Our Contact Centre team are available to help you. Visit contact us for details of our opening hours or to send us an enquiry. Please call us:

• For urgent prior approval – for treatment within five days
• To change your premium payment date or frequency
• To change your plan, let us know you’re leaving your employer or any other plan changes such as adding or removing members

Go to contact us on our website. There’s information and enquiry forms to help direct your query.

You can do many things to manage your policy in My Southern Cross. If you have an Adviser you can also contact them.

The quickest way to submit a claim is online through the My Southern Cross app or website, claims are usually paid within 5 working days. Our turnaround time for posted claims is 10-15 days once we’ve received the claim form.

Our team aims to respond to all other online enquiries within 3 working days.

Southern Cross Travel Insurance is run separately to Southern Cross Health Insurance. As we do not have access to Travel’s systems, we are unable to answer any queries regarding travel insurance. 

We recommend you first visit scti.co.nz for more information.

If you’re an older member, you live alone, or you need some help with managing your health insurance, please make sure you have a family member or friend noted as an ‘authorised person’ for your health insurance policy. An authorised person is able to contact Southern Cross on your behalf and discuss your policy with us.

To add, change or update an authorised person, please send us an enquiry. Please include their name, contact phone number (preferably a mobile phone) and an email address on the enquiry form. If you’ve added an authorised caller in the past, you can still send us an enquiry to check whether we have the correct details for the them.

Southern Cross health insurance policies are designed to complement the services provided by the public health system. There is therefore no cover for acute care under Southern Cross health insurance policies (acute care is provided in response to a sign, symptom, condition or disease that requires immediate treatment or monitoring).  

For a healthcare service to be eligible for cover under Southern Cross health insurance policies, it must also be performed in private practice. Due to the nature of COVID-19, it’s unlikely that anything other than GP consultations, prescriptions or ambulance allowances (depending on the plan held by the member) would be covered. However, Southern Cross health insurance policies don’t necessarily exclude cover for treatment of medical conditions which may develop as a result of having the virus. What cover is available will depend on the terms of the policy you hold and the treatment you require.

Acute care is an exclusion in our health insurance policies – i.e. a sign, symptom, condition or disease that requires immediate treatment or monitoring (emergency care in a public hospital). This means that if you need emergency treatment (acute care), this will be provided in the public system for free.

As yet, we don’t have a lot of information about specific ongoing medical issues that might arise from COVID-19. However, should you develop something such as a kidney problem that requires surgery as a result of having COVID-19, and it was not an emergency situation, then provided the surgery was undertaken in a private facility (you would need to be discharged from the public hospital) you may have cover for that kidney surgery under your health insurance policy. This would depend on the terms of your policy and be assessed under normal policy eligibility criteria.

Tests for COVID-19 are Government funded and are free, so they are not covered under Southern Cross health insurance policies.  

Although some policies include a benefit for laboratory tests, this benefit only covers laboratory tests performed for diagnostic purposes which are not funded by the Government.

Southern Cross health insurance policies don’t cover overseas medical evacuations. To find out whether you are covered under a travel insurance policy, please contact your travel insurer.

Please refer to the Ministry of Health website to find out if you are eligible for care under the New Zealand public health system and for the services that are covered. 

If you have a GP benefit in your plan, then submit your claim the usual way. Remember that GPs are asking that you phone them first if you have any concerns about COVID-19 symptoms, or you should contact Healthline. 

Yes, if you have a GP benefit in your plan and your GP offers phone or video consultations, you can claim for this in the usual way. If they offer Easy-claim, this is the simplest way to claim.

Yes. Other than for UltraCare, all specialist consultations must be with an Affiliated Provider. We have made a change to enable you to claim for specialist consultations undertaken over the phone or by video and specialists can process your claim as they usually would on your behalf.

If you are on UltraCare and consult a specialist who is not an Affiliated Provider, you will need them to send you a receipt and then submit your claim as you usually would. Remember that online claims are processed faster and there is currently a delay processing posted claims that could be further impacted by a reduction in postal services depending on the current Alert Level.

You’ll need to discuss this with your healthcare professional, GP or the specialist you are seeing, and also act according to the current Alert Level advice. They will be able to answer any specific questions about risks or concerns you may have.

If you would like to change the cover you have, please contact us or speak to your Adviser.

The Hardship Downgrade is a short-term option for members who have had their policies on hold for a minimum of 30 days due to financial hardship as a result of COVID-19.
 
It enables you to choose a different plan that would cost less (we call this a ‘downgrade to a lower plan’), and then return to the plan you’re on now (upgrade to your ‘original plan’) within 18 months without losing any pre-existing condition cover. On return to your original plan, you will also be covered for any new health conditions you develop while on the lower plan (these are called ‘developed conditions’), subject to policy terms and conditions.
 
Normally if you downgrade your plan and then upgrade later to your original plan, cover for any pre-existing health conditions remains covered to the lower plan. In addition, when applying to upgrade again all members on the policy would usually need to complete a medical declaration (‘be underwritten’) and any new health conditions (developed conditions) would only be covered to the benefit limits set out in the lower plan.
 
Before taking a Hardship Downgrade, it’s important to discuss your circumstances with one of our team to understand if it’s right for you and the other members on your policy. 
 
It’s only available until 31 December 2020, and you must return to your original plan within 18 months of changing. 

It’s important to understand that while you are on the lower plan, your cover will be that of your new, lower plan including for your pre-existing conditions. 
 
The special Hardship Downgrade benefits relate to what happens when you return to your original plan within 18 months.

If you answer yes to the following questions then talk to us about your individual circumstances, and whether the Hardship Downgrade option is suitable for you and any other members on your policy:

• You’ve had your policy on hold for a minimum of 30 days due to the impact of COVID-19.
• You have cover for pre-existing health conditions, or you’re in the process of earning cover for them. For example, you’re in a work scheme with this special concession, or you’re on a plan like RegularCare or UltraCare where pre-existing conditions are covered after 3 years.
• You want to keep some health insurance cover but you’re looking to reduce the cost of your health insurance premiums.
• You are comfortable with decreasing your level of cover and benefit limits (these will depend on the lower plan you choose) for up to a maximum of 18 months.
• You intend to go back to your original plan within 18 months.

The policyholder can view this information for all members in My Southern Cross or on the membership certificate.

Please contact us, so we can discuss your personal circumstances and help you decide the option that best suits your current healthcare needs as well as your budget.

No, this is for genuine situations of financial hardship due to the impact of COVID-19. You must have had your policy on hold for at least 30 days to be eligible for the Hardship Downgrade.

The Hardship Downgrade is designed specifically to help members that have already provided evidence of financial hardship due to COVID-19 and who can’t afford the same level of health insurance that they had previously, but who want to retain some cover.

If you do not return to your original plan within 18 months of exercising the Hardship Downgrade option, then any change from your lower plan is subject to the normal terms and conditions of plan changes. 
 
In most cases, this would mean that on upgrading plans, pre-existing health conditions would only be covered to the benefit limits set out in the lower plan; all members on the policy would be required to complete a new medical declaration (‘be underwritten’); and any new health conditions developed while you were on the lower plan (‘developed conditions’) would only be covered to the benefit limits set out in the lower plan.

You can return to your original plan at any time within 18 months to be eligible for the Hardship Downgrade benefits.

The Hardship Downgrade is only available once per policy. It must be taken before 31 December 2020.

You must have an active policy for 6 months between premium suspensions / on hold periods.
 
This means that you’d need to stay on your lower plan for 6 months before being able to put it on hold. If you do place your policy on hold again, you must still upgrade to your original plan within 18 months of taking the Hardship Downgrade to be eligible for the Hardship Downgrade benefits.

Yes, you can. The Hardship Downgrade is still relevant to you, because if you develop any health conditions while you are covered under the lower plan (‘developed conditions’),  then when you return to your original plan these will be covered to the level of your original plan (subject to policy terms and conditions), provided you return to your original plan within 18 months. 
 
In normal circumstances, developed conditions would only be covered to the level of the lower plan if you chose to upgrade at a later date.

Please contact us - it’s important to talk through your circumstances and budget, and the implications for you and any other members on your policy.

Pre-existing conditions mean any health condition, sign or symptom occurring or existing prior to joining Southern Cross or prior to changing your plan. If you’re not sure if you, or any members on your policy already have any pre-existing conditions listed, the policyholder can view this information for all members in My Southern Cross or on the membership certificate.

If you’ve lost your income and are no longer in paid work (i.e. lost your job or been made redundant) as a result of the impact of COVID-19, we have extended our support so you’re able to put your policy on hold for up to six months. When your policy is on hold you don’t pay premiums and you’re unable to make claims. Please let us know your situation so we can assess your request. 

If you haven’t lost your job but you’re in financial hardship we have a range of options, including putting your policy on hold for up to three months. The best thing to do is contact us so we can assess your request.

This means that you are no longer in paid work and are experiencing a total loss of taxable income.

If you’ve lost your income, you’ll need to provide a copy of the official notice from your employer (such as a letter or an email), or if this is not possible, other alternative documents suggested by us, to prove this. 

For other financial hardship situations, we’ll need some evidence to support your request – we can discuss this with you. 

Let us know your situation and we’ll be in touch about the type of evidence we require and how to provide it.

Providing proof is a normal part of applying for any type of hardship relief.

If you need to contact us urgently, you can still phone us on 0800 800 181 – Monday to Friday. The online form helps us get the information needed to assess your hardship request and means we can deal with it faster.

We aim to get back to you within two working days. If you’re able to provide all the information we need for proof of hardship, it will help us to process your request as fast as possible.

Yes, you can restart your policy at any time during the on hold period by restarting your payments. When you restart your policy, you can start claiming from the date payments begin. Please contact us if you want to reinstate your policy early.

Yes, the special six-month relief is for members who have lost their income and are no longer in paid work (i.e. loss of job or redundancy) due to the impact of COVID-19. 

If you haven’t lost your job but you’re in financial hardship we have a range of options, including putting your policy on hold for up to three months. The best thing to do is contact us so we can assess your request. If your policy is put on hold, we can work with you at the end of the three month period to help with your options.

Let us know your situation here - there are a range of options including adding an excess, downgrading your plan, or removing modules that will all help to reduce your premium.

It keeps it fair for everyone and helps us to moderate claims costs during a period of reduced premium income.

Yes, you can submit claims for eligible healthcare services provided, up to the date your policy goes on hold. The eligible healthcare service must have taken place before your on hold period starts, and it’s a good idea to submit any claims now through My Southern Cross.

If you decide to cancel your policy and re-join Southern Cross in the future, it’s important to know that you will start as a new member and will likely have to complete a full medical declaration. All previous history including any loyalty benefits will be lost and pre-existing conditions you are currently covered for may not be covered again. 

When your policy is on hold, you retain or continue to earn loyalty benefits (for example, cover for benefits or pre-existing conditions that is earnt by having your policy for a certain amount of time). You also retain all currently covered pre-existing medical conditions.

To be eligible to put your policy on hold we need to set up a direct debit so payments can restart automatically on the date your on hold period finishes. We’ll be in touch by email or through My Southern Cross before any payments are taken and to re-confirm when payments will begin again. You’ll be able to make any further changes at this point (for example, the account the payments will be made from).

We have doubled our standard hardship option from three months to six months for members who have lost their income and are no longer in paid work. We have also removed some of the rules, e.g. members no longer have to have held their policy for 12 months continuously before they can access hardship relief.

There are a range of options available to our business customers ‒ please contact your Account Manager or Adviser in the first instance.

Please let us know about your situation so we can look at the options for you.

In most cases the premium credit was calculated on a percentage of your annual premium as it was at 1 April 2020, and it equates to 14.4% of three months’ premium.

In some cases, due to the status of the policy, we had to calculate the premium credit as a percentage of annual premium as at an earlier date, for example where the policy was on hold at 1 April 2020.

The premium credit was applied to all eligible policies on 27 May 2020. 

We contacted the majority of all eligible policyholders between Friday 5 and Friday 12 June to advise the details of the credit (you’ll receive this by post if we don’t have your email address, which may take longer to arrive). If you still have questions after you’ve received this update, please send us an enquiry and one of our team will aim to get back to you within 3 working days. (Note, there are some policyholders that will have their update provided after 12 June due to the complexity of their billing or work scheme arrangement.)

The premium credit was made to whoever the bill-payer was on 27 May 2020. This is because some policies are paid for by someone other than the policyholder (for example, employers that pay for health insurance for their employees), so the premium credit benefits the person / entity responsible for paying the premium at the time the premium credit was applied. 

This depends on how you pay your premium and the timing of your payments. 

If you pay any of your policy by direct debit or recurring credit card deduction, then the credit has been applied to your policy and will automatically change the amount of your payment/s. 

If you pay by invoice, then your invoice will reflect this.

Details of your upcoming payments are available in My Southern Cross.

If you pay through wage or salary deduction, then we have been in touch with your employer and advised of the amount that needs to change in your deduction (after your employer has processed the change), so you receive the appropriate premium credit. We’re working closely with our group businesses to make sure they have everything they need to apply the credit to your policy. Please allow them some time to process it, particularly if you work for a larger organisation.   

If you do not contribute anything to your health insurance premium, i.e. your employer pays for all of your premium - the premium credit will benefit the bill-payer (i.e. your employer, if they pay your bill).

We believe it’s important to support all of our members in a way that is fair and equitable. That’s why, instead of applying premium price freezes for those members whose policies renewed during lockdown, we decided to apply credits to all eligible policies, so everyone benefits. 

While claims did drop significantly during Level 4, claims have returned to normal in Level 1. Therefore, it’s important that we continue to apply increases related to the rising cost of medical procedures, and our growing health needs as we age.

We have shared the $50 million to support our membership by applying a credit to each eligible policy. It has been shared out proportionally based on a percentage of the policy premium. The amount used to calculate the premium credit is the total after any discounts (such as the low claims discount) have been applied.

As a general rule, the premium credit was applied to all eligible health insurance policies (including Health Essentials) that were in place as at 12.01am Wednesday 1 April 2020 and were not cancelled before the premium credit was applied on Wednesday 27 May 2020. Policies where no premium is payable as a result of a specific policy benefit or a specific group arrangement are an exception to this rule.

The premium credit does not apply to the following:

• Critical Illness policies
• Cancer Assist policies
• Southern Cross Travel Insurance policies
• Southern Cross Pet Insurance policies
• Southern Cross Life Insurance policies

We’ve contacted all policyholders (most by email, with a small number by post if we don’t have your email address) with details of their premium credit. We’ll also notify you in the usual way about your payments. If you’re not already, do register for My Southern Cross as this is the quickest way to receive updates and communications.

In My Southern Cross go to ‘What I pay’ to see details of your next payment. You’ll also receive an updated invoice or direct debit confirmation - we let you know when these are available to view in My Southern Cross or, if you’re not registered, you’ll receive this in the post.    

Your premium credit directly relates to the amount you pay towards your health insurance, and it’s been applied even when it’s a small amount of money. We did consider a threshold (for example, not paying where it was under $1) but we opted to apply the premium credit regardless how small - this is because we committed to return a share of the pledge to every eligible policy.

Your premium credit directly relates to the amount you pay towards your health insurance, and it’s been applied even when it’s a small amount of money. As a member-based organisation, fairness and equity are paramount, so the premium credit has been applied to all eligible health insurance policies. If you’re facing financial hardship and need more support, please contact us to discuss the options we have available to help you.

In the majority of cases the premium credit was calculated on a percentage of your annual premium as it was at 1 April 2020, and it equates to 14.4% of three months’ premium. In some cases, due to the status of the policy, we had to calculate the premium credit as a percentage of annual premium as at an earlier date, for example where the policy was on hold at 1 April 2020.

Your premium credit directly relates to the amount you pay towards your health insurance, and it was applied even when it was a small amount of money.

In some cases, due to the status of the policy, we had to calculate the premium credit as a percentage of annual premium as at an earlier date, for example where the policy was on hold at 1 April 2020.

If you pay through wage or salary deduction, then we have been in touch with your employer to advise the details of your premium credit (if your policy is eligible) so you receive the appropriate amount. 

We’re working closely with businesses to make sure they have everything they need to apply the credit to your policy. Please allow them some time to process it, particularly if you work for a larger organisation. 

The premium credit was applied to the bill-payer on 27 May 2020. If you and your employer both contribute towards the policy premium, then the premium credit has been shared between you and your employer according to how much of your premium you each pay, and this information has been sent to you.

We’re working closely with businesses to make sure they have everything they need to apply the credit to your policy. Please allow them some time to process it, particularly if you work for a larger organisation.

No, you won’t get this directly. The premium credit was applied to the bill-payer on 27 May 2020, so if your employer is the bill-payer for your policy, then your employer will have received the premium credit. It’s our way of supporting the thousands of New Zealand businesses providing health insurance to their employees - so you do benefit from this indirectly. 

We have provided this information to businesses and are working closely with them to make sure they have everything they needed to apply the credit for your policy. Please allow them some time to process it, particularly if you work for a larger organisation.

We have provided your employer with details of how much your premium credit is (if your policy is eligible). We’re working closely with businesses to make sure they have everything they need to apply the credit to your policy. Please allow them some time to process it, particularly if you work for a larger organisation. 

The amount of premium credit that is applied to employers varies depending on a range of factors, including the proportion of premium they contribute. It’s up to your employer if they want to share this detail with you.

The credit has been applied to the policy, rather than as a payment to specific members. So, it simply reduces the next bill, for whoever pays for the policy. 

The credit has been applied to the policy, rather than as a payment to specific members. So, it simply reduces the next bill, for whoever pays for the policy. 

The premium credit applies to all eligible health insurance policies in place as at 12.01am Wednesday 1 April 2020.

This means if you took out a health insurance policy after this date you will not be eligible for the premium credit.

If your eligible policy is on hold you have still received the premium credit. It does not change the status of your policy - your policy will remain on hold until you advise us you would like to restart it, or until the end of your on hold period. When you restart paying premiums, your first payment/s will be reduced by the amount of the credit.

As a general rule, the premium credit applies to all eligible health insurance policies in place as at 12.01am Wednesday 1 April 2020 that were not cancelled before the premium credit was applied on 27 May 2020.

This means if you cancelled your policy before 27 May 2020, unfortunately you won’t be eligible for the premium credit.

However, if you cancelled your policy before 1 April 2020, or after 1 April but before 27 May 2020 and your policy was/is reinstated within 30 days, then you will be eligible for the premium credit. If your health insurance policy was in place on 1 April 2020 and you cancelled your policy after 27 May 2020, then the premium credit will have been applied to your policy and your final premium payment will have been reduced by the amount of the premium credit. Please note that the premium credit will not be paid out as a cash payment. 

No, we will not be making any cash payments.

To make this as fair and equitable as possible, we have elected to make the premium credit apply to eligible health insurance policies as they were in place as at 12:01am on 1 April 2020. 

We realise that some people will have made changes before or after this date that may have increased or decreased their premium, but we will not be revisiting the premium credit in these circumstances.

If you’d like to look at your cover options, please contact us.

If you’re behind in your premium payments for your eligible policy, you have still received the premium credit, so the amount you are behind will be less after the credit. 

You should continue to make any payments that are due. If you’re having difficulty in paying for your health insurance, please contact us so we can work through your options with you. 

Please contact us to discuss our financial hardship options.

No this will not impact any loyalty rewards or discounts such as the low claims discount. 

Essentially, we looked at the claims we would normally have paid during Alert Levels 4 and 3 and estimated the proportion we expected to be deferred versus cancelled altogether. This number was our best estimate of the value of those claims that were likely be cancelled altogether, and we pledged to return that back to eligible policies by way of a credit based on a percentage of each policy’s premium.

Now we are at Alert Level 1, our claims have returned to normal levels. 

The total amount of the pledge that we shared with members and businesses came to $50,003,826.27.

79.61% of the premium pledge was applied directly to policyholders (who pay for all or some of their health insurance personally), and 20.39% was applied to business customers who pay for all or some of their employees’ health insurance. 

We can’t say for sure, but if we continue to remain at a lower Alert Level, it’s unlikely. At Alert Level 1, private healthcare services have resumed, and claims have returned to normal levels. 

The Premium Pledge was given in response to the lower number of claims that were made during Alert Level 3 and 4, due to the limited access to private healthcare services during the lockdown.

Claims reduced significantly during Level 4, as expected due to reduced access to private healthcare services. They picked up again significantly at Level 3 and 2 and at Level 1 claims have returned to normal levels.

As a member-based organisation, fairness and equity are paramount, so the premium credit has been applied to all eligible health insurance policies.

We’ve made this decision so it’s as fair as possible to every member and business customer of Southern Cross.

We believe it’s important to support all of our members through this tough time in a way that is fair and equitable. 

All members have the potential for being impacted whilst treatment options are limited during Alert Levels. This is not a recognition of loyalty but a very specific response to the situation experienced throughout Alert Levels 3 and 4.

This is a large undertaking, and not something we’ve ever done before. With over 880,000 members and 4,000 business customers we aren’t able to change the way we apply this premium credit for individual members. 

Some members have told us they intend to donate the equivalent amount to charity once they have received their premium credit. You may wish to do the same and donate it to a charity of your choice.  

We’ll be contacting all policyholders in the next couple of weeks with details of your credit, now that it’s been applied to your policy.

Please contact us to do this or speak to your Adviser.

It’s important that you let us know if you or family members have returned, within 30 days of coming back to New Zealand, to ensure your health insurance policy can be continued. Please contact us and we’ll get back to you as soon we can.