Chronic conditions — diabetes, cardiac, or autoimmune
Ongoing-condition cover, specialist consultations, and pre-existing rules compared.
You or a family member already has a diagnosed chronic condition (Type 1 or 2 diabetes, ischaemic heart disease, lupus, Crohn's, etc.) and need cover that meaningfully supports ongoing specialist visits, diagnostics, and treatment costs — without that condition being permanently excluded by underwriting.
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 1.62
#1 · Southern Cross
KiwiCare
Show matched clauses (4)
Query: "chronic condition cover and ongoing specialist consultations" · similarity 60% · weight 1
Section B: What the KiwiCare and the RegularCare plans cover > Consultations > Specialist consultations
**$4,000 each claims year** This benefit provides cover for consultations performed by a specialist who is an Affiliated Provider contracted for consultations. Consultations with a health services provider who is working under the supervision of a specialist are also covered if this type of consultation is: - included in the Affiliated Provider's contract with us, and - approved by us. This be…
Source PDF →Query: "diagnostic imaging and pathology for ongoing conditions" · similarity 59% · weight 0.6
Section B: What the KiwiCare and the RegularCare plans cover > Imaging and tests
The following diagnostic imaging and tests are covered.
Source PDF →Query: "moratorium underwriting for chronic conditions" · similarity 44% · weight 0.8
Section B: What the KiwiCare and the RegularCare plans cover > Surgical allowances > Prophylactic treatment allowance
**$30,000 during a lifetime** After 3 years of continuous cover on this plan, this benefit contributes towards prophylactic treatment to address a highly increased risk of developing a disease due to your medical history or genetic predisposition. This benefit also covers any follow-up healthcare services that are related to the prophylactic treatment. Unless your membership certificate specific…
Source PDF →Query: "diabetes cardiac specialist annual limit" · similarity 46% · weight 0.7
Section B: What the KiwiCare and the RegularCare plans cover > Imaging and tests > Cardiac tests
**$3,000 each claims year** This benefit provides cover for cardiac tests performed by an Affiliated Provider contracted for cardiac tests, but only when you're referred by a specialist in private practice. For certain tests, eligibility criteria need to be met before we'll cover them. This benefit covers the following cardiac tests. - Advanced electrocardiogram (A-ECG) - Dobutamine stress ech…
Source PDF → - score 1.62
#2 · Southern Cross
RegularCare
Show matched clauses (4)
Query: "chronic condition cover and ongoing specialist consultations" · similarity 60% · weight 1
Section B: What the KiwiCare and the RegularCare plans cover > Consultations > Specialist consultations
**$4,000 each claims year** This benefit provides cover for consultations performed by a specialist who is an Affiliated Provider contracted for consultations. Consultations with a health services provider who is working under the supervision of a specialist are also covered if this type of consultation is: - included in the Affiliated Provider's contract with us, and - approved by us. This be…
Source PDF →Query: "diagnostic imaging and pathology for ongoing conditions" · similarity 59% · weight 0.6
Section B: What the KiwiCare and the RegularCare plans cover > Imaging and tests
The following diagnostic imaging and tests are covered.
Source PDF →Query: "moratorium underwriting for chronic conditions" · similarity 43% · weight 0.8
Section B: What the KiwiCare and the RegularCare plans cover > Surgical allowances > Prophylactic treatment allowance
**$30,000 during a lifetime** After 3 years of continuous cover on this plan, this benefit contributes towards prophylactic treatment to address a highly increased risk of developing a disease due to your medical history or genetic predisposition. This benefit also covers any follow-up healthcare services that are related to the prophylactic treatment. Unless your membership certificate specific…
Source PDF →Query: "diabetes cardiac specialist annual limit" · similarity 46% · weight 0.7
Section B: What the KiwiCare and the RegularCare plans cover > Imaging and tests > Cardiac tests
**$3,000 each claims year** This benefit provides cover for cardiac tests performed by an Affiliated Provider contracted for cardiac tests, but only when you're referred by a specialist in private practice. For certain tests, eligibility criteria need to be met before we'll cover them. This benefit covers the following cardiac tests. - Advanced electrocardiogram (A-ECG) - Dobutamine stress ech…
Source PDF → - score 1.31
#3 · Southern Cross
Wellbeing One
Show matched clauses (3)
Query: "chronic condition cover and ongoing specialist consultations" · similarity 65% · weight 1
Section B: What the Wellbeing plans cover > Consultations
Consultations are covered with certain specialists, psychiatrists, and dietitians. If you have the Wellbeing One plan, an extra 6-month condition applies to your cover for consultations with specialists and dietitians, as we explain in more detail below.
Source PDF →Query: "diabetes cardiac specialist annual limit" · similarity 47% · weight 0.7
Section B: What the Wellbeing plans cover > Imaging and tests > Cardiac tests
**$5,000 each claims year** This benefit provides cover for cardiac tests performed by an Affiliated Provider contracted for cardiac tests, but only when you're referred by a specialist in private practice. For certain tests, eligibility criteria need to be met before we'll cover them. This benefit covers the following cardiac tests. - Advanced electrocardiogram (A-ECG) - Dobutamine stress ech…
Source PDF →Query: "diagnostic imaging and pathology for ongoing conditions" · similarity 55% · weight 0.6
Section B: What the Wellbeing plans cover > Imaging and tests
The following diagnostic imaging and tests are covered. If you have the Wellbeing One plan, an extra 6‑month condition applies to your cover for diagnostic imaging, cardiac tests, and diagnostic tests, as we explain in more detail below. Laboratory tests are only covered if you have the Wellbeing Two plan.
Source PDF → - score 1.30
#4 · Southern Cross
Wellbeing Two
Show matched clauses (3)
Query: "chronic condition cover and ongoing specialist consultations" · similarity 65% · weight 1
Section B: What the Wellbeing plans cover > Consultations
Consultations are covered with certain specialists, psychiatrists, and dietitians. If you have the Wellbeing One plan, an extra 6-month condition applies to your cover for consultations with specialists and dietitians, as we explain in more detail below.
Source PDF →Query: "diagnostic imaging and pathology for ongoing conditions" · similarity 55% · weight 0.6
Section B: What the Wellbeing plans cover > Imaging and tests
The following diagnostic imaging and tests are covered. If you have the Wellbeing One plan, an extra 6‑month condition applies to your cover for diagnostic imaging, cardiac tests, and diagnostic tests, as we explain in more detail below. Laboratory tests are only covered if you have the Wellbeing Two plan.
Source PDF →Query: "diabetes cardiac specialist annual limit" · similarity 46% · weight 0.7
Section B: What the Wellbeing plans cover > Imaging and tests > Cardiac tests
**$5,000 each claims year** This benefit provides cover for cardiac tests performed by an Affiliated Provider contracted for cardiac tests, but only when you're referred by a specialist in private practice. For certain tests, eligibility criteria need to be met before we'll cover them. **This benefit covers the following cardiac tests.** - Advanced electrocardiogram (A-ECG) - Dobutamine stress…
Source PDF → - score 1.29
#5 · nib
Ultimate Health Max
Show matched clauses (3)
Query: "chronic condition cover and ongoing specialist consultations" · similarity 61% · weight 1
02. Your Base Cover > I've been referred for tests, or to see a health professional for consultation or treatment > OPTIONS
You may also have cover available under the following Option if you have added this to your policy: **Specialist Option** - Specialist Consultations Benefit - Specialist Second Opinion Benefit - Sports Physician Benefit - Diagnostic Tests Benefit - Cardiac Investigations Benefit ---
Source PDF →Query: "moratorium underwriting for chronic conditions" · similarity 46% · weight 0.8
02. Your Base Cover > I need financial support > Terminal Illness Waiver of Premium Benefit > What am I covered for?
We won't charge any premiums if a **policyowner** is diagnosed with a terminal illness before the age of 70.
Source PDF →Query: "diagnostic imaging and pathology for ongoing conditions" · similarity 51% · weight 0.6
02. Your Base Cover > I've been referred for tests, or to see a health professional for consultation or treatment > Diagnostic Investigations Benefit > What am I covered for?
We'll pay for you to have the following **diagnostic investigations** if your GP or **specialist** refers you for them: - Arthroscopy - Capsule endoscopy - Colonoscopy - Colposcopy - CT scan - CT angiogram - Cystoscopy - Gastroscopy - MRI scan - Myelogram - PET scan (including PET/CT scan)
Source PDF →
What to watch out for
- pre-existing: Existing diagnoses are almost always excluded on join. Look for moratorium-style underwriting (exclusions lift after symptom-free period) rather than full permanent exclusion.
- annual limit: Some policies cap specialist visits per year (e.g. 4-6) which is tight for chronic-condition management. Check the actual number.
Ready to shortlist a policy for chronic conditions — diabetes, cardiac, or autoimmune?
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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.