Specialists
Medical specialists
A specialty in medicine is a branch of medical science. After completing medical school, physicians or surgeons usually further their medical education in a specific specialty of medicine by completing a multiple year residency.
Cover for a specialist depends on your plan type.
If your specialist sees you out-of-hospital
On the N Option Plus and the N Option Basic, we pay specialist consultations from your day-to-day benefits. If you visit a specialist on the Custom Direct Payment Arrangement, the specialist will charge an agreed rate, and we will pay him or her directly.
The N Option Basic will only provide cover for specialists that form part of the Custom Direct Payment Arrangement.
If your specialist sees you in hospital
We pay up to 100% of the Fund Rate or the negotiated rate, where applicable. We pay this from your hospital benefit, subject to the overall annual limit as long as you have confirmed your hospital admission.