Can I obtain the services of a specialist on Value Care Plan?
Q: Can I obtain the services of a specialist i.e. paediatrician, specialist physician, cardiologist, etc. on the Value Care Plan?
Yes, you can. You need a referral from a Prime Cure Network GP and you also need to obtain authorisation before you see a specialist. Without authorisation and referral, you would be liable for the full amount of your claim, or, if your claim is Prescribed Minimum Benefit (PMB) related, a co-payment of 30%. You may have to pay for the services upfront and submit the claim to request a refund. The Prime Cure Network might have an agreed rate with certain specialists. These specialists can, however, charge their normal rates, which might result in a co-payment. Ask your specialist for a quote before you phone Prime Cure for an authorisation (0861 665 665). The call centre agent will also be able to assist you with the amount you may be required to pay in if the specialist charges above the Prime Cure Rate.
More FAQs for members of the Value Care Plan are available here