{ "vertical": "health", "insurer": { "slug": "southern-cross", "name": "Southern Cross", "brand_family": "southern-cross" }, "product": { "slug": "wellbeing-two", "name": "Wellbeing Two", "status": "active", "positioning_summary": null }, "wording": { "version": "2026-04-01", "ingested_at": "2026-05-16T07:44:55.414772+00:00", "pdf_hash": "d49433a23467e8c47889a58bfbb82e201b3882ca0585609560de4baa54e03f87", "source_url": "https://www.southerncross.co.nz/-/media/Southern-Cross-Health-Society/Health-insurance/Member-collateral/Plan-documents/Current-plan-documents/PD_Wellbeing_plan.pdf", "page_count": null }, "confidence_tier": "inferred", "facts": { "ivf_cover": "We don't cover any costs related to infertility or assisted reproduction.", "exclusions": [ "Pre-existing conditions unless clearly stated otherwise on your membership certificate", "Chronic conditions: Cystic fibrosis, Dementia, Kyphosis, Loeys-Dietz syndrome, Marfan syndrome, Pectus carinatum, Pectus excavatum, Polycystic kidney disease, Scoliosis, Spina bifida", "Any congenital conditions except for umbilical hernia, inguinal hernia, undescended testes, hydrocele, tongue tie, phimosis, and squint", "Gynaecomastia", "Illnesses, injuries, conditions, or disabilities that are caused or contributed to by the abuse of substances such as alcohol or drugs", "Self-inflicted illnesses or injuries", "Injuries or disabilities from war, or any act of war (whether declared or not)", "Injuries or disabilities from active duty in the military of any country or international authority", "Injuries or disabilities from terrorism", "Unapproved healthcare services", "Healthcare services related to any accident, treatment injury, or work-related gradual process injury (except Accident and treatment injury top-up benefit)", "Any surgery, procedure or treatment that changes, improves, or enhances appearance, regardless of whether it was done for medical, physical, functional, psychological, or emotional reasons", "Pregnancy and childbirth (except Obstetrics allowance on Wellbeing Two, and prescription/physiotherapy cover under optional modules)", "Termination of a pregnancy", "Infertility or assisted reproduction", "Contraception, including the insertion or removal of intrauterine devices, except when used for medical reasons", "Sterilisation or its reversal, for example, vasectomy", "Treatment of obesity (including weight loss surgery), except for what is covered under the Gastric banding or bypass allowance", "Breast reduction, except for what is covered under the Breast reduction allowance", "Subsequent breast reconstruction surgery (including replacing prostheses) or breast symmetry surgery, except as specified", "Gender affirmation (confirmation) surgery", "Correction of refractive visual errors or astigmatism by surgery, or by surgically implanted intraocular lenses, or by laser treatment", "Healthcare services performed by a dentist, periodontist, endodontist, or orthodontist, except under Keeping Well Module or Vision and Dental Module", "Implantation of teeth, including titanium dental implants, except under Keeping Well Module or Vision and Dental Module", "Extraction of teeth, except under Surgical procedures benefit or optional modules", "Surgery designed to assist or allow for orthodontic healthcare services, except under optional modules", "Health screening (with limited exceptions)", "Maintenance examinations or medical check-ups, except for annual health checks under Day-to-day Module", "Any examination required by a third party (including preparing reports) such as physical examinations for life insurance, travel insurance, and driver licence", "Vaccinations, except for flu vaccinations under Keeping Well Module or Day-to-day Module", "Prophylactic healthcare services, except under the Prophylactic treatment allowance", "Treatment for any medical condition that is not causing significant problems to your physical health, except under optional modules", "Healthcare services that are not approved treatment", "Healthcare services provided at a public facility" ], "sublimits_nzd": { "cardiac_tests": 5000, "palliative_care": 2400, "allergy_services": 750, "diagnostic_tests": 3000, "gp_minor_surgery": 1000, "laboratory_tests": 70, "chemotherapy_base": 60000, "diagnostic_imaging": 60000, "overseas_treatment": 30000, "ambulance_allowance": 180, "skin_lesion_services": 5000, "dietitian_consultation": 500, "iv_infusions_non_cancer": 750, "skin_lesion_cryotherapy": 150, "specialist_consultation": 5000, "breast_symmetry_lifetime": 10000, "chemotherapy_100_upgrade": 100000, "chemotherapy_300_upgrade": 300000, "travel_and_accommodation": 500, "body_care_module_podiatry": 250, "breast_reduction_lifetime": 15000, "psychiatrist_consultation": 750, "psychiatric_hospitalisation": 3500, "vision_dental_module_dental": 750, "keeping_well_module_combined": 200, "skin_lesion_gp_not_affiliated": 1000, "day_to_day_module_gp_per_visit": 65, "vision_dental_module_audiology": 200, "vision_dental_module_optometry": 50, "body_care_module_allied_natural": 500, "day_to_day_module_physiotherapy": 300, "day_to_day_module_prescriptions": 600, "prophylactic_treatment_lifetime": 40000, "vision_dental_module_orthoptist": 200, "intravitreal_injection_drug_cost": 100, "day_to_day_module_nurse_per_visit": 30, "keeping_well_module_prescriptions": 100, "gastric_banding_or_bypass_lifetime": 7500, "post_operative_home_nursing_annual": 2800, "post_operative_home_nursing_per_day": 175, "post_operative_physiotherapy_annual": 300, "day_to_day_module_annual_health_check": 90, "psychiatric_hospitalisation_ancillary": 200, "psychiatric_hospitalisation_per_night": 700, "vision_dental_module_glasses_contacts": 500, "post_operative_physiotherapy_per_visit": 60, "body_care_module_dietitian_nutritionist": 250, "keeping_well_module_clinical_psychology": 100, "obstetrics_allowance_wellbeing_two_only": 750, "vision_dental_module_brainstem_auditory": 210, "chemotherapy_non_pharmac_medsafe_indicated": 10000, "post_operative_speech_language_therapy_annual": 350, "post_operative_speech_language_therapy_per_visit": 70 }, "gap_payment_rules": "Where a healthcare service is performed by an Affiliated Provider, Southern Cross covers 100% of the actual charges incurred unless Southern Cross or the Affiliated Provider advises otherwise — in this case there is no gap for the member. Where Southern Cross covers the reasonable charges (typically when a non-Affiliated Provider is used), the member is responsible for paying any amount exceeding the reasonable charges directly to the health services provider. The member is also responsible for paying any amount exceeding the policy limits, and for paying any excess, directly to the health services provider.", "pre_existing_rules": "We don't cover any costs related to, or incurred as a consequence of, any pre-existing conditions unless we've clearly stated otherwise on your membership certificate. This exclusion doesn't apply to cover provided under the optional modules. Pre-existing conditions that the policyholder has made us aware of are listed on the membership certificate.", "waiting_periods_days": { "maternity": 365 }, "acc_interaction_rules": "The Wellbeing plans do not provide cover for healthcare services related to acute care or to an accident, treatment injury or work-related gradual process injury that ACC is legally responsible for. If ACC does not pay the full amount charged for treatment, the member can make a claim for the shortfall under the relevant benefit if that healthcare service is covered under the policy — this is the 'Accident and treatment injury top-up' benefit. The member must do everything reasonably possible to obtain ACC approval for payment, including signing all documents and doing everything necessary to enable Southern Cross to protect any entitlement from ACC. Southern Cross will cover the remaining cost of the eligible healthcare service after the ACC contribution has been deducted, up to the policy limits for the relevant benefit.", "mental_health_sublimit_nzd": 3500, "mental_health_admission_rules": "The 'Psychiatric hospitalisation' benefit provides cover for admission and care by a specialist who is vocationally registered in psychiatry in an approved facility. Cover is up to $3,500 each claims year, including sub-limits of up to $700 for each night or day-stay in hospital accommodation and up to $200 each claims year for ancillary hospital charges. We'll cover the reasonable charges incurred. No excess applies to this benefit. Psychiatrist consultations (outpatient) are covered under a separate benefit up to $750 each claims year.", "oncology_high_cost_drugs_cover": "Under the Chemotherapy for cancer (base) benefit, chemotherapy drugs that are not Pharmac approved but are Medsafe-indicated for treatment of the cancer diagnosed are covered up to $10,000 each claims year, within the overall $60,000 annual limit. Under Cancer Cover Plus Chemotherapy 100 upgrade, non-Pharmac approved but Medsafe-indicated chemotherapy drugs are covered within the $100,000 annual limit with no separate sub-limit. Under Cancer Cover Plus Chemotherapy 300 upgrade, non-Pharmac approved but Medsafe-indicated chemotherapy drugs are covered within the $300,000 annual limit with no separate sub-limit.", "pharmac_vs_non_pharmac_drug_rules": "Pharmac approved chemotherapy drugs are covered under the Chemotherapy for cancer (base) benefit ($60,000 each claims year). Non-Pharmac approved but Medsafe-indicated chemotherapy drugs are covered up to $10,000 each claims year within that $60,000 limit under the base benefit. Under Cancer Cover Plus upgrades (Chemotherapy 100 or Chemotherapy 300), chemotherapy drugs that are not Pharmac approved but are Medsafe-indicated are covered up to the upgraded annual limit ($100,000 or $300,000) with no separate sub-limit for non-Pharmac drugs. IV infusions (non-cancer) do not cover the cost of drugs that are not Pharmac approved. Allergy services do not cover the cost of drugs that are not Pharmac approved. Optional modules (Keeping Well and Day-to-day) exclude cover for drugs that are not Pharmac approved." }, "endpoints": { "summary": "/api/product/southern-cross/wellbeing-two/summary.md", "wording": "/api/product/southern-cross/wellbeing-two/wording.md", "history": "/api/product/southern-cross/wellbeing-two/history.json" }, "canonical_url": "https://healthinsurancecomparison.co.nz/api/product/southern-cross/wellbeing-two/facts.json", "generated_at": "2026-05-16T12:53:25.109Z", "license": "CC BY 4.0 — attribute https://healthinsurancecomparison.co.nz" }