific chronic conditions on the Chronic Diseases List (CDL). Medihelp makes use of designated healthcare providers and a network of specialists to provide care for these conditions. Some plans offer separate insured benefits for other chronic conditions as well, including medicine required to treat these conditions, while others provide only day-to-day cover for acute prescribed medicine intended to treat minor ailments such as colds and flu. It is therefore important to pick a medical aid plan that suits your healthcare needs.

All Medihelp’s plans cover medical emergencies. Should you require emergency transport, always phone Netcare 911 on 082 911 at all hours of the day. You can rely on their expert assistance in a medical emergency, such as a motor vehicle accident, and they can provide advice in a medical emergency via their 24-hour helpline.

You can also go to an emergency facility at a hospital to receive treatment in an emergency – if you are admitted, you will receive hospital cover.