Do I need to pre-authorise my medical treatment?

What is pre-authorisation?

Pre-authorisation is when we confirm to you before your proposed medical treatment starts that we’ll pay for the treatment.

Do I need your pre-authorisation for all treatments?

No. Typically we only need to pre-authorise treatment that you receive while you’re admitted to hospital as an in-patient. Here’s the complete list of treatments that need pre-authorisation:

• Hospitals costs (e.g., in-patient treatment, hospital accommodation)
• Cancer treatment
• Organ, bone marrow or tissue transplants
• Kidney dialysis (whether as an in-patient or out-patient)
• Reconstructive surgery
• Congenital conditions or hereditary conditions
• Mental health treatment
• HIV/AIDS treatment
• Physiotherapy (after you’ve had 6 sessions)
• Rehabilitation treatment
• Home nursing costs
• Lifetime care (e.g., hospice and palliative care)
• Maternity care (e.g., pregnancy and childbirth)
• Emergency medical evacuation
• All treatment you receive in the USA

Why do I need pre-authorisation?

Pre-authorisation helps us co-ordinate your admission and treatment with the hospital. It also allows us to confirm if your proposed treatment is covered by your plan.

How does pre-authorisation work?

Please tell us when you know you need treatment that requires pre-authorisation. We need at least 5 days’ notice. We’ll ask you to complete our online pre-authorisation form and sign a consent form that permits the hospital to share medical information with us. Then, we arrange your admission with the hospital and deal with the hospital’s billing team.

What happens in an emergency?

If you’re admitted to hospital in an emergency and it’s not reasonably possible for you to contact us to pre-authorise your treatment, please contact us within 24 hours of your admission.