One month before the renewal date, you will receive a new Insurance Certificate indicating
the premium for the next Insurance Year. If you do not receive your Insurance Certificate one
month before your renewal date, it is important that you notify us.
We have the right to apply revised policy terms and conditions, effective from the renewal
date. The policy terms and conditions and the Table of Benefits that exist at renewal will apply
for the duration of the Insurance Year.
Treatment Guarantee
Your Table of Benefits will confirmwhich benefits available to you require pre-authorisation
through submission of a Treatment Guarantee Form. If Treatment Guarantee is not obtained,
the following will apply:
•
If the treatment received is subsequently proven to be medically unnecessary, we reserve
the right to decline your claim.
•
For the benefits listed in the Table of Benefits with a 1, we reserve the right to decline
your claim. If the respective treatment is subsequently proven to be medically necessary,
we will pay only 80% of the eligible benefit.
•
For the benefits listed in the Table of Benefits with a 2, we reserve the right to decline
your claim. If the respective treatment is subsequently proven to be medically necessary,
we will pay only 50% of the eligible benefit.
Treatment in the USA
If you have “Worldwide” cover and wish to locate a medical provider in the USA, simply go to:
. If you have a query about a medical provider, or if
you have selected a provider and wish to arrange an appointment, please call
(+1) 800 541 1983 (toll-free from the USA). You can also apply for a discount pharmacy card
which can be used any time your prescription is not covered by your healthcare policy. To
register and obtain your discount pharmacy card, simply go to:
and click on “Print Discount Card”.
Please note that treatment in the USA is not covered, if we know or suspect that cover was
purchased for the purpose of travelling to the USA to receive treatment for a condition, when
the symptoms of the condition were apparent to the member prior to the purchase of cover.
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