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.

Specialist consultations

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

Diagnostic tests

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)

Ear, nose and throat (ENT)

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

General 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)

Interventional radiology

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