You may have heard an insurer, an agent or a clinic say "is the doctor on your panel?" It sounds like a technicality. It can make a real difference to your bill.
What a panel is
Most Integrated Shield insurers keep a list of private specialists they have an arrangement with. That list is their panel. Each insurer has its own panel, and a specialist can be on one insurer's panel and not on another's.
Why it matters
Insurers often give better terms when you use a panel specialist, especially if the treatment is approved in advance (pre-authorisation). Depending on your plan, it can look like this:
| Panel specialist with pre-authorisation | Non-panel specialist | |
|---|---|---|
| Your share of the bill | Often lower | May be higher |
| Paying the bill | Hospital may bill insurer directly | Often pay first, claim later |
| Visits before and after hospital | May be covered for longer | May be covered for less time |
Seeing a non-panel specialist is not wrong, and is sometimes the right choice for a particular condition. It usually just means you should expect to pay more yourself, or to go through more steps to claim.
Panel lists change
Specialists join and leave panels, and plans are updated. A list you looked at last year may not be accurate now. Always check close to the time of treatment.
Questions worth asking
- Is this specialist on my insurer's panel for my plan?
- Does my rider treat panel and non-panel specialists differently?
- Do I need pre-authorisation, and who applies for it?
Where we come in
Matching the right specialist for your condition with the right status for your policy is a large part of what we do. We do the checking so you are not choosing blind.
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.
More guides