Affiliated Provider-only healthcare services
In all Southern Cross health insurance policies (except UltraCare) a number of procedures are only eligible for cover if
they are performed by an Affiliated Provider. Unless you are advised otherwise by Southern Cross or your Affiliated Provider,
we will pay:
- for RegularCare, KiwiCare and First Cover plans, 80% of the amount charged by your Affiliated Provider for the procedure
up to policy limits.
- for all other plans (except UltraCare) , 100% of the amount charged by your Affiliated Provider for the procedure up
to policy limits.
You can search for an Affiliated Provider here.
Please be aware that not all healthcare services are available from all Affiliated Providers or in all areas. In order to
receive cover, the healthcare services must be approved treatment and meet applicable eligibility criteria. Members must
also meet the terms and conditions of their policy at the time the services are provided.
For full details, please refer to your policy document.
Simply select the healthcare service you require from the list below to understand what you need to do to confirm cover for your treatment.
What is a transition period?
A transition period is the time between a healthcare service becoming ‘Affiliated Provideronly’ and, in our view,
there being sufficient Affiliated Providers in place to provide that healthcare service. If there is a transition period,
we'll continue to issue prior approvals for those healthcare services until we have sufficient Affiliated Providers in
place.