You have seen a specialist, you have been told you need a procedure, and you have a number on a piece of paper. Before you say yes, it is worth slowing down for a day or two.
Read what the quote actually includes
A quote, often called a financial counselling estimate, usually breaks the bill into parts. Check whether follow-up visits and tests after the operation are included.
Questions to ask the clinic
- What is the name of the procedure, as it will appear on the bill?
- Will it be a day procedure or a hospital stay, and what ward type?
- Is the doctor on my insurer's panel?
- Will you apply to my insurer for approval in advance?
Questions to ask your insurer
- Is this procedure claimable under my plan, for my condition?
- What will my deductible and co-insurance be, and does my rider reduce them?
- Is there anything in my history that could affect the claim?
Watch for these
- Ward type. Staying in a higher ward than your plan covers can reduce what is paid on the whole bill, not just the room.
- Pre-existing conditions. A claim can be reduced or rejected if the condition started before your policy.
- Cosmetic or not. If part of a procedure could be seen as cosmetic, that part may not be covered.
Where we come in
If you already have a quote, send it to us. We will tell you what is likely to be covered under your plan and whether anything stands out, before you commit.
Want us to check yours?
Tell us what is going on. We check your coverages, give you an indicative cost and book a suitable specialist. Free for you.
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