{ "vertical": "health", "insurer": { "slug": "accuro", "name": "Accuro", "brand_family": "accuro" }, "product": { "slug": "staffcare", "name": "StaffCare", "status": "active", "positioning_summary": null }, "wording": { "version": "2026-05-16", "ingested_at": "2026-05-16T11:29:50.218019+00:00", "pdf_hash": "80b04ba78b1dd4e174b4e5ee756e9a1a8443713ddf2c228bf6e0e60bd2e5b1d0", "source_url": "https://production-media-accuro.s3.ap-southeast-2.amazonaws.com/public/Collateral/Policy-Documents/2025/Health-Plan-Documents-1-September/StaffCare-Sept-2025.pdf", "page_count": null }, "confidence_tier": "verified", "facts": { "ivf_cover": "Treatment, investigation, and diagnosis of infertility and assisted reproduction is explicitly excluded.", "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", "Admission for convalescence, recovery, respite care, geriatric or senile care, obstetrics, mental health, psychiatric or psychological treatment or counselling, or recurrent health conditions (under private hospital medical admission benefit)" ], "sublimits_nzd": { "ct_scan": 2500, "mri_scan": 3000, "pet_scan": 2500, "angiogram": 3500, "gp_per_visit": 55, "home_nursing": 2500, "oral_surgery": 100000, "mental_health": 1000, "minor_surgery": 500, "sterilisation": 3000, "general_surgery": 200000, "gp_health_check": 150, "public_hospital": 3000, "home_nursing_daily": 100, "melanoma_screening": 200, "gp_module_annual_max": 500, "parent_accommodation": 500, "prophylactic_surgery": 60000, "post_operative_therapy": 1000, "spinal_surgery_lifetime": 200000, "myocardial_perfusion_scan": 2000, "public_hospital_per_night": 300, "registered_nurse_per_visit": 35, "prescription_drugs_per_item": 20, "registered_nurse_annual_max": 200, "transport_and_accommodation": 2000, "non_surgical_cancer_treatment": 60000, "prescription_drugs_annual_max": 300, "treatment_outside_new_zealand": 10000, "parent_accommodation_per_night": 125, "specialist_module_mental_health": 1000, "day_to_day_health_plan_annual_max": 600, "private_hospital_medical_admission": 65000, "support_person_accommodation_per_night": 200, "support_person_accommodation_max_nights": 10, "specialist_consultations_and_diagnostic_tests": 5000 }, "gap_payment_rules": "We cover Reasonable charges, defined as the cost for a procedure or medical treatment judged to be reasonable and within a range of cost charged for the same procedure under similar circumstances. If the cost exceeds Reasonable charges or the benefit limit, the member must pay the difference directly to the healthcare provider. The insurer will not reimburse any amount exceeding 100% of actual costs incurred. Members must first claim any other refunds, subsidies, or entitlements (including from ACC, another insurer, or government-funded agency), and the insurer will deduct those amounts before assessing the claim. The insurer does not cover an excess applicable under another insurance plan.", "excess_amounts_nzd": [], "pre_existing_rules": "Pre-existing conditions are excluded unless accepted by the insurer. With group insurance schemes, cover for pre-existing conditions may be offered in certain circumstances. If a full application is required, all pre-existing conditions must be disclosed. Personal exclusions may be placed on the policy certificate for pre-existing conditions, lasting from 1 year to life depending on the condition. After the exclusion period has passed, the member can then claim for that condition. If a pre-existing condition is not disclosed and a claim is made relating to it, the claim may be declined. The insurer reserves the right to exclude any declared or non-declared pre-existing condition or congenital condition at any time, backdated to the start of the policy if necessary.", "waiting_periods_days": {}, "acc_interaction_rules": "The StaffCare Health Plan is designed to complement ACC and will not cover claims related to accidents that ACC covers. If ACC does not cover the full amount for treatment, the policy may pay the difference if there is cover for that treatment under the policy. Under the ACC full payment option, ACC pays the total cost and all claims must be submitted to ACC. Under the ACC partial payment option, the policy covers the shortfall up to Reasonable charges or the benefit limit, whichever is less. If ACC declines cover, the insurer may ask for a review or appeal, requiring the member to provide the ACC decline letter within 3 months. The insurer will not cover any medical costs declined by ACC if injury is caused by an accident outside New Zealand. Any expense recoverable from ACC is excluded. The ACC top-up benefit covers the shortfall between what ACC pays and actual costs of surgical procedure or medical treatment in an approved private hospital or facility, subject to the excess and benefit maximum.", "mental_health_sublimit_nzd": 1000, "mental_health_admission_rules": "The mental health benefit covers $1,000 per person per policy year (no excess applies) for consultations with a psychiatrist, psychologist, psychotherapist or counsellor who is registered with the relevant professional body. Inpatient or hospital admission for mental health, psychiatric or psychological treatment or counselling is explicitly excluded under the private hospital medical admission benefit. Treatment or counselling for any psychiatric, psychological and neurodevelopmental disorders is also listed as a general exclusion.", "oncology_high_cost_drugs_cover": "Non-surgical cancer treatment is covered up to $60,000 per person per policy year for admission to a private hospital or facility. This includes chemotherapy drugs administered orally at home prescribed by a registered medical specialist during an approved cycle of chemotherapy treatment under the policy, as well as other prescription drugs used during non-surgical cancer treatment in hospital. No specific high-cost cancer drug benefit (such as a named drug like Keytruda) or separate oncology drug sub-limit beyond the $60,000 non-surgical cancer treatment benefit is mentioned in the policy wording.", "pharmac_vs_non_pharmac_drug_rules": "Prescription drugs are only covered under the GP module (up to $20 per item, maximum $300 per person per policy year) for drugs ordered by a New Zealand-registered medical practitioner or registered medical specialist. Chemotherapy drugs administered orally at home that are prescribed by a registered medical specialist and used during an approved cycle of chemotherapy treatment are covered under the Non-surgical cancer treatment benefit. Other prescription drugs used during hospital admission are covered as part of the Private hospital medical admission and Non-surgical cancer treatment benefits. No explicit PHARMAC vs non-PHARMAC distinction or Keytruda-specific rules are stated in the policy wording." }, "endpoints": { "summary": "/api/product/accuro/staffcare/summary.md", "wording": "/api/product/accuro/staffcare/wording.md", "history": "/api/product/accuro/staffcare/history.json" }, "canonical_url": "https://healthinsurancecomparison.co.nz/api/product/accuro/staffcare/facts.json", "generated_at": "2026-05-16T12:53:15.998Z", "license": "CC BY 4.0 — attribute https://healthinsurancecomparison.co.nz" }