This article is specifically for BUPA Global Members under the care of The Insurance Concierge


A Guarantee of Payment (GOP)—also known as Pre-authorisation, Prior Approval or Letter of Guarantee (LOG) — is a formal confirmation from the insurer that a specific medical treatment will be covered under the insurance plan, subject to the policy terms and limits.


Key Functions of a GOP:

  • Ensures Direct Billing: Allows the healthcare provider to bill the insurer directly, so the member does not need to pay upfront and claim later.

  • Confirms Coverage: The GOP confirms that the treatment is medically necessary and within the scope of the member’s insurance benefits.

  • Prevents Claim Rejections: Getting GOP in advance helps avoid claim denials due to lack of coverage, exceeding benefit limits, or charges beyond reasonable and customary.


A GOP is essentially an offer from the insurer to cover your medical bill; the medical provider still has control over whether they accept the arrangement and what services they will cover under the GOP (e.g. only inpatient treatment). Some providers who don't have an agreement with BUPA (non-panel providers) may also accept GOP from time to time.  


Do you know when it's required? 

The insurer mandates pre-authorisation specifically for treatment in the USA. Although it is not mandatory when seeking treatment outside of the USA, we recommend securing one regardless of whether your medical provider accepts a GOP arrangement whenever you need any of the following treatments:  

  1. Treatment at the hospital 
  2. Advanced imaging such as MRI, CT Scan, and PET Scan
  3. Cancer Treatment 
  4. When you're unsure if the treatment is within the scope of your cover. 


Is it necessary, given that my medical provider requires payment up front? 

We strongly recommend securing one, regardless of whether your treatment is hospital-based or complex (i.e. surgery or cancer treatment). The claim assessors need to verify that the treatment aligns with the diagnosis and is medically necessary, and may require further clarification. Our past experience shows that medical providers are much more responsive before treatment or payment than after payment. Additionally, the GOP speeds up the claims assessment and reimbursement process, especially.  


Should I secure a GOP for an upcoming outpatient treatment?

The Insurer is happy to issue a GOP for any treatment you need. However, depending on whether your medical provider accepts the arrangement, you will need to arrange payment. Please note that the turnaround time for a GOP request can take 2-3 business days. 


Related Article

Securing a Prior Approval/Guarantee of Payment from BUPA