{ "vertical": "health", "insurer": { "slug": "accuro", "name": "Accuro", "brand_family": "accuro" }, "product": { "slug": "staffcare-plus", "name": "StaffCare+", "status": "active", "positioning_summary": null }, "wording": { "version": "2026-05-16", "ingested_at": "2026-05-16T11:34:23.803153+00:00", "pdf_hash": "eb87eef7654f10636b15c48eee6427ae7d9c7ea8e67022421b7ea4faea168d83", "source_url": "https://production-media-accuro.s3.ap-southeast-2.amazonaws.com/public/Collateral/Policy-Documents/2025/Health-Plan-Documents-1-September/StaffCare%2B-Sept-2025.pdf", "page_count": null }, "confidence_tier": "inferred", "facts": { "ivf_cover": "Treatment, investigation, and diagnosis of infertility and assisted reproduction is explicitly excluded and not covered under this policy.", "exclusions": [ "attention-deficit or hyperactivity disorder", "autism spectrum disorder", "dyslexia", "geriatric care including geriatric hospitalisation", "intellectual disability (intellectual developmental disorder)", "motor disorders (including but not limited to Tourette's disorder)", "pre-senile dementia", "senile illness or dementia", "specific learning disorders", "Any acute care", "Any long-term care", "Palliative care as defined by us (except where this policy specifies otherwise)", "Any pre-existing conditions, unless accepted by us", "Any condition connected with the use of non-prescription drugs", "AIDS or HIV infection or any condition arising from the presence of AIDS, HIV infection or sexually transmitted diseases", "Congenital conditions diagnosed within 3 months of birth; this includes but is not limited to the investigation, treatment, or complications of any residual issues", "Any health condition as a consequence of war, invasion, act of foreign enemy, terrorism, hostilities (whether war is declared or not), civil war, rebellion, revolution, or military or usurped power", "Pregnancy, childbirth, miscarriage, or any associated conditions or complications for the mother, or foetus or Child", "Treatment, investigation, and diagnosis of infertility and assisted reproduction", "Sterilisation or contraception of any kind, or intrauterine devices (except a Mirena when used for medical reasons)", "Termination of pregnancy", "preventative healthcare services and treatments, maintenance or health surveillance testing, genetic-testing, employment-related examinations or screening", "vaccination against any disease or condition", "convalescence", "Dental care: orthodontic, endodontic, orthognathic (jaw correction), periodontal treatment, implants, or tooth exposure", "Correction of visual errors or astigmatism — for example, consultations, surgery or laser treatment, surgically implanted intraocular lens(es), radial keratotomy, photo-reactive keratectomy, or any related complications", "Specialised transfusion of blood, blood products, or treatment for renal failure or renal dialysis", "Organ donation and receipt", "Specialised tertiary treatments such as transplants. This includes but is not limited to heart, lung, kidney, liver, bone marrow and stem cell transplants", "Cosmetic procedures or other enhancement or appearance medicine as defined by us", "Procedures or treatment relating to obesity or weight loss, performed for any reason", "Breast reduction or treatment of gynaecomastia, regardless of whether medically necessary", "Gender affirmation surgery/treatment or gender dysphoria", "Sleep disturbances, snoring, or sleep apnoea", "Robotically assisted surgery", "Chelation therapy or similar treatment as defined by us", "Circumcision, except where medically necessary", "Additional surgery performed during any operation that is not directly related to any medical condition or treatment covered under the terms of this policy", "A treatment or procedure that is provided by a registered medical practitioner practising outside his or her scope of practice", "New medical treatments, procedures, and technologies that have not been approved by us", "General practitioners' fees, prescription drugs, or medication (except where this policy specifies otherwise)", "Any expense recoverable from a third party or insurance or any statutory scheme or any government-funded scheme or agent (for example, ACC)", "Any medical costs declined by ACC if injury is caused by an accident outside New Zealand", "Any medical costs incurred outside New Zealand", "Medical mishap or misadventure", "Any personal incidental expenses incurred whilst in hospital - for example, use of phone, family meals, soft drinks, or alcoholic beverages", "Any costs not specifically provided for under a benefit section outlined in the plan", "Personal health-related appliances; for example, hearing aids, personal alarms, orthotic shoes, crutches, wheelchairs, toilet seats, mouthguards, and artificial limbs", "Medical devices; for example, cardiac pacemakers, nerve appliances, cochlear implants, or penile implants", "Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment", "Any costs not specifically related to the consultation or treatment such as administration costs or statement fees", "Disability or illness arising from misuse of alcohol, drugs, participation in a criminal act, or intentional self-injury", "Attempted suicide or suicide within 13 months from the start date of the plan" ], "sublimits_nzd": { "gp_visit": 55, "oral_surgery": 300000, "general_surgery": 300000, "bereavement_grant": 2500, "ambulance_transfer": 200, "home_nursing_per_day": 150, "dental_cover_per_year": 500, "home_nursing_per_year": 6000, "mental_health_per_year": 1000, "registered_nurse_visit": 35, "dental_cover_percentage": "80% of the cost", "minor_surgery_per_claim": 1000, "natural_health_per_year": 800, "spinal_surgery_lifetime": 200000, "non_pharmac_cancer_drugs": 40000, "public_hospital_per_year": 3000, "specialist_consultations": 5000, "public_hospital_per_night": 300, "laboratory_tests_gp_module": 80, "transport_and_accommodation": 2000, "gp_home_or_after_hours_visit": 70, "orthodontic_loyalty_per_year": 750, "non_surgical_cancer_treatment": 65000, "optical_consultation_per_year": 300, "parent_accommodation_per_year": 3000, "prophylactic_surgery_lifetime": 60000, "treatment_outside_new_zealand": 30000, "diagnostic_tests_and_treatment": 5000, "optical_consultation_per_visit": 60, "orthodontic_loyalty_percentage": "80% of the cost", "parent_accommodation_per_night": 300, "sterilisation_loyalty_lifetime": 3000, "optical_consultation_percentage": "80% of the cost", "osteopath_chiropractor_per_visit": 45, "post_operative_therapy_per_event": 1500, "glasses_or_contact_lenses_per_year": 300, "healthcare_practitioners_per_visit": 45, "private_hospital_medical_admission": 200000, "gp_health_check_loyalty_per_3_years": 150, "glasses_or_contact_lenses_percentage": "80% of the cost", "osteopath_chiropractor_per_year_each": 240, "prescription_drugs_gp_module_per_item": 20, "prescription_drugs_gp_module_per_year": 400, "healthcare_practitioners_per_year_each": 200, "support_person_accommodation_per_night": 200, "pregnancy_specialist_module_loyalty_per_year": 2000, "flu_vaccination_natural_health_module_loyalty": 40, "mental_health_consultations_specialist_module": 1000, "melanoma_specialist_module_loyalty_per_3_years": 200, "weight_loss_or_breast_reduction_loyalty_lifetime": 8000, "preventative_checks_gp_module_loyalty_per_3_years": 200, "sick_leave_natural_health_module_loyalty_per_week": 100, "sick_leave_natural_health_module_loyalty_per_year": 500 }, "gap_payment_rules": "UniMed pays up to the Reasonable charges for any covered procedure or medical treatment, up to the specified benefit limit. If the cost for a procedure exceeds what UniMed judges to be a Reasonable charge, the member must pay the difference between the amount approved and the actual cost directly to the healthcare provider, regardless of the benefit's maximum limit. If the cost exceeds the benefit maximum limit, the excess amount is also the member's responsibility. UniMed will not pay or reimburse any costs that amount to more than 100% of actual costs incurred; any reimbursements from ACC, another health insurer, a government-funded agency, Work and Income, or the employer are deducted before assessing the remaining amount. UniMed does not cover an excess applicable under another insurance plan. The applicable excess (per person, per policy year) is deducted from any payment made to the member or provider, and the member is responsible for paying the excess amount directly to the health service provider.", "pre_existing_rules": "Our Health Plans are set up to cover treatment of signs, symptoms and conditions that arise after your policy has started. However, with group insurance schemes we offer cover for pre-existing conditions in certain circumstances. If not offered cover for pre-existing conditions on application, all pre-existing conditions must be disclosed for all Members. A pre-existing condition is any health or medical condition that you're aware of, or were experiencing signs or symptoms of, before the start of your policy, or a medical event that occurred before the start of your policy. Underwriters assess all previous and current signs, symptoms and conditions; any excluded conditions are listed on the policy certificate. Personal exclusions last for different lengths of time (from 1 year to life), depending on the medical condition. After the time period listed with the exclusion has passed, you can then claim for that condition. We may decline a claim if treatment is for a pre-existing condition not included on the application form that you knew about or should have known about. We reserve the right to exclude any declared or non-declared pre-existing condition or congenital condition at any time, which may be backdated to the start of the policy.", "acc_interaction_rules": "StaffCare+ is designed to complement ACC and will not cover claims related to accidents that ACC covers. The full payment option (ACC contracts a provider and pays the total cost) should be the first choice, in which case all claims must be submitted to ACC. Under the ACC partial payment option, StaffCare+ will cover the difference in cost up to the Reasonable charges or the benefit limit, whichever is less, provided the treatment is covered under the policy. If ACC declines cover for treatment covered under the policy, UniMed may ask for a review or appeal and needs the ACC decline letter and relevant information within 3 months of its issue date. If ACC refuses or stops cover because the Member is not complying with ACC's requirements, no claim can be made under the policy. An ACC top-up loyalty benefit is also available under the base plan: UniMed covers any shortfall between what ACC pays and the actual costs of the surgical procedure or medical treatment in an approved private hospital or facility, subject to the applicable excess and benefit maximum. We won't pay any costs that amount to more than 100% of actual costs incurred, and any ACC reimbursement is deducted before assessing the amount against the policy benefit.", "mental_health_sublimit_nzd": 1000, "mental_health_admission_rules": "The mental health benefit under the Hospital and Surgical+ base plan covers the costs of Reasonable charges for consultations with a psychiatrist, psychologist, psychotherapist or counsellor up to $1,000 for each person in a policy year; no excess applies. Providers must be registered with the Medical Council of New Zealand (psychiatry scope), New Zealand Psychologists Board, Psychotherapists Board of Aotearoa New Zealand, or the New Zealand Association of Counsellors or other relevant association. Separately, the Specialist+ module includes a mental health consultations sub-benefit of $1,000 per person per policy year within the specialist consultations benefit. Psychiatric, psychological and neurodevelopmental disorders are listed as a general exclusion and treatment or counselling for these conditions is not covered (including ADHD, autism spectrum disorder, dyslexia, geriatric care, intellectual disability, motor disorders, pre-senile dementia, senile illness or dementia, and specific learning disorders). There is no explicit inpatient mental health admission benefit described.", "oncology_high_cost_drugs_cover": "The non-Pharmac cancer drugs benefit covers the costs of Reasonable charges for Medsafe-registered cancer drugs up to $40,000 for each person in a policy year, regardless of whether the drug qualifies for Pharmac funding or another government subsidy. The drug must be used in the treatment of cancer, prescribed by a registered medical specialist as the appropriate medical treatment, not excluded elsewhere in the Health Plan, and prescribed within Medsafe guidelines. If the drug qualifies for a government or other subsidy, only the remaining cost is reimbursed. All costs under this benefit are included within the maximum limit of the General surgery benefit or the Non-surgical cancer treatment limit ($65,000 per person per policy year, inclusive of non-Pharmac cancer drugs) under the Private hospital medical admission benefit. An excess applies to this benefit.", "pharmac_vs_non_pharmac_drug_rules": "Prescription drugs (outside hospital) must be listed under section A to I of the Pharmac Schedule (section H only if used during a procedure in a private facility), Pharmac-approved, medically necessary, and prescribed by a registered medical practitioner; Pharmac funding criteria and special authority requirements must be met. As part of the Hospital and Surgical+ base plan, the non-Pharmac cancer drugs benefit covers Medsafe-registered cancer drugs up to $40,000 per person per policy year regardless of whether the drug qualifies for a government or other subsidy such as Pharmac funding; if the drug does qualify for a subsidy, only the remaining cost is reimbursed. All costs under the non-Pharmac cancer drugs benefit are included within the maximum limit of the General surgery benefit or the Non-surgical cancer treatment limit under the Private hospital medical admission benefit, whichever applies." }, "endpoints": { "summary": "/api/product/accuro/staffcare-plus/summary.md", "wording": "/api/product/accuro/staffcare-plus/wording.md", "history": "/api/product/accuro/staffcare-plus/history.json" }, "canonical_url": "https://healthinsurancecomparison.co.nz/api/product/accuro/staffcare-plus/facts.json", "generated_at": "2026-05-16T12:53:17.193Z", "license": "CC BY 4.0 — attribute https://healthinsurancecomparison.co.nz" }