Southern Cross Wellbeing One vs Two: Benefits and alternatives

Southern Cross Wellbeing One vs Two

What does Wellbeing One cover?

Wellbeing One offers a range of benefits designed to cover essential health needs. Here's a list of the features and limitations of Wellbeing One:

features

• Surgical treatments: Covers eligible private surgical procedures, including surgeon, anaesthetist, and hospital fees (excess applies)
• Cancer care: Includes surgery, chemotherapy, radiotherapy, and related hospitalisation. Also provides financial assistance for Medsafe-indicated chemotherapy drugs that are not funded by Pharmac (excess applies)
• Skin lesion services, including consultations, excision, biopsy, cryotherapy, curettage, and diathermy of skin lesions under local anaesthetic or with no anaesthetic
• GP minor surgeries, such as removal or resection of ingrown toenails, steroid or cortisone injections, and abscess drainage
• Surgical allowances for gastric banding or bypass, breast reduction, and prophylactic treatment (available after three years of continuous cover)
• IV infusions of Medsafe-indicated drugs
• Allergy services, including allergy testing and desensitisation
• Reimbursement of medical expenses for approved overseas treatment if not available in New Zealand’s public or private health facilities
• Recovery services, such as home nursing, speech and language therapy, and physiotherapy
• Allowance for support services during treatment, like ambulance transport, travel and accommodation, and parent accommodation
• Palliative care and treatment allowance (after three years of continuous cover)
• Accident and treatment injury top-up: If ACC does not fully cover the costs for healthcare services associated with an accident, treatment injury, or work-related gradual process injury, you may claim the difference under the applicable benefit if it’s included in your policy.

limitations

• Does not cover laboratory tests and obstetric care
• The following will only be covered if they’re performed within six months of related eligible surgical treatment, chemotherapy, or radiotherapy:
  • Specialist and dietitian consultations
  • Diagnostic imaging procedures
  • Diagnostic tests
  • Cardiac tests.

What does Wellbeing Two cover?

Wellbeing Two offers the same cover as Wellbeing One, on top of other benefits.

BENEFITS

• Everything under Wellbeing One

• No six-month condition for specialist consultations, diagnostic imaging and tests, and cardiac tests. These costs can be covered even if they are beyond six months of a related treatment, chemotherapy, or radiotherapy.
• Laboratory tests that are performed for diagnostic purposes, but not publicly funded
• Allowance for obstetric care and services (after one year of continuous cover).

What’s not covered under Wellbeing plans?

There are several conditions and services that Wellbeing One and Two plans can’t cover. Some of these are listed below:

• Pre-existing conditions (unless clearly stated on your membership certificate), chronic conditions, most congenital conditions, dementia, gynaecomastia
• Illnesses, injuries, and conditions related to substance abuse, self-harm, war, terrorism, or military active duty
• Health services unapproved by Southern Cross
• Acute care
• ACC-covered treatments and other healthcare services for accidents, treatment injury, or work-related gradual process injury
• Costs related to respite, convalescent, and long-term care
• Organ transplants
• Services related to infertility, assisted reproduction, contraception, and sterilisation
• Costs related to pregnancy and childbirth, aside from those under Wellbeing Two’s obstetrics allowance, prescriptions under the Keeping Well module, and prescriptions or physiotherapy under the Day-to-Day module.

Optional upgrades and add-ons for enhanced cover

Both Wellbeing One and Wellbeing Two offer optional add-on plans to boost health services not included in the standard plans. These add-ons include:

• Cancer Cover Plus: Increases your cancer chemotherapy benefit cap to $100,000 each claims year for Chemotherapy 100, and $300,000 per claims year for Chemotherapy 300. This benefit covers cancer chemotherapy drugs funded and not funded by Pharmac and their administration; hospital accommodation, and ancillary hospital charges.
• Keeping Well Module: Provides cover for general practitioner, nurse, optometry, audiology, and dental services, as well as flu vaccination, prescriptions, and clinical psychology.
• Body Care Module: Cover for allied and natural healthcare services, such as acupuncture, massage therapy, chiropractic, osteopathy, homeopathy, naturopathy, and podiatry, as well as services provided by dietitians and nutritionists.
• Day-to-day Module: Provides cover for day-to-day medical care, such as annual health check-up, flu vaccination, prescriptions, and services by a general practitioner, nurse, and physiotherapist.
• Vision and Dental Module: Provides cover for dental, visual, and audiology services, including prescription glasses and contact lenses, optometry consultations, orthoptist treatment, and hearing tests.

Alternative health insurance plans

Aside from Southern Cross, there are other health insurers offering comprehensive plans with similar or even higher maximum benefit amounts for hospital surgical and non-surgical treatments, cancer care, non-Pharmac drugs, and diagnostic imaging and tests.

• Accuro SmartCare+: Covers hospital surgical, medical, and diagnostic costs, plus non-Pharmac drugs and overseas treatment. It also provides allowances for public hospital admission, hospice care, and funeral costs.
• AIA Private Health: Covers private hospital surgical, medical, and diagnostic imaging and tests, non-Pharmac-funded cancer chemotherapy drugs, and overseas treatment. It also provides allowances for mental health consultations and obstetrics care. This plan can be integrated with AIA Vitality, a wellness programme that rewards healthy habits with premium discounts and other perks.
• nib Ultimate Health Max: Covers hospital surgical, medical, and cancer treatments, non-Pharmac drugs, as well as overseas treatment. It offers an obstetrics benefit for high-risk pregnancy and pre-existing cover for dependant newborns added to the plan within four months of birth. Allowances are also provided for public hospital admission, hospice care, and funeral expenses.
• Partners Life Private Medical Cover: Covers hospital surgical, medical, specialist consults, major diagnostic expenses, non-Pharmac drugs, and overseas treatment. Offers automatic cover for babies for a few months from birth, and support for hospice, home nursing, and funeral costs.

The table below compares the maximum amount for various benefits. For an in-depth comparison of these plans, download our FREE health insurance comparison chart, and check out our buying guide for a sample health cover quote comparison.

Policywise advisers can compare and choose the right plan to fit your needs and budget. They can help you find ways to get lower premiums, such as by choosing a higher health insurance excess or utilising ongoing insurance promos and discount offers.

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