The Social Health Authority (SHA) covers a defined list of services at contracted facilities. What is covered, and up to what amount, depends on the benefit package and can change, so always check before you book.
Three things to confirm
- Is the procedure in the benefit package? Check the current SHA benefits and tariffs, or ask the facility's SHA desk.
- Is the facility contracted? Cover only applies at facilities contracted for that service.
- Do you need pre-authorisation? Many planned procedures need approval before treatment. Ask the facility to start it early.
When SHA pays part of the bill
If the facility charges more than the SHA rate, you may pay the difference. Ask for the expected top-up in writing.
Private insurance
Private covers often exclude cosmetic procedures, fertility treatment and some dental work, or cap them under a dental or optical limit. Ask your insurer before treatment, not after.
This guide is general. Confirm current cover with SHA or your insurer.