Hospitalisation

Even if your chosen Benefit Option has designated specific hospitals as the providers that should be used to ensure cover in full, we will cover your emergency admission in full as a Prescribed Minimum Benefit in whatever hospital you are admitted to. 

You, the hospital or one of your family members must inform the Scheme of your admission as soon as possible after the emergency – and at least within 48-hours thereof.

The Scheme will not transfer you to another hospital, except where the required medical treatment is not available from the non-network hospital to which you were admitted. The Scheme therefore has no intention of moving a patient who has been admitted to a non-network hospital to any other hospital, except for sound medical reasons.

The possibility of moving you from a non-network hospital to one that is in the network, other than in the above situation, would under normal circumstances only be done with your consent after discussing this with your treating doctor, where you are out of danger but likely to remain hospitalised for a lengthy period for monitoring purposes, or to receive ongoing treatment.

If you choose to stay in the non-DSP hospital, we will pay your claims in terms of the specific rules of your chosen benefit option and you may have to make a co-payment or self-fund the shortfall.