Access Core

Subject to DSPS, pre-authorisation and case management,
clinical guidelines and scheme rules.
Emergency admissions must be notified to the Scheme within 48
hours of admission.

All admissions (including PMBs)
are subject to pre-authorisation, case management, clinical
protocols and scheme rules. Admissions for elective procedures
must be pre-authorised at least 72 hours before the admission
date. A 30% penalty will be imposed for non-emergency late
pre-authorisations.

Department of Health Protocols apply. Unlimited benefits for PMBs. Subject to preauthorisation, clinical guidelines, medicine formulary* and registration on the Disease Management Programme.

Subject to PMBs, preauthorisation, managed care protocols and scheme rules

Subject to PMBs and preauthorisation at Day Clinic or as Day Case.

Subject to PMBs and preauthorisation at Day Clinic or as Day Case.