Affiliated Provider-only healthcare services

A number of healthcare services are only eligible for cover if they are performed by an Affiliated Provider. This applies to all health policies except UltraCare.

Find an Affiliated Provider

In order to receive cover for the healthcare service you must meet any applicable eligibility criteria and the terms and conditions of their policy at the time the services are provided.

Please be aware that not all healthcare services are available from all Affiliated Providers or in all areas.

Unless otherwise advised by Southern Cross / your Affiliated Provider, we will pay the following:

  • RegularCare, KiwiCare and First Cover plans – 80% of the amount charged by your Affiliated Provider for the healthcare service up to policy limits.
  • All other plans (excluding UltraCare) – 100% of the amount charged by your Affiliated Provider for the procedure up to policy limits.

For full details, please refer to your policy document.

Select the healthcare service you require from the list below to understand what you need to do to confirm cover for your treatment.

For the healthcare services below find an Affiliated Provider here. If you can’t find one please contact us.
  • All specialist consultations

For the healthcare services listed below (unless stated otherwise) check here to find an Affiliated Provider. For prior approval you can apply online through My Southern Cross or if you have any questions or need more information call 0800 800 181. We’re here to help Monday to Friday, 8am to 6pm 

  • Mammography
  • X-ray
  • Ultrasound
  • Digital breast tomosynthesis
  • Nuclear scanning (scintigraphy)
  • Myocardinal perfusion scan
    • Please note, must be referred by a specialist in private practice
  • CT angiogram
  • CT coronary angiogram
    • Please note, must be referred by a specialist in private practice
  • MR angiogram
    • Please note, must be referred by a specialist in private practice
  • Computer axial tomography (CT scan) 
    • Please note, cone beam computed tomography (CBCT) must be referred by a specialist in private practice
  • Magnetic resonance imaging (MRI Scan)
    • Please note, must be referred by a specialist in private practice
  • Positron emission tomography / computed tomography (PET/CT)
    • Please note, cover is limited to specific diagnosed cancers and must be referred by a specialist in private practice
    For the healthcare services below find an Affiliated Provider here. If you can’t find one please contact us.
    • Ambulatory blood pressure monitoring (when performed by a specialist)
    • Breath nitric oxide test
    • Corneal topography
    • Fundus fluorescein angiography
    • Fundus photography
    • GDx Retinal scanning
    • Heidelberg Retinal Tomography (HRT)
    • Intraocular pressure test (IOP)
    • Matrix screen
    • Optical Coherence Tomography (OCT)
    • Optic disc photos
    • Visual fields
    • Retinal photography

    For the healthcare services below please call 0800 800 181. We’ll discuss the cover available under your policy and explain the process. We’re here to help Monday to Friday, 8am to 6pm.

    • Chemotherapy treatment
    • Radiotherapy (including radiotherapy planning and radiation treatment)

    For the healthcare services below find an Affiliated Provider or General Practitioner with an Easy-claim agreement here. If you can’t find one please contact us.

    • Drug challenge testing for allergy
    • Food challenge testing for allergy
    • Injection for allergy
    • Skin testing for allergy
    • Desensitisation
    • Coronary artery bypass graft surgery (CABG)
    • Valve replacement
    • Valvuloplasty
    • Bentall’s procedure
    • Coronary angiogram and/or angioplasty
    • Electrophysiology studies
    • Ablation of cardiac arrhythmias
    • Percutaneous patent foramen ovale (PFO) closure
    • Percutaneous atrial septal defect (ASD) closure
    • Transcatheter aortic valve implantation/replacement (TAVI/TAVR)
    • Left atrial appendage occlusion

    For the healthcare services below find an Affiliated Provider here. If you can’t find one please contact us.

    • Coronary angiogram and / or angioplasty
    • Electrophysiology studies and ablation of cardiac arrhythmias
    • Percutaneous patent farmen ovale (PFO) closure
    • Percutaneous atrial septal defect (ASD) closure
    • Peripheral angiogram and / or angioplasty
    • Advanced electrocardiogram (AECG)
    • Resting ECG (when performed by a specialist)
    • Exercise ECG (when performed by a specialist)
    • Holter monitoring (when performed by a specialist)
    • Echocardiogram (when performed by a specialist)
    • Stress echocardiogram (when performed by a specialist)
    • Dobutamine stress echocardiogram (when performed by a specialist)
    • Transoesophageal echocardiogram (when performed by a specialist)

    For the healthcare services below find an Affiliated Provider here. If you can’t find one please contact us.

    • Grommets (insertion and / or removal of grommets in theatre)
    • Aural toilet (when performed by a specialist)
    • KTP Laser ear surgery
      • KTP laser mastoidectomy
      • KTP laser revision mastoidectomy
      • KTP laser tympanoplasty
      • KTP laser second look tympanoplasty
      • KTP laser middle ear adhesiolysis
      • KTP laser stapedectomy
      • KTP laser medial canalplasty
      • KTP laser myringotomy
    • Balloon sinuplasty
    • Endoscopic modified Lothrop
    • Functional endoscopic sinus surgery (FESS) Septoplasty
    • Nasal cautery (when performed by a specialist)
    • Adenoidectomy
    • Tonsillectomy
    • Laser treatment for pharyngeal, laryngeal and oesophageal conditions
    • Transoral robotic surgery
    • Contrain biofeedback and electrostimulation for faecal incontinence
    • Sacral nerve stimulation for faecal or urinary incontinence (no reimbursement will be made towards the cost of the stimulation device used to treat faecal or urinary incontinence)
    • Adrenal vein sampling (AVS)
    • Basivertebral nerve ablation
    • Image-guided ablation for bone tumours or metastases (including cementoplasty)
    • Percutaneous medial branch thermal radiofrequency neurotomy (cover is limited to 2 percutaneous medial branch thermal radiofrequency neurotomy procedures per lifetime)
    • Endoscopic third ventriculostomy
    • Posterior vitrectomy
    • Entropion and ectropion repair
    • Upper eyelid blepharoplasty
    • Correction of ptosis
    • Removal of tarsal cyst
    • Probing/syringing of lacrimal passage
    • Bleb needling
    • Minor eyelid surgery
    • Cataract surgery (cover is limited to the surgical insertion of a standard monofocal intraocular lens only, there is no cover for the additional cost of any other type of surgically implanted intraocular lens or associated costs)
    • Excision of pterygium
    • Excision of pinguecula
    • YAG laser capsulotomy
    • Laser iridotomy
    • Laser iridoplasty
    • Laser trabeculoplasty
    • Cyclodiode laser cyclophotocoagulation
    • Photocoagulation of the retina
    • Pan retinal laser
    • Macular laser
    • Corneal crosslinking, intravitreal injections (cover for drug costs is limited to $100 per injection regardless of the type of drug used)
    • Implantation of minimally invasive subconjunctival filtration device

    For the healthcare services below find an Affiliated Provider here. If you can’t find one please contact us.

    • Tooth extraction
      • Please note, no cover for RegularCare and KiwiCare policies
    • Primary total knee joint replacement
    • Primary partial (hemi) knee joint replacement
    • Primary total hip joint replacement
    • Carpal tunnel release
    • Radiofrequency ablation of benign bone lesions
    • Synthetic ligament repair and reconstruction

    For the healthcare services below find an Affiliated Provider here. If you can’t find one please contact us.

    • Mohs surgery (includes cover for excision and closure)
    • Excision of skin lesion
    • Skin biopsy (only applies if under general anaesthetic)
    • Currettage and diathermy (only applies if under general anaesthetic)
    • Cryotherapy (only applies if under general anaesthetic)
    • Resection of bladder tumour
    • Ureteroscopy, laparoscopic or percutaneous renal cryoablation
    • Circumcision
    • Nephrectomy
    • Robotic partial nephrectomy