Southern Cross UltraCare vs nib Easy Health Compared

Southern Cross UltraCare vs nib Easy Health: Which is a better fit for you?

UltraCare fits you better if you want the widest cover, including everyday treatment, with no excess, no co-payment, and no cap on reasonable surgical charges. Easy Health fits you better if you'd rather trade an excess for a lower premium, or skip medical questions at application.

Neither plan wins outright because your choice highly depends on your medical state and needs.

UltraCare vs Easy Health side by side

The main difference is scope: Southern Cross puts no ceiling on reasonable surgical charges and prices everyday benefits individually. nib caps surgical treatment at $300,000 a year and non-surgical treatment at $200,000 a year, as two separate pools.

Here’s a detailed comparison for UltraCare/UltraCare 400 and Easy Health Base Cover:

How to choose between UltraCare and Easy Health

Which plan suits you often comes down to your health history as much as the benefit limits. Here are the factors worth considering:

• Mental health: UltraCare covers mental health support, with annual limits on consultations and psychiatric hospitalisation. Easy Health's general exclusions include psychological, developmental, and behavioural conditions.
• Everyday care and scans: UltraCare includes GP visits, prescriptions, and physiotherapy with no excess or co-payment. Easy Health's Base Cover doesn't cover GP visits or out-of-hospital prescriptions, apart from physiotherapy after a hospital stay, and applies a 20% co-payment to most scans, such as CT and MRI.
• Applying and buying: nib asks no health questions at application and sells Easy Health only through a financial adviser. Southern Cross asks for a medical declaration and sells UltraCare direct or through an adviser.

How Southern Cross and nib compare as companies

Southern Cross Health Society is a member-owned friendly society registered under the Friendly Societies and Credit Unions Act 1982, run for the benefit of its 950,000-plus members.

Southern Cross says that in the year to 30 June 2025, 94% of the premiums it received went back to members' healthcare, and it paid over 68% of the value of all NZ health insurance claims.

Southern Cross's hospital network sits separately, under Southern Cross Healthcare Limited, a subsidiary of the charitable Southern Cross Health Trust. They have over 2,000 Affiliated Providers and 3,000-plus Easy-Claim partners.

*This figure is from a shorter period than Southern Cross's year-to-30-June-2025 figures above, so the two aren't directly comparable.

nib health insurance in New Zealand is nib nz limited, part of the nib Group along with the Australian nib holdings limited. The nib Group covers over 1.4 million Australian and New Zealand residents combined.

nib's New Zealand business reported insurance revenue of $402.1 million in FY24, up 9.4% on FY23, and $250.8 million in insurance revenue against $174.1 million in claims in the more recent 1H26 period.

Financial strength and credit ratings

Both insurers hold a strong S&P Global Ratings financial strength rating: Southern Cross Medical Care Society A+ (Strong), nib nz limited A (Strong), both from each insurer's own required disclosure and undated.

What does the Southern Cross UltraCare plan cover?

Cancer and non-Pharmac medicines

Radiotherapy is unlimited within a defined treatment range. The $10,000 allowance for non-Pharmac drugs that are Medsafe-indicated for cancer treatment (approved but not funded by Pharmac) sits inside the $60,000 chemotherapy limit, not on top of it.

Mental health, maternity, and ACC

Psychiatrist or psychologist consultations are covered to $1,500 a year, psychiatric hospitalisation to $3,500. An obstetrics allowance of $1,000 a year starts after a year of continuous cover. Infertility and assisted reproduction are excluded.

UltraCare's ACC top-up pays the shortfall above ACC's contribution for services otherwise covered under the policy, provided you've first done everything reasonably possible to get ACC approval, capped at that benefit's own limit.

Day-to-day treatment

Prescriptions are covered to $600 a year, and physiotherapy, chiropractic, and osteopathy to $60 a visit, up to $300 a year each. UltraCare 400 adds dental insurance cover to $750 a year and glasses or contact lenses to $500.

What is covered with the nib Easy Health Base Cover?

Easy Health Base Cover pays up to $300,000 a year for surgical treatment and $200,000 for non-surgical treatment, as two separate pools rather than one shared ceiling.

Hospital specialist consultations (within six months before or after an admission), diagnostics, and cancer treatment have no limits of their own and draw down those two pools instead.

Diagnostics

Diagnostic investigations are paid at 80% of eligible costs, rising to 100% only where the test appears on nib's separate Diagnostics Schedule. CT, MRI, PET, ultrasound, mammography, and cardiac investigations are absent from it, so the 20% co-payment applies.

The schedule instead lists procedures such as biopsies, endoscopies, and scope procedures. Hospital specialist consultations are also paid at 80%, only within six months before or after an admission.

Cancer and non-Pharmac medicines

Private-hospital chemotherapy, immunotherapy, radiotherapy, and brachytherapy draw on the relevant pool, and a Non-PHARMAC Cancer Treatment Benefit covers up to $20,000 a year for non-PHARMAC chemotherapy or immunotherapy medicines.

Mental health, maternity, and ACC

Psychological, developmental, and behavioural conditions are general exclusions, and none of Easy Health's three optional modules restores covers for them.

A High-Risk Pregnancy Benefit pays $2,000 per pregnancy for an obstetrician's treatment of a pregnancy with recognised risk factors, though it excludes IVF, Caesarean deliveries, ectopic pregnancy treatment, pregnancies conceived before your join date, and public-hospital treatment.

The ACC top-up covers the difference between what ACC pays and the actual cost, drawn from the relevant surgical or non-surgical pool, except for injuries occurring before your join date.

Everyday care

GP and out-of-hospital charges, including prescriptions, aren't covered under Base Cover, nor are dental and vision. Physiotherapy is covered only after a hospital stay, at $750 per hospitalisation.

Pre-existing conditions and underwriting

Both plans use a three-year rule for pre-existing conditions, but handle it differently.

Southern Cross may extend cover for a qualifying condition after three years of continuous cover, through a review you ask for. nib commits to covering eligible pre-existing conditions after three years, assessed at claim, except for six permanently excluded categories.

Having a pre-existing condition doesn't mean automatic exclusion. Providers structure this cover differently across the NZ market, so check your specific plan. The guide to health insurance and pre-existing conditions explains how this works.

Southern Cross UltraCare

Pre-existing conditions aren't covered unless stated on your membership certificate. After three years of continuous cover, you may get cover for qualifying pre-existing conditions where a benefit exists for the treatment you need 'Qualifying' means not otherwise excluded, assessed via a member-initiated review against criteria including being symptom-free and no longer needing ongoing care. 10 chronic conditions are excluded for everyone, so the concession never reaches them. This includes the following:

• Cystic fibrosis
• Dementia
• Kyphosis
• Loeys-Dietz syndrome
• Marfan syndrome
• Pectus carinatum
• Pectus excavatum
• Polycystic kidney disease
• Scoliosis
• Spina bifida

nib Easy Health

Six categories stay permanently excluded even after the three-year mark:

• cardiovascular conditions
• cancer
• hip or knee conditions
• back conditions
• transplant surgery
• reconstructive or reparative surgery performed before your join date

Appropriately treated pre-malignant findings (abnormal but not yet cancerous cells) are the exception within the cancer category.

Southern Cross asks for a medical declaration when you apply, with no medical examination. nib asks nothing about your medical history at application, instead assessing records at claim, where it must prove a causative link to the claim.

That burden lifts for named cardiovascular risk factors:

• a BMI over 30 in the three years before you took out the policy
• diabetes depending on duration and control
• hypercholesterolaemia (high cholesterol)

Either way, switching insurers probably means conditions that developed since your original policy started are treated as pre-existing. Which exclusions and underwriting approach apply to you depends on your own history. Check with an adviser if you're unsure.

What UltraCare and Easy Health cost

Neither insurer publishes a premium. Premiums are individually underwritten and quoted on your age, cover level, and other factors. What you can compare is structure: Easy Health lets you trade risk for price through an excess while UltraCare has none.

The Easy Health excess and co-payment

You choose an excess from Nil to $6,000 across seven tiers, with a single-life premium discount from 0% up to 60%, applied once per insured person per policy year on Base Cover claims, not once per claim.

A separate 20% co-payment applies to diagnostics not listed on nib's Diagnostics Schedule, to hospital specialist consultations, and to some other benefits, including Proactive Health Option services, and comes off before the excess.

See the explainer on what an excess is.

What drives each premium

nib prices on age, gender, smoking status, and your chosen excess, with a parallel vaping-cessation discount. Anyone aged 21 or older who has been smoke-free for 12 months can apply for a reduction.

Southern Cross's materials confirm age and claims history as pricing factors, but don't say whether gender or smoking affects price. Premiums reprice at each annual renewal until age 75, then common-rate (no further age increases), with a low-claims reward for a clean record.

Gap payments

Through an Affiliated Provider, Southern Cross covers 100% of actual charges up to policy limits. Outside it, cover drops to reasonable charges, though free provider choice is retained.

nib pays a First Choice Network provider 100% of eligible costs, less any excess and co-payment. Outside it, nib pays only its Efficient Market Price (its benchmark rate for that service), and you carry the difference between that and the provider's charge.

A $6,000 excess lowers the premium, but you carry that amount at claim time. Comparing health insurance plans shows where each would leave you.

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