Going to see a healthcare professional
We recognise that healthcare professionals play a critical role in helping you improve your health and wellbeing by sharing their expert knowledge. We believe that we have a responsibility to you, our member and our industry to use our experience, our expertise and our scale to help keep private healthcare cover affordable.
That is why we have entered into arrangements with specialists and GPs which offer them a higher rate of reimbursement while ensuring you have limited co-payments.
Our arrangements benefit you.
You can benefit by using healthcare professionals who we have an arrangement with because we will cover their approved consultations and procedures in full.
We pay claims directly to the healthcare professional when we have an arrangement with them.
What is my cover for GPs and specialists?
General Practitioners (GP) and Specialists
- 100% of Scheme Rate
- Included in out-of-hospital overall annual limit. GP network applies.
Specialists Consults
- 100% of Scheme Rate
- Included in out-of-hospital overall annual limit
- Specialist visits are limited depending on the size of your family, please refer to your brochure for more information
General Practitioners (GP) and Specialists
- 100% of the Scheme Rate
- Specialist visits are limited depending on the size of your family, please refer to your brochure for more information
Specialists Consults
- 100% of Scheme Rate
- Specialist visits are limited depending on the size of your family, please refer to your brochure for more information
General Practitioners (GP) and Specialists
- 100% of Scheme Rate
- Included in out-of-hospital overall annual limit. GP network applies.
Specialists Consults
- 100% of Scheme Rate
- Included in out-of-hospital overall annual limit
What is my cover for the dentist?
Out-of-hospital
Dental procedures (performed out-of-hospital by dentist or dental specialists).
- 100% of the Scheme Rate
- Dental visits are limited depending on the size of your family, please refer to your brochure for more information
In-hospital
Dental procedures (performed in-hospital by dentist or dental specialist).
- 100% of the Scheme Rate, subject to pre-authorisation
- Unlimited
Out-of-hospital
Dental procedures (performed out-of-hospital by dentist or dental specialists).
- 100% of Scheme Rate
- Dental visits are limited depending on the size of your family, please refer to your brochure for more information
In-hospital
Dental procedures (performed in-hospital by dentist or dental specialist).
- 100% of the Scheme Rate, subject to pre-authorisation
- Limited to in-hospital annual limit
Out-of-hospital
Dental procedures (performed out-of-hospital by dentist or dental specialists).
- 100% of the Scheme Rate
- Included in annual out-of-hospital limit
In-hospital
Dental procedures (performed in-hospital by dentist or dental specialist).
- 100% of the Scheme Rate, subject to pre-authorisation
- Included in annual in-hospital limit
