What does Medihelp hospital Plan cover?

Medihelp offers a range of hospital plans designed to provide comprehensive coverage for various medical needs. In this blog post, we will explore what the Medihelp hospital plan covers and why it might be the right choice for you.

Comprehensive Hospital Coverage

Medihelp’s hospital plans are designed to provide extensive coverage for hospitalisation, ensuring that members receive quality care without worrying about financial constraints. Here are some of the key features:

  1. Unlimited Private Hospital Care: All Medihelp plans offer access to private hospitals with no overall annual limit, ensuring that you receive the best possible care without worrying about exceeding your coverage.
  2. Emergency Services: Unlimited cover for ambulance services and treatment of medical emergencies is included, providing peace of mind in critical situations.
  3. Serious Medical Conditions: Comprehensive cover and treatment for 271 serious medical diagnoses, including 26 specific chronic conditions, are part of the plan.

Pre-Authorization Process

Medihelp applies a standard pre-authorization process for all planned hospital procedures or admissions. This process helps confirm your benefits and ensures that you know exactly what your cover entails. However, pre-authorization is not required for emergency admissions.

Alternatives to Hospitalisation

To ensure a smooth recovery after hospitalisation, Medihelp offers alternatives such as subacute care or nursing services. These services are designed to provide continued care and support once you leave the hospital.

Network and Non-Network Hospital Options

Medihelp provides flexibility in choosing hospitals. Some plans offer a choice between using any hospital or a network hospital. Opting for a network hospital can significantly lower your premium, thanks to negotiated tariffs with efficient networks of hospitals and day procedure facilities.

Coverage for Scans

If your doctor requires a CT scan or MRI to confirm a diagnosis, Medihelp’s plans provide cover for unlimited scans during hospitalisation. Plans with more comprehensive cover or larger savings accounts also offer cover for scans while not in hospital.

Emergency Care

In case of an emergency, all Medihelp plans cover medical emergencies. For emergency transport, members can call Netcare 911 at any time. This service provides expert assistance in medical emergencies, such as motor vehicle accidents, and offers advice via a 24-hour helpline.

Chronic Conditions

Medihelp’s plans cover the diagnosis, treatment, and care of 271 serious medical diagnoses known as prescribed minimum benefits (PMB), as well as 26 specific chronic conditions on the Chronic Disease List (CDL). Designated healthcare providers and a network of specialists ensure that members receive the necessary care for these conditions.

Conclusion

Medihelp’s hospital plans offer comprehensive coverage, ensuring that members receive quality care in private hospitals without financial worries. With extensive benefits, including emergency services, coverage for serious medical conditions, and flexible hospital options, Medihelp provides a robust solution for your healthcare needs