All about 
SuperCare policy updates

From 17 July 2017 some updates will be made to your SuperCare policy. 

  • You’ll be able to get more from your cover with access to some of the latest health technologies.
  • We’ve extended the Affiliated Provider programme and from 17 July all specialist consultations and diagnostic imaging will need to be with an Affiliated Provider in order to be covered under your policy.
Policyholders will have received formal notice of changes. 

To help you understand more here you’ll find:
Remember if you haven’t already, register for My Southern Cross and download the app now – for faster claiming and more on the go. Plus you’ll receive your communications online so you can have all the information you need right at your fingertips.

Frequently asked questions

General information about policy updates

Feedback from members is an important part of regular plan reviews. We also consult with medical professionals, and consider changes in healthcare such as new technology and new procedures.

These considerations help us to decide on the policy updates that will give members the most value. We know that balancing improvements in benefits with premium affordability is important for our members.  
No, your approval is still valid. We’ve made sure that any approvals we’ve issued are valid for the day you told us the healthcare service is taking place. So, if you told us your healthcare service was going to be on or after 17 July, your approval will already reflect the policy updates.

If the date of your healthcare service changes, or you need this healthcare service again in the future, please contact us. We’ll let you know if it needs to be performed by an Affiliated Provider and confirm your level of cover.

Affiliated Provider changes

Affiliated Providers are doctors, specialists and facilities who are contracted to provide healthcare services for members at agreed prices. We now have over 1,000 Affiliated Provider agreements in place and claims through Affiliated Providers account for over 55% of all Southern Cross claims costs.

When you use an Affiliated Provider:
1 – It’s easy. No forms and no fuss as prior approval and claiming are sorted for you directly with the Affiliated Provider.

2 – It keeps your future premiums more affordable by helping us to keep claims costs down. 

3 – Agreed prices mean you know up-front how much your contribution will be (if any).
Making healthcare services Affiliated Provider-only is an important way we can manage increases in healthcare costs and help keep future premiums more affordable.

Using an Affiliated Provider also makes prior approval and claiming quicker and easier for members. 
No, your approval is still valid. We’ve made sure that any approvals we’ve issued are valid for the day you told us the healthcare service is taking place. So, if you told us your healthcare service was going to be on or after 17 July, your approval will already reflect the policy updates. 

If the date of your healthcare service changes, or you need this healthcare service again in the future, please contact us
You can check the list of Affiliated Provider-only healthcare services here. They’re also listed in your policy document
You must see an Affiliated Provider for any healthcare service that is Affiliated Provider-only in order to be certain of your cover under your health insurance policy.

If your provider is, or becomes an Affiliated Provider then you’ll continue to be covered for healthcare services you receive from that provider. 

If your provider performs an Affiliated Provider-only healthcare service but isn’t an Affiliated Provider, you won’t be eligible for cover under your policy. 

It’s important to check first – see Healthcare finder, the list of Affiliated Provider-only healthcare services, or contact us.
Agreed prices with Affiliated Providers mean you know up-front how much, if anything, you’ll need to contribute to the cost of a healthcare service. The Affiliated Provider will confirm this. 

Unless you’re advised otherwise by an Affiliated Provider, Southern Cross will pay:
We take an inclusive approach when entering into Affiliated Provider agreements with healthcare providers. However, providers must have vocational registration with the New Zealand Medical Council for their area of practice, have a current practising certificate and be working from a facility that meets certain quality standards. 

We also need to be able to agree a reasonable price with them.
Simply complete a request for cover available in My Southern Cross and one of our team will be in touch to help you within a few days. If it is urgent please call us.

Specific - Changes to your policy

This list outlines the prostheses, specialised equipment, donor tissue preparation charges and associated costs covered by your policy. If a prosthesis is not listed we will not provide cover unless we advise otherwise.
We have guidelines to ensure a clear and consistent approach for making decisions about which healthcare services we provide cover for. Our approach to assessing health technology is to ensure there is a clinical benefit to our members, at an acceptable cost.
Your premium generally remains the same until your next renewal. At this time, your premium will include an adjustment to allow for the policy updates as well as other factors we consider when reviewing premiums, such as claims trends and ageing.
Your premium generally remains the same until your next renewal. Your next renewal date is in My Southern Cross under ‘My policy’ or on your membership certificate. At this time, your premium will include an adjustment to allow for the policy updates as well as other factors we consider when reviewing premiums, such as claims trends and ageing, plus things like low claims rewards.
A lifetime allowance is the total allowance available for the duration of a member’s relationship with Southern Cross whether or not the membership is continuous. The allowance includes all associated costs.