What if I cannot use a network Healthcare Professional?
In a medical emergency, go straight to the nearest hospital. If it is not an emergency, you should use a Healthcare Professional, pharmacy or hospital in our network for Prescribed Minimum Benefit care, to make sure we pay for the cost of care in full.
There are other situations in which we pay for Prescribed Minimum Benefits in full, even if you do not use a Healthcare Professional in our network, as long as you contact us for permission (pre-authorisation) beforehand. Examples of these situations are:
The healthcare service is not available from someone in the Bankmed Network, or you would have to wait an unreasonably longtime to receive the treatment or service
You need immediate medical or surgical treatment for a Prescribed Minimum Benefit condition, and the circumstances or location mean you cannot reasonably use a network provider
No network provider is within a reasonable proximity to your home or work address