Prior approval and claiming

Apply for prior approval to confirm your cover

It’s important that you apply for prior approval to confirm whether the healthcare service you need is covered under your policy, and any conditions that may apply.

With prior approval, you enjoy peace of mind knowing that you’re covered.

If the cost of your healthcare service is likely to be over $1,000 or you need hospital care, you must apply for prior approval. You can apply for prior approval through My Southern Cross or by calling us on 0800 800 181 within 60 days of your healthcare service. Urgent approvals (ie within 5 working days) can only be provided by phone.

Please note: if you have any other questions about your benefits or cover for a healthcare service please call us.

More information about prior approval.

Making a claim

Policyholders can claim online with My Southern Cross, on the go with the My Southern Cross app or download a claim form and post it to us. There’s also on-the-spot claiming for some healthcare services at Easy-claim providers. Or, when you use an Affiliated Provider for a contracted service, they’ll claim on your behalf.  

Claim online

Online claiming is easy and convenient. If you’re the policyholder, login to My Southern Cross with scans or photos of your invoices and/or receipts, and you’re ready to make a paperless claim. Make sure you give us your bank account number and you’ll get paid faster by direct credit.

We aim to process online claims faster – usually within 5 working days – so you won’t wait as long for claim refunds.

Login now, register, or find out more about My Southern Cross.

Claiming on the go with the My Southern Cross app

Use the My Southern Cross app for fast claiming on the go. Policyholders can make medical (non-surgical) claims under any plan, plus all members can check benefit balances and use as a virtual Member card

Find out more information.

To download the app go to

appstore googleplay 

 

Please note, you need to register for My Southern Cross to use this app.

Affiliated Providers

An Affiliated Provider is a doctor, specialist or medical facility that is contracted to provide Southern Cross members with certain healthcare services at agreed prices. Using an Affiliated Provider is simple and hassle-free because they organise prior approval and claim on your behalf – leaving you to focus on getting well. Some healthcare services are also only covered under Southern Cross policies when they’re performed by an Affiliated Provider.

More information about Affiliated Providers.
See a list of Affiliated Provider-only healthcare services.

Easy-claim with your Member card

Claim on-the-spot with your Member card for some healthcare services at Southern Cross Easy-claim providers. Our Easy-claim providers include selected pharmacies, GPs, optometrists, dentists, and more.

Find out more about Easy-claim.

Claiming and the low claims reward

See ways to claim under your policy and everything you need to know about our low claims reward.

More information.

Unapproved healthcare services

A full list of healthcare services that are ‘unapproved healthcare services’ and are excluded under all Southern Cross policies.

See the list of unapproved healthcare services.