Pre-authorisation & Cashless arrangement

Pre-authorisation & Cashless arrangement service inside AXA network is applicable to:

• AXA WiseGuard Pro Medical Insurance Plan
• AXA WiseGuard Medical Insurance Plan ^※
• AXA Executive Health Medical Plan ^#
• GBA EverGuard Medical Insurance *
• Global Elite Health Plan
• Global Elite II Health Plan
• GlobalReach Medical Insurance Plan
• MediPartner Health Plan
• Smart Medicare ^※
• Smart Start Medical Insurance <sup>※
  
  ※</sup> For this policy, Cashless arrangement service is applicable to designated day case procedure only

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Pre-authorisation & Cashless arrangement service outside AXA network is applicable to:

• AXA WiseGuard Pro Medical Insurance Plan
• AXA Executive Health Medical Plan ^#
• GBA EverGuard Medical Insurance *
• Global Elite Health Plan
• Global Elite II Health Plan
• GlobalReach Medical Insurance Plan
  
  ^# Coverage and payment arrangements will follow the terms of your policy
  * For this policy, Cashless arrangement service in Hong Kong is applicable to designated illnesses only

1. Download Pre-Authorisation Form I and II and complete the Pre-Authorisation Form I

2. If your attending doctor advises hospitalisation or day case procedure, kindly ask them to fill out the Pre-Authorisation Form II for you.

3. Submit documents by email or Fax to us before hospital admission or day case procedure begin.

Documents Required:

• Completed Individual Medical Pre-authorisation Form I & Pre-authorisation Form II
  
  Via Email: individual.preauth@axa.com.hk
  Via Fax: (852) 3009 4548

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4. AXA will review your application and send you a confirmation letter once it is approved

5. Begin treatment as planned without budgetary worries ⁴

1. Download Pre-Authorisation Forms and complete the Pre-Authorisation Form Part 1

2. If your attending doctor advises hospitalisation or day case procedure, kindly ask them to fill out the Pre-authorisation Form Part 2

3. Submit documents by email or Fax to us before hospital admission or day case procedure begin
Documents Required:

• Completed Pre-Authorisation Form Part 1 & Part 2
• Copies of supporting document(s) such as medical reports from attending doctor on proposed in-patient treatment/surgery/diagnostic investigations/long term medication
  
  Via Email: individual.preauth@axa.com.hk
  Via Fax: (852) 3009 4548

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4. AXA will review your application and send you a confirmation letter once it is approved

5. Begin treatment as planned without budgetary worries ⁴

Eligible medical expenses incurred will be covered in accordance with your medical scheme arrangement and up to your maximum benefit limit (ie the expenses may not be covered in full). You will be required to personally settle all expenses not falling within your benefit entitlement under the medical scheme arrangement. For any query, please call medical insurance helpline during office hour for details.