From request to care
What happens at each step, from your first question to using the covered services at a provider.
The member journey
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01
Learn about the services
Read about the health services and what they may include, and ask about the options available to your family.
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02
Complete the membership form
Get the membership application form from the Cooperative and fill in the required details accurately.
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03
Provide the required information and documents
Attach the information and documents required to complete your request.
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04
Your request is reviewed
The Cooperative reviews the request under its regulations and the approved conditions.
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05
Approval and activation
Once official approval is issued, membership is activated under the approved terms.
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06
Receive and use your benefit card
You receive the benefit card that identifies you at approved providers.
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07
Use the covered services
Use the covered services at approved providers within the network.
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08
Obtain approvals when needed
Some services require prior approval, requested under the approved procedures.
When you visit a provider
What happens in practice when you walk into an approved hospital, clinic or pharmacy.
Present your benefit card
Identify yourself as a member at the approved provider.
The provider verifies eligibility
Your eligibility and the services approved for you are checked.
Approval is requested if needed
If the service requires prior approval, the provider submits the request.
You receive the service
You receive the service within the limits and conditions approved for you.
Reimbursement in specific cases
In certain specified cases, reimbursement procedures may apply according to the document's conditions, time limits and required paperwork.
The details of these cases, the applicable time limits and the required documents are set out in the services document, which is the authoritative reference.
Care closer to your family starts with a question
The Cooperative's team is ready to answer your questions and walk you through the membership steps.