AA Health health insurance — what's not covered

40 exclusions from wording effective 2026-05-16 · source PDF ↗

• anything cosmetic that is not medically necessary regardless of whether it's done for physical, functional, psychological, or emotional reasons (for example: treatment that improves, changes, or enhances your appearance)
• assisted reproduction
• hormone therapy
• infertility
• intrauterine devices
• pregnancy (for example: normal pregnancy, caesarean section, ectopic, or termination of)
• erectile dysfunction
• sterilisation or reversal of sterilisation
• psychiatric, psychological, behavioural, or developmental conditions (for example: depression, ADHD, and eating disorders)
• injuries that are self-inflicted
• congenital or chromosomal disorders (for example: a birth defect)
• congenital kyphosis, congenital scoliosis, cystic fibrosis, or pectus excavatum
• Marfan's syndrome
• genetic testing
• hereditary, or genetic conditions
• health services due to concerns of familial risk or familial predisposition, in the absence of signs or symptoms that a condition exists
• any acute medical conditions or acute care
• any treatment for a condition relating to a crime committed by you
• treatment for allergies or allergic disorders (for example: desensitisation)
• providers who don't meet our criteria
• services provided by a family member (for example: health services, travel costs or accommodation)
• claims that don't meet the terms of your policy
• expenses recoverable from a third party (for example: another insurer, company or person)
• health services that you have received during a waiting period
• health services after the applicable benefit limit has been reached
• health services not covered under your policy
• anything that isn't medically necessary (for example: alcohol, toiletries, car parking, visitor meals or administration costs)
• seeing the same provider twice on the same day – we'll pay the cost of the first visit only
• services or goods that were received or purchased outside of New Zealand (for example: goods bought online from another country)
• false or inaccurate information provided for a policy application or claim request
• substance misuse (for example: misuse of alcohol or drugs)
• Cryotherapy, Pulse light therapy or Photodynamic therapy
• any other services in GP rooms, such as minor surgery
• injections of any kind
• medicines that aren't funded by PHARMAC at the time of your treatment
• treatments covered under the school dental service or government dental scheme
• any extra costs such as gold or other materials that are not normally used in dental treatments or are unreasonably expensive
• replacing lenses as part of a repair
• sunglass tinting, coating, or hardening lenses
• Hospital services

66 exclusions from wording effective 2023-10-01 · source PDF ↗

• anything cosmetic or reconstructive that is not medically necessary regardless of whether it's done for physical, functional, psychological, or for emotional reasons (for example: treatment that improves, changes, or enhances your appearance)
• Abdominoplasty, Hyperhidrosis, Rectus divarication repair
• weight loss or bariatric investigations or treatment (for example: gastric banding, sleeve, and bypass), even if the purpose is to treat other health conditions (for example: diabetes or cardiovascular conditions)
• breast implants
• breast reductions
• Gynaecomastia
• revision of breast reconstruction
• assisted reproduction
• childbirth including caesarean sections
• hormone therapy
• infertility
• intrauterine devices
• pregnancy (for example: normal pregnancy, ectopic, or termination of)
• contraception
• erectile dysfunction
• sterilisation or reversal of sterilisation
• any treatment or procedures that are related to gender dysphoria
• gender reassignment
• psychiatric, psychological, behavioural, or developmental conditions (for example: depression, ADHD, and eating disorders)
• injuries that are self-inflicted
• congenital or chromosomal disorders (for example: a birth defect)
• congenital kyphosis, congenital scoliosis, cystic fibrosis, or pectus excavatum
• Marfan's syndrome
• gene therapy
• genetic testing
• hereditary conditions
• any acute medical conditions or acute care
• ambulance society subscriptions
• injuries that are covered by ACC
• aids that assist with rehabilitation and mobility (for example: crutches, toilet frames, artificial limbs)
• continuous care (for example: geriatric, palliative, rehabilitation)
• mechanical tools or appliances (for example: insulin pumps, CPAP machines and equipment, pacemakers)
• organ or tissue transplants or donations (for example: organ transplants)
• specialised transfusions (for example: transfusion of blood, blood products and derivatives, and dialysis of any type)
• dentures
• dental implants
• Orthognathic surgery
• Periodontics, orthodontics, and endodontic procedures
• tooth exposure
• vision enhancement and correction (for example: myopia, hypermetropia, presbyopia, astigmatism, or laser treatment)
• Blepharoplasty
• any treatment for a condition relating to crime commited by you
• conditions or treatment relating to wars, riots, or terrorism
• HIV or AIDS
• treatment for allergies or allergic disorders (for example: desensitisation or patch testing)
• medicines that aren't funded by PHARMAC under the latest PHARMAC Pharmaceutical Schedule
• conditions not registered with the Ministry of Health as a disease
• any form of risk management (for example: screening, preventative, or prophylactic health services)
• health services due to concerns of familial risk or familial predisposition, in the absence of signs or symptoms that a condition exists
• sleep problems or disorders (for example: snoring, insomnia, or sleep apnoea)
• alternative or complementary medicine or therapy (for example: homoeopathy and natural therapy)
• experimental, unproven, or unconventional treatments or procedures
• providers who don't meet our criteria
• health services provided by a family member (for example: health services, travel costs, or accommodation)
• health services provided by someone who is not recognised by the Medical Council of New Zealand
• technologies that we haven't approved that we consider novel or experimental or that are more expensive than an alternative treatment which will provide a similar outcome
• additional surgery or treatment that isn't covered under your policy
• claims that don't meet the terms of your policy
• expenses recoverable from a third party (for example: another insurer, company, or person)
• health services after the applicable benefit limit has been reached
• health services not covered under your policy
• anything that isn't medically necessary (for example: alcohol, toiletries, car parking, visitor meals, or administration costs)
• GP and out-of-hospital charges (including prescriptions)
• health services or goods that were received or purchased outside of New Zealand (for example: goods bought online from another country)
• false or inaccurate information provided for a policy application or claim request
• substance misuse (for example: misuse of alcohol or drugs)

66 exclusions from wording effective 2026-05-16 · source PDF ↗

• anything cosmetic or reconstructive that is not medically necessary regardless of whether it's done for physical, functional, psychological, or emotional reasons (for example: treatment that improves, changes, or enhances your appearance)
• Abdominoplasty, Hyperhidrosis, Rectus divarication repair
• weight loss or bariatric investigations or treatment (for example: gastric banding, sleeve, and bypass), even if the purpose is to treat other health conditions (for example: diabetes or cardiovascular conditions)
• breast implants
• breast reductions
• Gynaecomastia
• revision of breast reconstruction
• assisted reproduction
• childbirth including caesarean sections
• hormone therapy
• infertility
• intrauterine devices
• pregnancy (for example: normal pregnancy, ectopic, or termination of)
• contraception
• erectile dysfunction
• sterilisation or reversal of sterilisation
• any treatment or procedures that are related to gender dysphoria
• gender reassignment
• psychiatric, psychological, behavioural, or developmental conditions (for example: depression, ADHD, and eating disorders)
• injuries that are self-inflicted
• congenital or chromosomal disorders (for example: a birth defect)
• congenital kyphosis, congenital scoliosis, cystic fibrosis, or pectus excavatum
• Marfan's syndrome
• gene therapy
• genetic testing
• hereditary conditions
• any acute medical conditions or acute care
• ambulance society subscriptions
• injuries that are covered by ACC
• aids that assist with rehabilitation and mobility (for example: crutches, toilet frames, artificial limbs)
• continuous care (for example: geriatric, palliative, rehabilitation)
• mechanical tools or appliances (for example: insulin pumps, CPAP machines and equipment, pacemakers)
• organ or tissue transplants or donations (for example: organ transplants)
• specialised transfusions (for example: transfusion of blood, blood products and derivatives, and dialysis of any type)
• dentures
• dental implants
• Orthognathic surgery
• Periodontics, orthodontics, and endodontic procedures
• tooth exposure
• vision enhancement and correction (for example: myopia, hypermetropia, presbyopia, astigmatism, or laser treatment)
• Blepharoplasty
• any treatment for a condition relating to crime committed by you
• conditions or treatment relating to wars, riots, or terrorism
• HIV or AIDS
• treatment for allergies or allergic disorders (for example: desensitisation or patch testing)
• medicines that aren't funded by PHARMAC under the latest PHARMAC Pharmaceutical Schedule
• conditions not registered with the Ministry of Health as a disease
• any form of risk management (for example: screening, preventative, or prophylactic health services)
• health services due to concerns of familial risk or familial predisposition, in the absence of signs or symptoms that a condition exists
• sleep problems or disorders (for example: snoring, insomnia, or sleep apnoea)
• alternative or complementary medicine or therapy (for example: homoeopathy and natural therapy)
• experimental, unproven, or unconventional treatments or procedures
• providers who don't meet our criteria
• services provided by a family member (for example: health services, travel costs, or accommodation)
• services provided by someone who is not recognised by the Medical Council of New Zealand
• technologies that we haven't approved that we consider novel or experimental or that are more expensive than an alternative treatment which will provide a similar outcome
• additional surgery or treatment that isn't covered under your policy
• claims that don't meet the terms of your policy
• expenses recoverable from a third party (for example: another insurer, company, or person)
• health services after the applicable benefit limit has been reached
• health services not covered under your policy
• anything that isn't medically necessary (for example: alcohol, toiletries, car parking, visitor meals, or administration costs)
• GP and out-of-hospital charges (including prescriptions)
• services or goods that were received or purchased outside of New Zealand (for example: goods bought online from another country)
• false or inaccurate information provided for a policy application or claim request
• substance misuse (for example: misuse of alcohol or drugs)