Ever changed your plan? If you have cover for pre-existing conditions under a previous plan, you should check your membership certificate to see what these are. If you do have cover under your previous plan, you can view changes to that plan here to see if any of these changes affect your cover. Can’t find your membership certificate? Visit My Southern Cross or contact us for a copy.

Your policy update   Effective from 1 April 2026

This is a high-level summary to help you understand the key changes to the Wellbeing Starter plan that take effect on 1 April 2026. Please read it carefully so you understand the changes that are being made to your policy.

Your health insurance policy is made up of a number of documents, including your membership certificate, the policy document and the following documents which are updated from time to time: eligibility criteria, the list of unapproved healthcare services, the list of Affiliated Provider-only healthcare services, the list of prostheses and specialised equipment and the list of policy variations. Together, all these documents outline your cover. Terms, conditions and exclusions apply.

You should check your membership certificate to see if you have cover for pre-existing conditions under any previous Southern Cross plans and select those plans to view changes that might affect your cover. To find your membership certificate, visit MySouthernCross, our online member portal or contact us for a copy.

What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)
Graphical image of a megaphone
Changing how some skin-related procedures are covered
What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)

Relocating cover for Mohs surgery (including excision and closures) to the ‘Skin lesion services’ benefit, except for closures requiring general anaesthesia.

Mohs surgery including excision and closure following surgery is covered under the ‘Surgical procedures’ benefit.

Mohs surgery, including excision and closure is covered under the ‘Skin lesion services’ benefit where it is performed under local anaesthetic, no anaesthetic or oral sedation. This benefit has a policy limit of $5,000 each claims year, with a sub-limit of $1,000 for skin lesion services performed by a general practitioner.

The 'Surgical Procedures' benefit provides cover for the following procedures when performed under general anaesthetic or IV sedation:


  • Excision or biopsy of skin lesions; or
  • closure of the wound following a Mohs surgery.

Introducing a $150 sub-limit each claims year for skin cryotherapy.

Skin cryotherapy performed under local anaesthetic, or no anaesthetic is covered under the ‘Skin lesion services’ benefit.

Skin cryotherapy performed under general anaesthetic or sedation is covered under the ‘Surgical procedures’ benefit.

No sub-limit each claims year.

Skin cryotherapy is covered under the ‘Skin lesion services’ benefit with a sub-limit of $150 each claims year.

Moving skin lesion procedures performed by non-skin specialists from the ‘Surgical procedures’ benefit into the ‘Skin lesion services’ benefit.

The ‘Skin lesion services’ benefit only covers healthcare services performed by a skin specialist. Eligible skin lesion procedures performed by non-skin specialists are covered under the ‘Surgical procedures’ benefit.

Eligible skin lesion procedures performed by non-skin specialists will now be covered under the 'Skin lesion services' benefit.

Graphical image of a megaphone
Changing how we define and cover tooth extraction
What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)

We are extending the period that members must have continuous cover under their plan for healthcare services relating to impacted or unerupted tooth extraction from 1 year to 3 years.

Continuous cover period is 1 year

After 1 year of continuous cover on this plan, cover is provided for extractions of unerupted or impacted teeth.

Continuous cover period is 3 years

After 3 years of continuous cover on this plan, cover is provided for the complete extraction or partial removal of unerupted or impacted teeth.

We are clarifying that removing teeth - either partly or completely - is covered under the ‘Surgical procedures’ benefit when removal of teeth is required before an eligible surgical treatment, chemotherapy, or radiotherapy.

No cover for tooth extraction when it is required for eligible surgical treatment, chemotherapy or radiotherapy

No exception in tooth extraction exclusion for teeth required to be removed for eligible surgical treatment, chemotherapy or radiotherapy.

Cover for tooth extraction or partial removal of teeth when it is required for eligible surgical treatment, chemotherapy or radiotherapy

Cover is provided for complete extraction or partial removal of teeth if removal is required before an eligible surgical treatment, chemotherapy or radiotherapy. Must be on referral from the treating specialist.

We are making changes to the wording of the exclusion for ‘Extraction of teeth’ to clarify that extraction of teeth includes the complete extraction or partial removal of any part of a tooth, tooth root or tooth remnant.

Exclusion wording

No cover for extraction of teeth except for what is covered under the ‘Surgical procedures’ benefit for extraction of unerupted or impacted teeth.

Exclusion wording

No cover for extraction of teeth, including the complete extraction or partial removal of any part of a tooth, tooth root or tooth remnant, except for what is covered under the ‘Surgical procedures’ benefit for extraction of teeth.

Graphical image of a megaphone
Introducing a requirement for 3 years of continuous cover for varicose vein procedures for legs
What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)

Cover for varicose vein procedures for legs and related duplex vein mapping will only be available after 3 years of continuous cover.

No continuous cover period required for varicose vein procedures for legs and related duplex vein mapping.

Members are eligible for up to two procedures for each leg during their lifetime. If you have multiple procedures during a single operation, we count these as separate procedures under the lifetime limit for each leg.

Cover for varicose vein procedures for legs and related duplex vein mapping is available after 3 years of continuous cover on this plan.

Members are eligible for up to two procedures for each leg during their lifetime. If you have multiple procedures during a single operation, we count these as separate procedures under the lifetime limit for each leg.

The lifetime limit does not apply to duplex vein mapping.

Graphical image of a megaphone
Changing the way we manage cover for robot-assisted surgeries
What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)

We are removing the exclusion for robot-assisted surgery from the policy document and adding it to the list of ‘Unapproved healthcare services’, with cover available for selected procedures.

Costs related to, or incurred as a consequence of, robot-assisted surgery are excluded as a healthcare service that we don’t cover in section C of the policy document except for the following selected procedures which are covered under the ‘Surgical procedures’ benefit:


  • Robot-assisted hysterectomy (with or without oophorectomy and/or salpingectomy, or both)
  • Robot-assisted sacrocolpopexy
  • Robot-assisted ventral hernia repair
  • Robot-assisted prostatectomy
  • Robot-assisted partial nephrectomy
  • Robot-assisted total hip replacement
  • Robot-assisted knee replacement
  • Robot-assisted transoral surgery.

Robot-assisted surgery is excluded through its inclusion on the list of unapproved healthcare services except for the following procedures which are covered under the ‘Surgical procedures’ benefit when performed by an Affiliated Provider:


  • Robot-assisted hysterectomy (with or without oophorectomy and/or salpingectomy, or both)
  • Robot-assisted sacrocolpopexy
  • Robot-assisted prostatectomy
  • Robot-assisted partial nephrectomy
  • Robot-assisted total hip replacement
  • Robot-assisted knee replacement
  • Robot-assisted transoral surgery.

There is no cover for robot-assisted ventral hernia.
The policy exclusion for robot-assisted ventral hernia repair will be removed from the list of policy variations and robot-assisted ventral hernia repair is instead being added to the list of unapproved healthcare services.

Graphical image of a megaphone
Removing the ‘Being active’ benefit
What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)

We are removing the ‘Being active’ benefit.

After three years of continuous cover on this plan, we’ll reimburse up to $50 each claims year for entry fees if the policyholder or a dependant takes part in an organised sporting event or tournament.

This benefit is no longer available.

Graphical image of a megaphone
Adding physiotherapy to the Palliative care and treatment allowance
What's changing?
Existing policy document
(effective until 31 March 2026)
New policy document
(effective from 1 April 2026)

Physiotherapy is being added to the list of services that are covered under the ‘Palliative care and treatment allowance’ which provides support and comfort when someone is diagnosed with a progressive terminal illness.

No cover for physiotherapy.

Physiotherapy treatment performed by a physiotherapist registered with the Physiotherapy Board of New Zealand is covered.

  • Changing how we define reasonable charges.

    We are clarifying how we determine and apply reasonable charges

    Your policy document has been updated to explain how we determine and apply reasonable charges and what it means for you.

    Please seek prior approval as early as possible to enable us to determine the extent of your cover.

  • Changes to policy variations

    We are moving some policy variations currently published on the list of policy variations into the policy document

    In October 2024, we introduced a list of policy variations that form part of your policy. These variations may provide access to additional cover and outline changes to policy terms and conditions, such as how exclusions are treated, updates to benefit terms, or new ways of delivering healthcare services we’re testing.

    Until now, these policy variations have only been available to view on our website. However, we are now removing them from the list of policy variations and incorporating some of them directly into your policy document.

    The following variations will now be included in your policy document:

    We are updating the ‘Travel and accommodation allowance’ to include ride-sharing services and accommodation hosting platforms

    The policy document wording relating to the ‘Travel and accommodation allowance’ will be updated to include cover for less traditional but commonly used travel and accommodation providers such as ride-sharing services and accommodation hosting platforms.

    Travel costs include public transport charges for buses, trains, taxis, shuttles, planes, ferries, and ride-sharing services.

    Accommodation costs include charges for hotel rooms, motel rooms, or hospital rooming fees for the support person, hospital flats and short-term rentals through recognised accommodation hosting providers.

    Cover for in-hospital ultrasounds

    The definition of hospital fees is being updated to provide cover for in-hospital ultrasounds under the ‘Surgical procedures’ benefit.

    Cover for breast screening ultrasounds where dense breast tissue is confirmed

    Cover is included for breast screening ultrasounds where a mammogram alone is unsuitable due to confirmation of dense breast tissue by a mammogram or MRI. In all other circumstances, breast screening ultrasounds are not covered.

    Cover for healthcare services related to mental health

    We have updated our mental health exclusion wording to make cover clearer. GP consultations for mental health are covered.

  • Affiliated Provider-only healthcare services

    Healthcare services becoming Affiliated Provider-only

    We are always considering which healthcare services should only be performed by an Affiliated Provider to be eligible for cover. This helps us to manage overall healthcare costs which supports keeping premiums affordable. It also provides members with a simpler and more certain process:

    • The Affiliated Provider arranges prior approval for the healthcare service and submits claims directly on the member’s behalf.
    • Agreed pricing with Affiliated Providers ensures members have clarity in advance.

    A list of Affiliated Provider-only healthcare services is available on our website. Please check this regularly as the list will change from time to time.

  • We are reviewing our Eligibility criteria

    We are reviewing and clarifying our eligibility criteria to focus on providing healthcare services to those who need them, and we’re adding new eligibility criteria where appropriate.

    Certain healthcare services have eligibility criteria which need to be met before a healthcare service is eligible to be covered under your policy. This includes setting clear guidelines for when general anaesthesia can be used.

    A list of eligibility criteria is available on our website. Please check this list regularly as the eligibility criteria may change from time to time.

  • Changes to our policy document

    We have updated the wording of our policy document to better reflect current practice and to provide greater clarity around the cover available. These updates do not represent new benefits, but rather confirm and clarify the way cover is already applied.

    We are removing reference to the specialist’s vocational registration in internal medicine under the ‘Chemotherapy for cancer’ benefits

    This change is being made because specialists must work within their scope of practice.

    We are removing the standalone exclusion for Dementia and adding it to the ‘chronic conditions’ exclusion

    Dementia is a chronic condition so should be included under the 'chronic conditions' exclusions.

    We are removing a paragraph regarding pricing for children turning 21 years old

    This does not change the cover under your policy because pricing information is not included in your policy. Information on child rates and what happens when children turn 21 can be found on our website.

    Specialist consultations can be carried out by a health services provider working under specialist supervision

    Cover has been extended to include consultations with a health services provider who is working under the supervision of a specialist, if the type of consultation is:

    •  included in the Affiliated Provider’s agreement with us, and
    •  approved by us.

    General tidy-up of policy wording

    We've made some small changes to our policy documents to fix grammar, tidy things up, and refresh some links.

Reminder about documents that form part of your policy which are updated regularly

The following documents that form part of your policy are regularly updated as we continually review how we cover healthcare services and certain health technology. It's a good idea to check these documents if you are planning on accessing any healthcare services which you intend to claim for under your policy.  

You can refer to our website for the latest versions of these documents or contact us to request a copy.

Other important documents and links