X-rays
X-rays are photographs or examinations of body parts made by electromagnetic radiation.
How we pay for x-rays depends on whether you have the x-ray performed in- or out-of-hospital.
X-rays done in-hospital
We pay for the x-ray from the Hospital Benefit up to a maximum of the Society Rate as long as it is related to your confirmed hospital admission.
X-rays done out-of-hospital
We will pay these claims from your day-to-day benefits, as long as you have money available.
MRI and CT Scans
Who may refer you for a MRI or CT scan
Please note
- All MRI and CT scans must be referred by a specialist.
- We will only approve scans that have been referred by an appropriate specialist. We will fund MRI or CT scans appropriately referred by a GP during an emergency hospital admission from the Hospital Benefit, depending on benefit confirmation.
How we pay MRI and CT scans needed before planned surgery
If an MRI or CT scan is done as part of a pre-operative work-up for a planned surgical procedure, in other words the scan can be performed before the admission. We will pay the MRI or CT scan as an out-of-hospital scan.
How we pay MRI and CT scans needed for conservative back and neck treatment
If the MRI or CT scan is needed during an approved admission for a chronic back or neck condition, we will pay the MRI or CT scan as an out-of-hospital scan.
In-hospital
We pay approved MRI and CT scans performed during an approved hospital admission from the Hospital Benefit as long as the scan is related to the reason for the admission.
Out-of-hospital
We pay the account from your overall annual limit, up to an annual limit per family each year.
Other scans
Mammograms
A mammogram is an x-ray examination of the female breast. It uses low-energy x-rays to visualise fine details of breast tissue, particularly the presence of calcification or soft tissue masses. This allows for early diagnosis of breast cancer.
Mammograms done out-of-hospital
We will pay for one mammogram annually from your Screening and Prevention Benefit.
Pregnancy scans
Ultrasound imaging allows imaging of the interior of the human body. Images that can't be seen by x-rays are visible through ultrasound imaging.
A maximum of two 2D scans are covered during the pregnancy. if you need more scans, you need to send us a motivation from your doctor. If you have a 3D or 4D scan, it will only be paid up to the cost of a 2D scan.
We will pay these claims from your day-to-day benefits, as long as you have money available.