Planning your hospital event

Hospitalisation and associated in-hospital benefits are subject to pre-authorisation; failing to obtain pre-authorisation may lead to benefits being forfeited or co-payments applied. Pre-authorisation for a hospital admission is not a guarantee that all claims related to the hospital event will be covered in full.

Obtain your hospital authorisation

Limited to PMBs:

  • 100% of contracted rate in hospital network DSPs
  • 80% of Scheme rate in non-DSPs

Benefits limited to general ward rates. No benefit for dental surgery, except for PMBs.
Benefits only available on referral from a Bankmed GP Entry Plan Network GP or referred specialist.

Benefits for PMBs and non-PMBs:

  • 100% of contracted rate in hospital network DSPs
  • 80% of Scheme rate in non-DSPs

Benefits limited to general ward rates. No benefit for dental surgery, except for PMBs.
Benefits only available on referral from a Bankmed GP Entry Plan Network GP or referred specialist.

Benefits for PMBs and non-PMBs:

  • 100% of contracted rate in hospital network DSPs
  • 100% of Scheme rate in non-contracted private hospitals

Benefits limited to general ward rates.
No benefit for dental surgery, except for PMBs.

Benefits for PMBs and non-PMBs:

  • 100% of contracted rate in hospital network DSPs
  • 100% of Scheme Rate in non-DSPs
  • R4 750 deductible applies for use of non-DSPs

Benefits limited to general ward rates.

Benefits for PMBs and non-PMBs:

  • 100% of contracted rate in private hospitals
  • 100% of Scheme rate in non-contracted private hospitals

Benefits limited to general ward rates.

Benefits for PMBs and non-PMBs:

  • 100% of contracted rate in private hospitals
  • 100% of Scheme rate in non-contracted private hospitals

Benefits limited to general ward rates.

For more detail on your hospitalisation, download the Benefit and Contribution Schedule.