The pre-authorisation process ensures that the treatment or procedure is both necessary and appropriate. Except in emergencies, pre-authorisation must be obtained 48 hours before any hospital admission.

Pre-authorisation is required for the following, among others:

  • all admissions to hospital
  • outpatient treatment in a hospital, i.e. when you do not stay overnight at the hospital
  • admission to a day hospital
  • MRI or CT scans or radio-isotope studies
  • Access to patient care programmes
  • emergency ambulance transportation
  • specialised and surgical dentistry in hospital
  • visits to a specialist if you are on the Custom and Essential options
  • additional consultations on the Classic and Classic Network options once your savings are depleted

Ask your healthcare practitioner for a full description of:

  • the reason for admission to hospital or for the scan
  • the associated medical diagnosis
  • the planned procedure
  • all the tariff and ICD-10 codes that the doctor intends to use
  • Additional information required
  • Your membership number
  • Name and date of birth of the patient
  • Date of admission
  • Name and practice number of the provider
  • Name and practice number of the hospital

Remember: In case of an emergency you may obtain authorisation within 48 working hours. Any of your relatives/family/friends may phone to obtain a pre-authorisation number if it is not possible for you to phone.

You may request a quotation for planned procedures prior to the admission by sending the quotation to