Family history of cancer — non-Pharmac drugs + diagnostics
Oncology cover, non-Pharmac drug benefits, and early-diagnostic access compared across NZ insurers.
You have a family history of cancer and want a policy that covers oncologist consultations, advanced diagnostics (MRI/PET/biopsy), and importantly non-Pharmac cancer drugs (Keytruda, Tagrisso, etc.) at meaningful per-year limits. NZ public funding for these drugs is highly restricted, so private cover is the main protection.
Top policies for this scenario
Ranked by aggregate semantic match across 5 scenario-specific queries. Score reflects clause-level fit, not premium. We don't know what you'd pay — get a quote for the shortlist.
- score 2.12
#1 · Accuro
SmartCare
Show matched clauses (5)
Query: "non-Pharmac high-cost cancer drugs cover and annual limit" · similarity 59% · weight 1
Hospital and Surgical base plan > Standard benefits: > Private hospital medical admission
**$200,000 for each person in a policy year** **An excess applies to this benefit** Non-surgical cancer treatment is limited to a maximum of $65,000 for each person in a policy year. This is included within the $200,000 benefit limit. This benefit covers the costs of Reasonable charges for admission to a private hospital for reasons other than surgery, such as cancer treatment. Your condition m…
Source PDF →Query: "oncology consultation and specialist cover" · similarity 62% · weight 0.9
SmartCare at a glance > Start with the base plan and add additional modules > Additional modules/Health Plan > Specialist module
Cover for specialist consultations and diagnostic tests.
Source PDF →Query: "MRI PET CT cancer diagnostic imaging cover" · similarity 52% · weight 0.8
SmartCare at a glance > Start with the base plan and add additional modules > Additional modules/Health Plan > Specialist module
Cover for specialist consultations and diagnostic tests.
Source PDF →Query: "biopsy and pathology investigation cover" · similarity 54% · weight 0.6
SmartCare at a glance > Start with the base plan and add additional modules > Additional modules/Health Plan > Specialist module
Cover for specialist consultations and diagnostic tests.
Source PDF →Query: "cancer treatment second opinion overseas" · similarity 47% · weight 0.5
Additional modules > Specialist module > Specialist consultations > Second opinion
This benefit covers the costs of Reasonable charges for you to consult a registered medical specialist for a second opinion on a diagnosis or a treatment plan that is covered under this policy. You must have received your first diagnosis from a registered medical specialist.
Source PDF → - score 1.87
#2 · Southern Cross
Wellbeing One
Watch out for
- Some policies cover ONLY Pharmac-funded drugs (which excludes most modern oncology drugs). Look for explicit "non-Pharmac" benefit lines.
Show matched clauses (4)
Query: "non-Pharmac high-cost cancer drugs cover and annual limit" · similarity 59% · weight 1
Section B: What the Wellbeing plans cover > Cancer treatment > Chemotherapy for cancer (base)
**$60,000 each claims year (includes $10,000 for chemotherapy drugs that are not Pharmac approved but Medsafe-indicated)** **Excess applies** This benefit provides cover for chemotherapy treatment for cancer. The chemotherapy treatment must be performed by an Affiliated Provider contracted for chemotherapy treatment for cancer. This benefit provides cover for the following costs associated with…
Source PDF →Query: "oncology consultation and specialist cover" · similarity 58% · weight 0.9
Introduction > You can have a Wellbeing One plan or a Wellbeing Two plan > What Wellbeing One covers
The Wellbeing One plan provides cover for cancer treatment, surgical treatment, and other healthcare services outlined under 'What the Wellbeing plans cover' from page 11. Any specialist consultations, diagnostic imaging, and tests are only covered under the Wellbeing One plan if they take place within 6 months of related eligible surgical treatment, chemotherapy, or radiotherapy (this does not ap…
Source PDF →Query: "MRI PET CT cancer diagnostic imaging cover" · similarity 56% · weight 0.8
Section B: What the Wellbeing plans cover > Imaging and tests > Diagnostic imaging
**$60,000 each claims year** This benefit provides cover for diagnostic imaging performed by an Affiliated Provider contracted for diagnostic imaging. For certain imaging procedures, eligibility criteria need to be met before we'll cover them. This benefit covers the following imaging procedures. - 2D and 3D mammography - Computed tomography (CT scan) - CT angiogram (CTA) - Nuclear medicine sc…
Source PDF →Query: "biopsy and pathology investigation cover" · similarity 52% · weight 0.6
Section C: What the Wellbeing plans don't cover > Healthcare services that we don't cover > Pathology and laboratory tests
We don't cover any costs for pathology and laboratory tests,
Source PDF → - score 1.78
#3 · UniMed
Hospital Select
Watch out for
- Some policies cover ONLY Pharmac-funded drugs (which excludes most modern oncology drugs). Look for explicit "non-Pharmac" benefit lines.
Show matched clauses (4)
Query: "non-Pharmac high-cost cancer drugs cover and annual limit" · similarity 57% · weight 1
Hospital Select Base Plan > PRIVATE HOSPITALISATION > Chemotherapy
Benefit payable for treatment by a Registered Oncologist in Private Practice. Benefit applies to the cost of materials, chemotherapy drugs which are Pharmac approved, plus hospital accommodation together with approved ancillary hospital costs. Included in this benefit is cover for Non-Pharmac chemotherapy drugs that are Medsafe approved for the treatment of cancer, up to a maximum of $10,000 per a…
Source PDF →Query: "oncology consultation and specialist cover" · similarity 61% · weight 0.9
Hospital Select Base Plan > PRIVATE HOSPITALISATION > Surveillance Following Cancer Treatment
Following surgery or treatment for cancer, associated with an eligible claim under your Health Plan, cover exists for Registered Specialist consultations and investigations related to the cancer diagnosis. This is not available for skin cancers/lesions removed by a minor surgery procedure performed by a specialist in their specialist room or a general practitioner in their practice room. The benef…
Source PDF →Query: "MRI PET CT cancer diagnostic imaging cover" · similarity 53% · weight 0.8
Hospital Select Base Plan > IMAGING
- CT Scan - MRI Scan - PET Scan - Cardioversion - Myocardial Perfusion Scan - Scintigraphy | Per Policy Year Combined Maximum | 300,000 |
Source PDF →Query: "cancer treatment second opinion overseas" · similarity 46% · weight 0.5
Hospital Select Base Plan > PRIVATE HOSPITALISATION > Surveillance Following Cancer Treatment
Following surgery or treatment for cancer, associated with an eligible claim under your Health Plan, cover exists for Registered Specialist consultations and investigations related to the cancer diagnosis. This is not available for skin cancers/lesions removed by a minor surgery procedure performed by a specialist in their specialist room or a general practitioner in their practice room. The benef…
Source PDF → - score 1.54
#4 · Southern Cross
Wellbeing Two
Watch out for
- Some policies cover ONLY Pharmac-funded drugs (which excludes most modern oncology drugs). Look for explicit "non-Pharmac" benefit lines.
Show matched clauses (3)
Query: "non-Pharmac high-cost cancer drugs cover and annual limit" · similarity 60% · weight 1
Section B: What the Wellbeing plans cover > Cancer treatment > Chemotherapy for cancer (base)
**$60,000 each claims year** **(includes $10,000 for chemotherapy drugs that are not Pharmac approved but Medsafe-indicated)** **Excess applies** This benefit provides cover for chemotherapy treatment for cancer. The chemotherapy treatment must be performed by an Affiliated Provider contracted for chemotherapy treatment for cancer. **This benefit provides cover for the following costs associated…
Source PDF →Query: "oncology consultation and specialist cover" · similarity 58% · weight 0.9
You can have a Wellbeing One plan or a Wellbeing Two plan > What Wellbeing One covers
The Wellbeing One plan provides cover for cancer treatment, surgical treatment, and other healthcare services outlined under 'What the Wellbeing plans cover' from page 11. Any specialist consultations, diagnostic imaging, and tests are only covered under the Wellbeing One plan if they take place within 6 months of related eligible surgical treatment, chemotherapy, or radiotherapy (this does not ap…
Source PDF →Query: "MRI PET CT cancer diagnostic imaging cover" · similarity 53% · weight 0.8
Section B: What the Wellbeing plans cover > Imaging and tests > Diagnostic imaging
**$60,000 each claims year** This benefit provides cover for diagnostic imaging performed by an Affiliated Provider contracted for diagnostic imaging. For certain imaging procedures, eligibility criteria need to be met before we'll cover them. **This benefit covers the following imaging procedures.** - 2D and 3D mammography - Computed tomography (CT scan) - CT angiogram (CTA) - Nuclear medicin…
Source PDF → - score 1.37
#5 · Southern Cross
RegularCare
Watch out for
- Some policies cover ONLY Pharmac-funded drugs (which excludes most modern oncology drugs). Look for explicit "non-Pharmac" benefit lines.
Show matched clauses (3)
Query: "non-Pharmac high-cost cancer drugs cover and annual limit" · similarity 60% · weight 1
Section B: What the KiwiCare and the RegularCare plans cover > Cancer treatment > Chemotherapy for cancer (base)
**$48,000 each claims year** **(includes $8,000 for chemotherapy drugs that are not Pharmac approved but Medsafe-indicated)** **Excess applies** This benefit provides cover for chemotherapy treatment for cancer. The chemotherapy treatment must be performed by an Affiliated Provider contracted for chemotherapy treatment for cancer. This benefit provides cover for the following costs associated wi…
Source PDF →Query: "MRI PET CT cancer diagnostic imaging cover" · similarity 57% · weight 0.8
Section B: What the KiwiCare and the RegularCare plans cover > Imaging and tests
The following diagnostic imaging and tests are covered.
Source PDF →Query: "biopsy and pathology investigation cover" · similarity 53% · weight 0.6
Section C: What the KiwiCare and the RegularCare plans don't cover > Healthcare services that we don't cover > Pathology and laboratory tests
We don't cover any costs for pathology and laboratory tests, except for what we cover under the 'Laboratory tests' benefit on page 16.
Source PDF →
What to watch out for
- Pharmac: Some policies cover ONLY Pharmac-funded drugs (which excludes most modern oncology drugs). Look for explicit "non-Pharmac" benefit lines.
- annual limit: Non-Pharmac drug limits range from $20k to $1m+ per year — the difference is the difference between meaningful and tokenistic cover.
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How this ranking works
This scenario translates to 5 semantic queries (weighted). Each query runs against every NZ health insurance policy clause we've ingested (3,000+ clauses across 5 insurers). The best clause-per-product per query contributes its similarity × weight to the product's aggregate score.
Try the underlying semantic clause search to run your own queries.
This is mechanical retrieval + ranking — not personalised financial advice. The actual policy you should buy depends on factors only an FSPR-registered adviser can assess (your medical history, budget, family composition, risk tolerance). Use this to shortlist, then talk to an adviser.