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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 (from 17 July 2017)

X-ray (from 17 July 2017)

Ultrasound (from 17 July 2017)

Digital breast tomosynthesis (from 17 July 2017)

Nuclear scanning (scintigraphy) (from 17 July 2017)

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) from 17 July 2017
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

Cardiac surgery

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

Coronary artery bypass graft surgery (CABG)
Valve replacement
Valvuloplasty
Bentalls procedure
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

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

Colonoscopy
Cholecystectomy
Balloon enteroscopy
wireless pH capsule (wireless capsule endoscopy)
Endoscopic ultrasound
Gastroscopy
Colonoscopy
Balloon enteroscopy
Wireless pH capsule (wireless capsule endoscopy
Hernia repair (femoral, hiatus, inguinal and umbilical hernia repair
Microwave ablation of lung tumour
Sacral nerve stimulatior

Please note, there will be no reimbursement for the cost of the stimulation device

Varicose vein (cover limited to two varicose vein leg procedures per leg, per lifetime)

endovenous laser treatment
ultrasound guided sclerotherapy
varicose vein surgery
radiofrequency (RF) endovenous ablation
duplex vein mapping

Contrain biofeedback and electrostimulation for faecal incontinence

Please note, there will be no reimbursement for the cost of the stimulation device

Interventional radiology

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

Superficial vascular malformation sclerotherapy and embolisation – simple

Please note, cover is limited to two procedure per vascular malformation per lifetime

Percutaneous medial branch thermal radiofrequency neurotomy

Please note, cover is limited to two procedures per lifetime

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

Endoscopic third ventriculostomy

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

Bleb needling
Cataract surgery
Corneal crosslinking
Corneal topography
Entropion and ectropion repair
Excision of pterygium
Excision of pinguecula
Fundus photography
Fundus fluorescein angiography
GDx retinal scanning
Heidelberg retinal tomography (HRT)
Intraocular pressure test (IOP)
Intravitreal injections
Laser eye treatment
Matrix screen
Minor eyelid surgery
Optic disc photos
Optical coherence tomography (OCT)
Probing / syringing of lacrimal passage
Correction of ptosis
Removal of tarsal cyst
Retinal photography
Upper eyelid blepharoplasty
Visual field tests
Vitrectomy

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

Orthopaedic surgery

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

Synthetic ligament repair and reconstruction
Carpal tunnel release
Hip joint replacement (primary total hip joint replacement)
Knee joint replacement (primary total knee joint replacement and primary partial hemi knee joint replacement)
Radiofrequency ablation of benign bone lesions

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)

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.

Prostate treatment
- laparoscopic prostatectomy
- prostate brachytherapy
- external beam radiotherapy
- prostate cryotherapy
- radical retropubic prostatectomy
- perineal prostatectomy
- transurethral resection of prostate (TURP)
- open enucleation of prostate
- laser resection of prostate
- robotically assisted laparoscopic prostatectomy
Laparoscopic renal cryotherapy
Vasectomy
- Please note, this is a loyalty benefit, there is no cover on SureCare or SureCare Concessionary policies and no cover for reversals
Robotic partial nephrectomy - find an Affiliated Provider here