UniMed vs Southern Cross Health Insurance Compared

UniMed vs Southern Cross: which is a better fit for you?

Southern Cross suits you if unlimited surgical cover matters most, and if you want the shortfall risk on a big operation taken off the table. UniMed suits you if you want a cheaper modular build, stronger non-Pharmac drug cover on SmartCare+, or cover for a child, a visiting parent, or a temporary-visa holder.

Each insurer describes its own aim plainly. Southern Cross calls UltraCare "a surgical and healthcare plan for those who want the highest level of cover". UniMed positions SmartCare and SmartCare+ as cover "designed for people who make their health a priority".

The two insurers differ in three ways:

• Surgical limits: UltraCare, Wellbeing One and Wellbeing Two pay surgical costs without a dollar maximum. UniMed caps surgery between $150,000 per claim, and $300,000 or $500,000 a year depending on the plan (figures on different bases rather than a single scale), and ParentStay has no elective surgical benefit at all.
• Gap exposure: Southern Cross pays 100% of actual charges through an Affiliated Provider (a provider contracted to deliver eligible services at agreed prices), removing the shortfall risk. UniMed has no affiliated provider network, so you carry anything above its reasonable charges (the amount UniMed determines a service should reasonably cost).
• Pre-existing conditions: UltraCare may cover qualifying pre-existing conditions after three years of continuous cover. UniMed's personal exclusions each run their own clock instead.

UniMed also answers needs Southern Cross does not cover at all. KidSmart insures a child on their own policy, ParentStay is built for Parent Boost Visitor Visa holders, and SmartStay covers work and student visa holders who are not entitled to publicly funded care.

UniMed and Southern Cross side by side

The ten focus plans split on one mechanic above all others. Southern Cross pays surgical costs without a dollar limit, while every UniMed plan except ParentStay's emergency-only cover sets a ceiling.

The table below sets that alongside non-Pharmac drug cover, routine dental, outpatient mental health, and how the excess works on each plan.

What UniMed and Southern Cross cost

Neither insurer publishes a price list. Both underwrite individually and quote on age, plan, excess and the modules you pick, so your premium sits on your certificate rather than a rate card. What you can compare before you apply is how each insurer builds that price, and what you still pay after a claim.

UniMed rates by age group throughout the policy's life and says so directly: "Premiums for each age group reflect the historical and expected claims for that group." Southern Cross age-rates most members individually until they turn 75, then moves them to common rating, pooling claims across everyone 75 and over.

The excess behaves differently too (see what is an excess on insurance). On UniMed's SmartCare-family plans (SmartCare, SmartCare+ and KidSmart) it accumulates across claims within a policy year: with a $1,000 excess, a $950 MRI claim pays nothing, but a second $950 MRI that year is reimbursed $900.

Southern Cross offers Wellbeing members an optional $500, $1,000, $2,000 or $4,000 excess that applies only to surgery, chemotherapy and radiotherapy. UltraCare carries no standard excess.

Co-payments are narrow on both: UniMed's Dental and Optical module leaves you 20% of the cost, and Southern Cross's Vision and Dental module leaves you 25%.

The gap payment is where the two diverge. Southern Cross pays 100% of actual charges when treatment goes through an Affiliated Provider, a provider contracted at agreed prices, so there is no shortfall to find.

Outside that network it pays only what it determines are reasonable charges, and you pay the difference. UniMed has no affiliated provider network, so the reasonable-charges test applies to every claim.

If your group health insurance cover comes through work, the routes differ. Southern Cross's workplace scheme needs at least five full-time employees joining, and sells its ordinary plans at group pricing.

UniMed describes StaffCare and StaffCare+ as cover "for smaller groups" and publishes no minimum headcount. If you leave that job, UniMed gives you 30 days to continue as an individual policy without full underwriting.

For the bigger picture on whether cover pays off for you, see is health insurance worth it.

NOTE: Quotes generated in October 2026. Indicative only. Actual premiums depend on individual underwriting. No policy fee.

How to choose between UniMed and Southern Cross

It helps to work through these in order of what they cost you, starting with the surgical limit and your gap exposure, then the benefits you are most likely to claim.

The public system is the backdrop to that decision—64.5% of patients received planned hospital treatment within four months in the quarter to December 2025, up from 59.2% a year earlier.

1. How much surgical cover do you want? Southern Cross removes the dollar ceiling on general surgical costs, though named procedures such as gastric and breast surgery keep their own limits. If a UniMed cap suits your budget, it's worth checking that against the cost of private surgery. One patient's shoulder operation would have cost about $40,000 without insurance.
2. Would a shortfall hurt? Southern Cross's Affiliated Provider network includes 2,526 healthcare providers and 46 medical specialists. Using one removes the gap payment. UniMed has no equivalent.
3. Do you want day-to-day cover? UltraCare includes GP visits, prescriptions and physiotherapy in the base plan. On UniMed's SmartCare-family and StaffCare plans, you buy those as modules. KidSmart has no GP cover in its base plan or Specialist module; only the Day to Day add-on provides it. ParentStay has no GP cover option at all.
4. Is cancer drug cover a priority? SmartCare+ covers Medsafe-registered, non-Pharmac medicines inside its $500,000 surgical or $300,000 non-surgical maximum. Southern Cross caps them at $10,000 a year unless you add Cancer Cover Plus.
5. Do you have a health history? UltraCare may cover qualifying pre-existing conditions after three years. Get both insurers quoted to compare what each charges for that certainty.
6. Who needs covering? Only UniMed writes a child-only plan (see the guide to health insurance for kids), plus a visitor-visa plan and a temporary-visa plan.
7. Can you get a specialist appointment? An ASMS analysis of seven districts found declined referrals rose to an estimated 112,348 in 2025, extrapolating to about 255,000 people a year refused a first specialist appointment.

A licensed adviser has to put your interests first by law, and must tell you clearly how they are paid. Talk to a Policywise adviser if you want both insurers priced against the rest of the market before you decide.

How UniMed and Southern Cross compare as companies

Both are member-owned societies rather than listed insurers, and both are licensed and supervised in New Zealand.

Southern Cross is much larger. It reported 951,808 members at 30 June 2025, against UniMed's stated 140,000-plus. Each holds an FMA Financial Institutions licence granted on 31 March 2025, with active status.

Is UniMed a good health insurance company? UniMed's registered entity is Union Medical Benefits Society Limited, and it describes itself as a mutual society existing "for our Members, not shareholders." It calls itself New Zealand's third-largest health insurer. Accuro's insurance portfolio transferred to UniMed in 2024, and UniMed began replacing the Accuro name from late July 2025, so you may still see the old branding while the transition finishes.

Is Southern Cross health insurance good? Southern Cross Medical Care Society is a licensed insurer, a licensed financial advice provider, and a for-purpose friendly society. In the year to 30 June 2025, it paid $1.706 billion in claims against $1.811 billion of premium income, returning 94 cents of every premium dollar as claims. It also states it paid over 68% of the value of all health insurance claims paid in New Zealand that year.

Those are each company's own disclosures, and no independent New Zealand market-share figure is published for either. Both belong to the Insurance and Financial Services Ombudsman scheme, so a complaint you cannot resolve directly can go to a free, independent dispute-resolution service.

Financial strength and credit ratings

Both insurers hold a financial strength rating from an approved agency, but from different agencies on different scales, so the letters are not directly comparable. Southern Cross holds A+ (Strong) from S&P Global Ratings Australia. UniMed publishes a Financial Strength Rating of A (Excellent) from AM Best. It also reports a solvency margin of 178%.

A rating is not optional here. Every licensed New Zealand insurer must hold a current financial strength rating from an approved agency. Failing to do so is an offence carrying a fine of up to $1,000,000. The Reserve Bank has approved exactly three agencies: AM Best, Standard & Poor's, and Fitch Ratings.

On the S&P scale, A+ sits inside the "Strong" band, below AAA (Extremely Strong) and AA (Very Strong). Southern Cross retained it in its FY25 results. AM Best's A (Excellent) is a separate scale with its own definitions.

Treat the two as evidence that each insurer meets the regulator's bar, not as a ranking of one against the other, whichever you choose.

What do UniMed's health plans cover?

UniMed builds most plans as a mandatory hospital and surgical base plan with optional modules for specialists, GP visits, natural health, and dental and optical.

ParentStay is the exception: a single plan with no modules and no elective surgical benefit. Every other plan caps surgery in dollars, from $150,000 per claim to $500,000 a year, on different bases rather than one scale.

The seven plans below are the ones named in this comparison. UniMed sells others, and its retail range is not the same as its employer-arranged range.

SmartCare+ and SmartCare

SmartCare+ is UniMed's top retail plan. You get a $500,000 a year surgical benefit and a $200,000 lifetime spinal sub-limit. SmartCare is the same shape at a lower ceiling of $300,000 a year. Both take up to four optional modules covering specialists, GP care, natural health, and dental and optical.

SmartCare+ and SmartCare diverge most on cancer medicine. SmartCare+ covers Medsafe-registered, non-Pharmac drugs inside its plan maximum with no separate cap, and UniMed's own site confirms that benefit is "SmartCare+ only" among UniMed's adult personal plans.

SmartCare has none. SmartCare's hospital admission benefit is also lower, at $200,000 a year with a $65,000 sub-limit for non-surgical cancer treatment, and it lacks the medical tourism and overseas waiting list sub-benefits.

For a fuller history of these plans, see the review of Accuro's health insurance plans, now under UniMed.

KidSmart

If you want to insure a child on their own policy, KidSmart gives you a $500,000 a year surgical benefit, a $200,000 lifetime spinal sub-limit, and $300,000 a year for oral surgery. Child rates run to age 25, after which the policy transfers to SmartCare+. A guardian owns the policy and pays the premium, but is not an insured member.

That last point is often misunderstood. A guardian does not need to hold UniMed cover themselves for the child to be insured, so no parent's lapsed policy can end the child's. The risk is simply non-payment, which cancels the policy after 90 days.

KidSmart has no GP benefit and no routine dental module, though babies under six months can be added with no medical-history exclusions. The Accuro and UniMed plan review sets out how the modules work.

StaffCare and StaffCare+

StaffCare and StaffCare+ are UniMed's employer-arranged plans, and both remain current 2026 products sold through advisers and employers rather than UniMed's consumer pages. StaffCare caps surgery at $200,000 a year with specialist and GP modules only. StaffCare+ raises that to $300,000 and adds all four modules.

StaffCare+ carries two benefits StaffCare does not: non-Pharmac cancer drugs to $40,000 a person a year, and triple the overseas treatment limit at $30,000 rather than $10,000.

The excess on both is chosen by the employer, though members may buy it out. UniMed describes these plans only as cover "for smaller groups" and publishes no minimum group size, where Southern Cross sets a five-employee floor.

For the underlying plan detail, see the Accuro and UniMed health insurance review.

ParentStay

ParentStay is a single plan for Parent Boost Visitor Visa holders, with five built-in benefits and no modules or add-ons. Its limits mirror Immigration New Zealand's visa minimums: emergency medical care of $250,000 a year, cancer care of $100,000, and repatriation of $250,000, from an insurer rated at least A (Strong).

There is no elective surgical benefit, no dental cover, no GP cover, and no excess anywhere in the policy. Cancer care is paid in a New Zealand public hospital. The guide to the Parent Boost Visitor Visa and its insurance requirements covers the visa side, and the Accuro and UniMed review covers the insurer.

SmartStay

SmartStay covers work and student visa holders who are not entitled to publicly funded healthcare, with a primary member aged 18 to 69. Its surgical benefit is $150,000 per claim, a different basis from every other plan in this comparison, which all work to an annual limit.

Cancer cover is the thinnest in the UniMed range: admission is $65,000 a year with a $25,000 sub-limit for non-surgical treatment, and only Pharmac-listed drugs are covered. There is no repatriation benefit and no loyalty benefits.

See the Accuro and UniMed plan review for the wider range.

Does UniMed cover dental?

Whether UniMed covers dental insurance depends entirely on the plan you hold. Routine dental sits in the optional Dental and Optical module, which exists on SmartCare+, SmartCare and StaffCare+ only, reimbursing 80% of cost to $500 a person a year after a 90-day no-claiming period.

ParentStay has no routine dental cover and no add-on that provides it; KidSmart, SmartStay and StaffCare members reach routine dentistry only through the Day to Day add-on.

Here is how each focus plan answers the question:

• SmartCare+, SmartCare and StaffCare+: available as an optional module, 80% to $500 a year, with an orthodontic benefit of 80% to $750 a year becoming available after three years on the module.
• KidSmart: oral surgery only, to $300,000 a year, with a 12-month wait on impacted teeth, plus a $200 a child a year orthodontic loyalty benefit on the Specialist module after five years' continuous cover. Routine dentistry comes only through the separate Day to Day plan.
• StaffCare: oral surgery only, to $100,000 a year. No dental module exists on this plan; routine dentistry comes only through the separate Day to Day plan.
• SmartStay: oral surgery only, up to $150,000 per claim. Routine dentistry comes only through Day to Day.
• ParentStay: no dental cover of any kind, and nothing you can add.

The Day to Day plan has a $600 a person a year overall cap, but its "Optical and Dentistry" line carries its own combined $150 a person a year sub-limit. The $150 is the real dental allowance for KidSmart and SmartStay members, not the $600 headline.

Adult dental is largely self-funded here. You pay privately for most adult dental services, and public funding is narrow. A dental examination averaged $89 and a single extraction $291 in a New Zealand Dental Association fee survey covering 2020 to 2023.

More than 40% of adults have unmet need for dental care because of cost. Basic dental care is free for children until they turn 18, orthodontics excluded. ACC pays for dental treatment needed because of an accident or injury.

What do Southern Cross's health plans cover?

Southern Cross's health plan range includes UltraCare and UltraCare 400, Wellbeing One and Wellbeing Two, and day-to-day-only plans such as HealthEssentials that carry no hospital or surgical cover.

This article covers the three named in the brief: UltraCare, Wellbeing One and Wellbeing Two. All three pay surgical costs on an unlimited basis for reasonable charges, which is the clearest contrast with UniMed's dollar caps.

'Unlimited' is not 'uncapped everywhere'. Named surgical allowances still carry their own lifetime ceilings on UltraCare. Gastric surgery is capped at $7,500 lifetime (after 3 years' continuous cover), breast reduction at $15,000 lifetime (after 3 years), breast symmetry at $10,000 lifetime, and prophylactic treatment at $50,000 lifetime (after 3 years)

Wellbeing One and Wellbeing Two carry the same four named-allowance caps, except prophylactic treatment, capped at $40,000 lifetime rather than UltraCare's $50,000.

Prostheses are handled differently again: on Wellbeing One and Two they are capped by a published schedule, where UltraCare covers them inside the unlimited surgical benefit.

The review of Southern Cross health insurance covers the range in more depth, and Southern Cross Wellbeing One vs Two compares the two Wellbeing tiers directly.

UltraCare

UltraCare is Southern Cross's most comprehensive plan: you get unlimited surgical cover, unlimited radiotherapy, $100,000 a claims year for diagnostic imaging, $10,000 for specialist consultations, and day-to-day treatment built into the base plan rather than bought as a module. There is no standard excess.

That day-to-day cover is unusually broad for a hospital plan. GP visits to $100, prescriptions to $600 a year, and physiotherapy, chiropractic and osteopathy to $60 a visit and $300 a year each. UltraCare 400 is a strict superset, adding prescription glasses and contact lenses to $500 a year plus dental treatment to $750 a claims year.

The base UltraCare plan excludes routine dental, though it covers tooth extraction before eligible surgery, chemotherapy or radiotherapy, and unerupted or impacted teeth after three years' continuous cover. The Southern Cross health insurance review sets out how the tiers compare.

Wellbeing One and Wellbeing Two

Wellbeing One and Wellbeing Two share the same unlimited surgical benefit as UltraCare, with lower allied limits: $60,000 a claims year for diagnostic imaging and $5,000 for specialist consultations. Both take four optional modules, and an optional $500, $1,000, $2,000 or $4,000 excess applies to surgery, chemotherapy and radiotherapy only.

The tier difference is a six-month condition.

On Wellbeing One, specialist consultations and diagnostic imaging are payable only within six months before or after related eligible surgery, chemotherapy or radiotherapy, and Wellbeing Two removes that restriction.

Wellbeing Two also adds laboratory tests to $70 a claims year, which Wellbeing One does not cover at all, plus an obstetrics allowance of $750 after a year on the plan.

For a direct comparison, see Southern Cross Wellbeing One vs Two.

Cancer cover and non-Pharmac medicines

UniMed's SmartCare+ offers the stronger non-Pharmac drug cover of the two, paying for Medsafe-registered medicines inside its $500,000 surgical or $300,000 non-surgical maximum with no separate cap.

Southern Cross covers non-pharmac approved drugs to $10,000 a claims year inside its $60,000 chemotherapy benefit, unless you add Cancer Cover Plus.

Medsafe approval and Pharmac funding are two different decisions. Medsafe assesses whether a medicine is safe and effective enough to be sold here, and states that it "is not involved in funding medicines; this is the responsibility of PHARMAC."

Pharmac decides what gets funded from a fixed budget, and currently funds over 1,300 chemicals in more than 3,300 presentations. A drug that is Medsafe-approved but not Pharmac-funded is the gap these benefits exist to fill.

That gap moves. In June 2024 the Government announced "an unprecedented $604 million funding boost to Pharmac's Combined Pharmaceutical Budget (CPB) over four years." Pharmac estimated the funding would cover approximately 26 cancer medicines, with pembrolizumab funded from 1 October 2024 and nivolumab from 1 November 2024.

As of January 2024, before that funding round, blood cancer patients in Australia had access to 36 treatment options not funded here, nine of which significantly improve survival and quality of life.

One Auckland patient's medication was capped at $25,000 by the manufacturer, but private administration cost $46,000 for 12 sessions over six months, because public hospitals cannot administer unfunded drugs.

Beyond drugs, the two insurers handle cancer like this:

• UniMed SmartCare+: private hospital medical admission to $300,000 a year, covering chemotherapy and radiotherapy, with no separate cancer sub-limit.
• UniMed SmartCare and StaffCare+: admission to $200,000 a year with a $65,000 a year non-surgical cancer sub-limit.
• Southern Cross: chemotherapy to $60,000 a claims year and unlimited radiotherapy on all three focus plans.
• Cancer Cover Plus: an optional Southern Cross upgrade lifting chemotherapy cover to $100,000 or $300,000 a claims year and removing the non-Pharmac sub-limit. It is available only where every member on the policy is under 60, and is fully underwritten regardless of any pre-existing condition concessions.

Do not confuse Cancer Cover Plus with Southern Cross Cancer Assist, a separate standalone product paying a lump sum on confirmed diagnosis rather than a benefit of UltraCare or Wellbeing.

New Zealand is seeing about 30,000 new cancer cases a year, projected to exceed 45,000 by 2044. Health insurance reimburses capped actual costs, which is a different job from replacing income or clearing a mortgage.

A trauma insurance policy pays a tax-free lump sum on confirmed first diagnosis of a covered condition, regardless of what treatment costs, and many people hold the two together for that reason. Ask a Policywise adviser whether your situation calls for both.

Mental health

UltraCare pays the highest base outpatient mental health insurance benefit here, $1,500 a claims year, for a psychiatrist or NZ-registered psychologist. UniMed pays $1,000 a year on every plan for a psychiatrist, psychologist, psychotherapist or counsellor; most plans add a module's $1,000 sub-limit on top (StaffCare+ nests it differently; ParentStay has no modules).

Wellbeing One and Two pay $750, psychiatrist only, plus $100 a year via the optional Keeping Well module.

Southern Cross is alone on inpatient care. UltraCare, Wellbeing One and Wellbeing Two each cover psychiatric hospitalisation to $3,500 a claims year, at $700 a night or day stay. No UniMed plan in this comparison covers psychiatric hospitalisation at all.

In 2024/25, 14% of people aged 15 and over, about 609,000 people, reported high or very high psychological distress in the four weeks before the New Zealand Health Survey, more than double the rate a decade earlier. Rates were higher among Māori (22.5%), Pacific peoples (24%), young people (23%), and disabled people.

A private therapy session typically costs $180 to $250, so a $1,500 benefit may cover six to eight sessions. No comparable per-session fee is published for psychiatrists, so the same maths cannot be applied to Wellbeing's $750 psychiatrist-only benefit.

Why does cover vary so much between insurers? A 2022 Consumer NZ mystery-shopping investigation across 14 insurers found no consistent approach, with some adding exclusions or limiting cover and others accepting the customer as they were. Consumer NZ called it a systemic failure.

The Financial Services Council responded that insurers had adapted underwriting to discern between mental ill health at varying degrees of severity, management and recurrence.

Both insurers run support outside the policy limits. Southern Cross members can access up to three free online mental health sessions each claims year through Raise. UniMed offers Clearhead, a partner service with around 600 mental health professionals usually bookable within 24 hours.

Free help exists outside insurance too. Seeing a health improvement practitioner or health coach through your GP practice costs nothing, with no limit on how often.

Maternity, IVF and fertility treatment

Neither insurer covers pregnancy or childbirth as standard, and both permanently exclude IVF and assisted reproduction.

Southern Cross offers a small obstetrics allowance on some plans after a year of cover. UniMed offers a narrow loyalty benefit on three of its plans after three years, two of which cover infertility treatment and one obstetric care only. Everything else is self-funded or public.

On the Southern Cross side, the obstetrics allowance is $1,000 a claims year on UltraCare and UltraCare 400, and $750 on Wellbeing Two, in each case after one year of continuous cover. Wellbeing One has no obstetrics benefit.

Southern Cross's own factsheet is explicit that it does not cover costs related to pregnancy, childbirth, infertility or assisted reproduction under any plan except through that allowance, and that midwives' fees and fertility consultations sit outside it.

UniMed excludes maternity permanently on all seven plans, with three narrow carve-outs that each take three years to become available. SmartCare+ pays a "Pregnancy and Infertility Treatment" benefit of $2,000 a year after three years on the Specialist+ module, and SmartCare pays $1,000 a year on the same basis.

StaffCare+ pays the same $2,000 a year after three years, but for obstetric care only. StaffCare, KidSmart, ParentStay and SmartStay have no carve-out at all.

Does health insurance cover infertility treatment? Not with UniMed or Southern Cross. Both exclude it outright, with one narrow exception: UniMed's three-year SmartCare+ and SmartCare benefit, capped at $1,000 to $2,000 a year. That is unlikely to fund a full treatment cycle, so budget for most of the cost yourself if this affects you.

The public and private picture fills in the rest:

• More than a quarter of couples in New Zealand have had problems conceiving at some point.
• Publicly funded treatment exists but is rationed by the Clinical Priority Access Criteria, which score a couple out of 100. A 2012 study of the system reported that couples needed at least 65 points to qualify.
• Midwifery-led maternity care is free for New Zealand residents and other eligible women, covering antenatal, labour and postnatal care to six weeks. A private obstetrician charges a fee, reported at more than $6,000 in Auckland.
• A private IVF round cost $8,000 to $10,000 excluding pre-treatment consultations, as reported in February 2023.

Pre-existing conditions and underwriting

Both insurers underwrite individually, and both exclude pre-existing conditions unless they agree in writing to cover them. The difference is what happens afterwards.

Southern Cross's UltraCare may cover qualifying pre-existing conditions automatically after three years, while UniMed's exclusions each run their own clock and are never lifted as a group.

Having a pre-existing condition doesn't mean you can't get cover at all. UniMed assesses each declared condition individually at underwriting, and may accept it, accept it subject to limits, or exclude it for a defined period or the term of the policy, rather than declining the whole application.

Southern Cross instead excludes a condition outright unless it agrees in writing to cover it, and on UltraCare that exclusion can lift automatically after three years, or on Wellbeing be opened to a review on request. The guide to health insurance and pre-existing conditions explains how that assessment works.

Disclosure carries real consequences. The Insurance and Financial Services Ombudsman says current law "is very harsh and does not distinguish between innocent and deliberate non-disclosure". In one IFSO case, a member who did not disclose two prior spinal injuries had a later spinal claim declined.

The insurer was entitled to cancel the policy from inception but instead offered to add the exclusion retrospectively so the member could keep the policy. You are expected to disclose everything that could be relevant, including undiagnosed symptoms, up to the moment cover starts.

That law is changing. The Contracts of Insurance Act 2024 received Royal assent on 15 November 2024, and any part not already in force commences on 15 November 2027. Section 13 replaces the broad duty of disclosure for consumer contracts with a duty to take reasonable care not to make a misrepresentation. Personal health insurance falls inside the Act's definition of a consumer insurance contract.

Switching resets the clock. IFSO warns that if you change insurer, the new insurer will likely treat those conditions as pre-existing under the new policy, and claims relating to them could be declined.

Even rejoining the same insurer can do it: UniMed says a reinstatement outside its 30-day window may require a new application and health declaration, with the likely loss of cover for previously covered conditions.

Health insurance disputes rose 91% in the year to June 2026, overtaking house and motor vehicle insurance for the first time. IFSO does not attribute the rise to any single cause, but names declined claims from exclusions and non-disclosure as common health-insurance complaints.

UniMed

UniMed applies personal exclusions written onto your certificate, each running for a defined period from one year to the life of the policy, and each ending on its own terms. There is no mechanism that revisits every excluded condition after a set time, so a condition excluded at underwriting stays excluded until its own clock runs out. UniMed does not publish a turnaround time for a new application.

Declaring a condition does not mean it is refused. UniMed says that once declared there is initially no cover for it, but it may accept the condition, accept it subject to limits, or exclude it for a defined period or the term of the policy. Upgrading your plan triggers a fresh declaration and a reassessment.

Group cover softens this. On StaffCare and StaffCare+ a concession applies in certain circumstances. ParentStay is strictest, with seven named conditions making an applicant ineligible outright.

Southern Cross

Southern Cross excludes pre-existing conditions unless it agrees in writing to cover them, and its application takes five to 10 working days to process, with a medical declaration required but no medical examination. What happens next depends on which plan you hold, and Southern Cross sets that difference itself rather than leaving it to interpretation.

On UltraCare, the lift is automatic. Southern Cross states that UltraCare "may cover eligible pre-existing conditions after 3 years of continuous cover." It does not apply to Cancer Cover Plus, and ten named chronic conditions are excluded from it permanently.

On Wellbeing One and Wellbeing Two there is no automatic lift. You may request a review of certain excluded conditions after a review period specific to your certificate, but not all exclusions are open to review, and Southern Cross decides, acting reasonably, whether to remove or change one. If a health history is the reason you are comparing these plans, this distinction affects which plan suits you more than the premium difference between them.

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