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2 yr. ago

  • Yes, interesting question! I've asked Bing as I'm tired of reading all policies :)

    For Southern Cross Wellbeing One, the eligibility requirements for non-pharmac medicines are:

    • The medicines must be prescribed by a registered medical practitioner for the treatment of a covered condition.
    • The medicines must be Medsafe approved but not funded by PHARMAC.
    • The medicines must be administered in a recognised private hospital or by an Affiliated Provider.
    • The medicines must be covered under the Cancer Assist benefit, which has a limit of $10,000 per claims year and is subject to prior approval.

    A doctor prescription is not sufficient to claim for non-pharmac medicines. You also need to obtain prior approval from Southern Cross before you receive the treatment.

  • Thanks for sharing this! I'm concerned about the low rating of NIB, so think we'll switch to Southern Cross. The only annoying thing I've found with them is the low cancer cover ($60k for chemo, $10k for non-Pharmac). For $50 / month it can be increased to $300k cover.

    You're right, it doesn't make much sense to have cover for specialist. So far the couple of times we've had a scan/xray it was always below our excess. We mainly want to have cover for very expensive treatments.

  • Thanks for those stats! We have health insurance with AA which is underwritten by NIB. They are substantially cheaper than SC but have better terms for eg major surgery and cancer care, things we find important. We pay about $200 monthly for a family of four and it includes specialist care and has a $500 excess. SC for a similar plan was almost double.

    But they must make up for the difference somehow. Do you have any explanation for this difference? I appreciate this is going off topic.