Pre-authorisation made easy

For all planned procedures, treatments, and hospital admissions (including day procedure facilities), you must get pre-authorisation from Medihelp. This is important because you’ll know beforehand if:

• Your plan covers the procedure or treatment.
• You’ll have any co-payments.

The good news is that you don’t have to make a phone call to get authorisation. You can simply log onto the Member Zone > PRE-AUTHS >. Select the type of pre-authorisation (for example hospital admission) in the dropdown menu and follow the prompts.

For what do I need pre-authorisation?

• All hospital admissions, including day procedure facilities, whether they form part of the Medihelp network or not;
• In the case of emergency hospital admissions, a family member or the hospital must call Medihelp on the first workday following the admission date;
• Medication: those listed as prescribed minimum benefits (PMBs), chronic, Section 21, and medication to be used for longer than 30 days;
• Oxygen for home use;
• Specialised radiology, including MRI and CT scans;
• Oncology treatment offered in cooperation with the oncologists of the Independent Clinical Oncology Network (ICON);
• Referrals to specialists; and
• Certain specialised dentistry and optometry services.