The plans impacted by reasonable charges and possible member contributions are:
Who do I contact if I have more questions? For questions surrounding your prior approval, contact us at [email protected] or call us on 0800 800 181.
What we’re doing to keep premiums down
More members are claiming and are doing so more frequently than ever before. Given these pressures we want to assure you that we are focused on minimising the impact to you so that you can continue to enjoy access to private healthcare.
We are working hard to tackle the escalating cost of healthcare services and reduce premium increases. We’re assessing whether surgeon fees are reasonable for some procedures and letting you know if they’re not.
Reasonable charges explained
After extensive review we know that some healthcare providers are charging more than what we consider to be reasonable for their surgical services. We want to assure you that we are contacting these healthcare providers and letting them know we can’t provide cover at the level of their current prices. Reasonable pricing by all healthcare providers contributes to the long-term sustainability of healthcare costs overall.
How reasonable charges may affect you and the choices you have
If your chosen healthcare provider’s fees are above what we consider reasonable, we may be in touch at prior approval time to discuss this. As part of the call, you will have the option of choosing an alternative healthcare provider who has reasonable charges or, keeping your preferred provider but paying an additional contribution towards the healthcare service.
Please seek prior approval as early as possible to allow time for you to make a choice.
Southern Cross Medical Care Society (trading as Southern Cross Health Society) is a licensed insurer and a licensed financial advice provider. For more information about the financial advice service we provide and a copy of our public disclosure statement please visit southerncross.co.nz/disclosure-statement.
Southern Cross Medical Care Society (trading as Southern Cross Health Society) has an A+ (Strong) financial strength rating given by Standard & Poor’s (Australia) Pty Limited. The rating scale is: AAA (Extremely Strong), AA (Very Strong), A (Strong), BBB (Good), BB (Marginal), B (Weak), CCC (Very Weak), CC (Extremely Weak), SD or D (Selective Default or Default). Ratings from ‘AA’ to ‘CCC’ may be modified by the addition of a plus (+) or minus (-) sign to show relative standing within the major rating categories. Full details of the rating scale are available at www.spglobal.com/ratings/en/about/intro-to-credit-ratings. Standard & Poor’s is an approved rating agency under the Insurance (Prudential Supervision) Act 2010.
