When we review premiums, we consider aspects such as changes in the healthcare environment – including the increasing number and cost of claims. And because there’s generally a need to claim more often and for greater amounts as we get older, premiums increase with age.
We have a number of initiatives to help manage premium costs. These include strengthening our Affiliated Provider programme, recovering costs from ACC, regular plan reviews, increasing our online services, and actively promoting better health and wellbeing to our members. See more information.
Your 2.5% direct debit discount is included in your new premium before any other rewards or discounts are applied.
If you’re part of a work scheme, it’s likely that you receive a discounted rate over private membership rates. This discount is reviewed each year and may take into account:
If you pay your premium by direct debit, credit card or wage and salary deductions, you don’t need to pay now. Your premium will be updated automatically.
If you pay your premium by invoice, please don’t pay your premium now. We’ll send an invoice soon.
As a policyholder you can make a claims, both medical and surgical, request prior approvals for upcoming healthcare services* and all members can view annual benefits and remaining balances. The app can also be used as a virtual Member card.
* HealthEssentials policy holders cannot request Prior Approvals or make surgical claims.
You must attach relevant documentation for claims or Prior Approvals to be processed. The app will state what you need to provide before you begin each process. You can send us up to ten claims in one submission, if you have more, simply submit the first batch, and continue a new set of claims.
The app allows you to take images when you're making a claim by accessing the device's camera - once the claim is submitted this image is deleted. If you wish to keep the image, take photos of the receipts using your device's camera app before you use the app to make a claim - the app will allow you to choose those images from your photo library.
Our list of Affiliated Provider-only healthcare services shows an up-to-date list of healthcare services that are in transition.
Your Member card holds both your Member card number and your membership number. Easy-claim providers will need this information to find your details in the Easy-claim system, to make electronic claiming possible. If you do not have your card with you, the provider can use your full name and date of birth to find your details.
You can now also use the My Southern Cross app as your virtual Member card.
If you have misplaced your Member card, call Southern Cross on 0800 800 181 to request a replacement.
Keep your receipts and claim online with My Southern Cross or on the go with the My Southern Cross app.
Alternatively you can complete a claim form. Send your completed form and receipt to us at Southern Cross Health Society, Claims Centre, Private Bag 3216, Waikato Mail Centre, Hamilton 3240. Freepost Authority 1440.
Find out more on how to claim.
Your Member card is an accepted means of identification to electronically claim for qualifying healthcare products and services at selected health service providers.
When you claim electronically for eligible healthcare services for yourself (or anyone else named on the policy) Southern Cross Medical Care Society deems this to be a claim under your policy, and you authorise Southern Cross Medical Care Society to process the claim in accordance with your policy coverage (or the policy coverage for the other person named on the policy) and pay the selected health service provider direct.
The policyholder will receive all communications from Southern Cross Medical Care Society in relation to each electronic claim.
At any time, you may advise Southern Cross Medical Care Society that you do not wish to electronically claim.
Yes, call Member Services on 0800 800 181.
Your eligibility for the low claims reward ends when you transfer into a subsidised work scheme. The low claims reward is replaced by whatever discounts apply to that work scheme.
If you are transferring from a subsidised work scheme to a non-subsidised scheme or individual membership, you may become eligible for the low claims reward. Your renewal communication will advise if you have qualified for this reward.
We use the previous two years so there is a long enough assessment period to even out your usage of plan benefits. If we only used one year, the threshold would be much lower and it would be harder for members to get the discount.
It also means that members aren't penalised if they have a health incident that falls across two claims years.
This is a 'low claims' reward, so you can claim up to certain thresholds and still be eligible for the discount.
Your health is important. Delaying or avoiding treatment could cause your health to worsen. You should seek treatment and make claims when necessary.
If your claim is for surgery, it is likely to be more than the low claims threshold. However, your claim refund is likely to be greater than any low claims reward.
If your plan covers day-to-day healthcare, like doctors visits, it’s likely you could make a number of claims for doctors visits without affecting the low claims reward.