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 271 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. We can also verify that members who are enrolled on network plans are admitted to network hospitals. We offer you alternatives to hospitalisation, such as subacute care or nursing services to ensure your recovery after you’ve left the hospital.

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 we make 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

If 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 choose a plan that offers more comprehensive cover or a larger savings account, you also enjoy cover for scans while not in hospital. View the plans’ out-of-hospital and core benefits for more details.

Why is pre-authorisation important?

By pre-authorising planned procedures or treatments, you and your doctors will know exactly what cover you will receive. You will also know beforehand if there are any additional expenses you have to make provision for. In case of an emergency requiring immediate hospital admission, a family member or the hospital has to call Medihelp on the first workday following the admission to get authorisation.

All Medihelp’s plans cover the diagnosis, treatment, and care of 271 serious medical diagnoses known as prescribed minimum benefits (PMB), as well as 26 specific chronic conditions on the Chronic Disease List (CDL). Medihelp uses designated healthcare providers and a network of specialists to provide care for these conditions. Some plans offer separate insured benefits for other chronic conditions  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 specific healthcare needs.

All Medihelp’s plans cover medical emergencies. If you require emergency transport, always call 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 the emergency room at a hospital to receive treatment in an emergency. If you are admitted, you will receive hospital cover.

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