Easy Health™

What is it?

Easy Health provides you and your family with comprehensive cover, including the more expensive medical costs, and some pre-existing conditions after three years.

At the foundation is the Base Cover, providing high levels of cover for the big expenses such as surgical and medical (non-surgical) treatment in a private hospital.

Each person on your policy can also choose their own excess amount and pick from two additional options to suit them – the Serious Condition Lump Sum Option and the Proactive Health Option.

Application is simple and easy, with no need to declare your health history upfront. To find out more, contact your financial adviser or call us, and we can put you in touch with an adviser who can help you.

Why is it worth it?

  • Easy sign up – no health questions at application
  • Cover for some pre-existing conditions after three years continuous cover*
  • $300,000 surgical cover per person each year
  • $200,000 medical cover, including cancer treatment, per person each year
  • Your choice of nil, $250, $500, $1,000, $2,000, $4,000 or $6,000 excess for each treatment per person
  • Your choice to add Serious Condition Lump Sum Option and / or Proactive Health Option
  • 2.5% discount off your overall premium if you add your spouse, partner, parent, child and / or grandchild to your Easy Health policy
  • Each person on the policy can choose their own excess levels and options

What will I be insured for?

  • Conditions

  • Benefits

  • Options

Covered conditions under this plan

The list of what is and is not covered by each nib cover is illustrated in the Hospital Category List (see insurance documents). To save your megabytes, we’ve tabled the details for Easy Health™ below for you.

All ACC top-up claims
Hernia, appendix
Anus, haemorrhoids
Oral (excluding orthognathic surgeries)
Unerupted and impacted teeth
Sinus, nose, ears
Ankle, elbow
Circumcision
Tonsils, grommets, adenoids
Skin lesion – GP
Skin lesion – specialist
Digestive tract, liver, kidney, pancreas, gall bladder
Breast, gynaecology, urology
Cancer surgeries and treatment
Shoulder, wrist
Varicose veins
Hip, knee
Heart
Brain, eyes, neck
Gland, vascular
Chest, back
Foot, toe, hands, fingers and thumbs
Non-surgical hospitalisation
 

Benefits of Easy Health™ Base Cover

These benefits apply to the conditions covered by Easy Health™ (click on 'Covered conditions')
All benefit limits apply to each person on the policy (just in case you thought you'd have to share!)

Note: this is not the policy document. For all the legal bits, see the Easy Health™ policy document under 'insurance documents'.

Surgery
Surgery in a private hospital.
Includes costs for:
  • Surgeon's operating fees.
  • Anaesthetist's fees.
  • Intensivist's fees.
  • Hospital accommodation (e.g. the admitted patient's bed, a private room, excludes suites).
  • Operating theatre fees.
  • Surgically implanted prosthesis (in line with the prosthesis schedule).
  • Laparoscopic disposables.
  • In-hospital X-ray examination and ECG.
  • Intensive post-operative care and special in-hospital nursing.
  • In-hospital post-operative physiotherapy.
  • Ancillary hospital charges (e.g. dressings, sutures, needles, bandages)
  • In-hospital pharmaceutical prescriptions (in line with the PHARMAC Pharmaceutical Schedule A to H).

Click on 'what's covered' for the list of conditions this benefit applies to.

Oral surgery

Oral surgery in a private hospital performed by a registered oral or maxillo-facial surgeon.

We will cover for removal of unerupted or impacted teeth (e.g. wisdom teeth) when performed by a registered oral or maxillo-facial surgeon, or a registered dentist. A 12-month waiting period applies.

Cancer treatments
Covers costs for and relating to cancer treatment, including:
  • Chemotherapy.
  • Radiotherapy.
  • Brachytherapy.
  • Hospital accommodation (i.e. the admitted patient’s bed and a private room if available).
  • In-hospital X-ray examination and ECG.
  • Intensive post-operative care and special in-hospital nursing.
  • In-hospital post-operative physiotherapy.
  • Ancillary hospital charges (e.g. dressings, sutures, needles, bandages).
  • In-hospital pharmaceutical prescriptions (in line with the PHARMAC Pharmaceutical Schedule A to H).
Follow-up investigations for cancer

Registered specialist consultation and diagnostic investigation following cancer treatment.

We cover one registered specialist consultation, and one diagnostic investigation each year. We pay up to $3,000 each year for up to five consecutive years.

ACC top up

Covers the difference in cost between what ACC pays for a physical injury and the actual costs of surgery or medical treatment.

Specialist consultations

Covers registered specialist consultations up to six months before and six months after admission to an approved private hospital for a medical condition.

No limits on each consultation. No limit on the number of consultations.

Diagnostic investigations

Covers diagnostic investigation up to six months before and six months after admission to an approved private hospital for a medical condition.

No limits each diagnostic investigation. No limit on the number of diagnostic investigations.

Post-hospital physiotherapy

Covers physiotherapy up to six months after hospitalisation.

We pay up to $750 per hospitalisation.

Post-hospital home nursing care

Covers home nursing care up to six months after hospitalisation.

We pay up to $150 each day and $6,000 each year.

Travel and accommodation

Travel and accommodation costs for you and an accompanying support person when you need to travel further than 100km from where you live for treatment.

We pay up to $5,000 each year.

Ambulance transfer
Road ambulance to and from a public hospital or an approved private hospital to another approved private hospital.
Suspension of cover
After 12 months of continuous cover, you can put your cover on hold for up to six months due to unemployment, or up to 24 months for travel outside New Zealand.
Waiver of premium
We cover the cost of all premiums on the policy for up to two years if a policyowner dies before age 65.
Funeral support grant
We provide a cash payment of $3,000 if an insured person dies between the age of 16 and 64 (inclusive), from any cause.
GP minor surgery

Minor surgery performed by a GP. Not limited to skin lesion surgery.

We pay up to $750 each year.

Registered specialist skin lesion surgery

Skin lesion surgery performed by a registered specialist.

We pay up to $6,000 each year.

Varicose veins surgery

Varicose vein surgery performed by a registered specialist or medical practitioner who is registered with the Medical Council of New Zealand and a fellow of the Australian College of Phlebology. Not limited to leg varicose veins.

No limit on each procedure. No limit on the number of procedures.

Non-surgical hospitalisation

Covers medical treatment (not involving surgery) in an approved private hospital in relation to a medical condition (e.g. heart disease, asthma, pneumonia or diabetes).

We also cover the cost of associated intensive nursing care, X-rays, disposables and consumables, dressings and in-hospital pharmaceutical prescriptions (in line with the PHARMAC Pharmaceutical Schedule A to H).

Public hospital cash grant

Provides a cash payment when you are admitted to a public hospital in New Zealand for three or more consecutive nights.

We pay up to $300 each night for the third and each subsequent night and up to $3,000 each year.

Major diagnostics (not related to hospitalisation)
Covers for the following diagnostic investigations, whether or not you have been hospitalised.
  • Arthroscopy
  • Capsule endoscopy
  • Colonoscopy
  • Colposcopy
  • CT Scan
  • CT Angiogram
  • Cystoscopy
  • Gastroscopy
  • MRI Scan
  • Myelogram
  • PET Scan
No limit per diagnostic investigation. No limit on the number of diagnostic investigations each year.
Parent accommodation

Accommodation costs for a parent or legal guardian accompanying an insured person under age 20 (inclusive) who is being treated in an approved private hospital.

We pay up to $200 each night, and up to $3,000 per hospitalisation.

Post-hospital therapeutic care

Includes osteopathic and chiropractic treatment, speech and occupational therapy, and dietician consultations up to six months after hospitalisation.

We pay up to $250 for each hospitalisation, with no limit per treatment / consultation.

Overseas treatment

Covers treatment and travel costs when treatment cannot be provided at all in New Zealand and the Ministry of Health provides only partial funding, but that funding does not cover the full cost.

We cover up to $20,000 each overseas visit.

Cover in Australia

Covers costs for treatment undertaken in an approved private hospital in Australia.

We pay up to 75% of the cost that would be payable in New Zealand for treatment performed in New Zealand.

Intravitreal eye injections

Intravitreal injections administered by a registered specialist and the cost of drugs administered (in line with the PHARMAC Pharmaceutical Schedule A to H).

We pay up to $3,000 per year.

Obstetrics

Treatment by an obstetrician of a medical condition that is affecting or may affect a pregnancy.

We pay up to $2,000 for each pregnancy.

Loyalty benefit – sterilisation

After two years of continuous cover, covers the cost of a male or female sterilisation as a means of contraception.

We pay up to $1,000 per procedure.

Loyalty benefit – wellness

Provides you with a reimbursement every three years of continuous cover to help proactively take care of your health through a check-up with a GP.

We pay up to $100 every three years per insured person aged 21 or over.

ACC Treatment Injury
Delayed Care
Medical misadventure
Pre-existing cover for newborns
Non-PHARMAC drugs
Premium waiver extension

Additional options on Easy Health™ Base Cover

Add options to your Easy Health™ Base Cover to tailor your policy to your needs. Each person on your policy can choose the options that suit them. If you choose an excess, this does not apply to these options.

Note: this is not the policy document. For all the legal bits, see the Easy Health™ policy document under 'insurance documents'.

Serious Condition Lump Sum Option

This option pays out a one-off lump sum to help reduce the strain of dealing with specific trauma conditions.

You can use this lump sum for whatever you wish, such as expensive out-of-hospital drug treatments, rehabilitation expenses, paying off the mortgage or maybe a holiday to recuperate.

Key features:

  • Choice of cover - $20,000 or $50,000
  • Covers 17 trauma conditions, including:
  • Heart and Circulation
    • Aortic surgery*
    • Coronary artery bypass grafting surgery*
    • Heart valve surgery*
    • Major heart attack* (Myocardial infarction)
  • Organs
    • Chronic liver failure
    • Chronic lung failure
    • Chronic renal failure
    • Major organ transplant*
    • Pneumonectomy
  • Functional loss / neurological
    • Benign tumour of the brain and spinal cord*
    • Paralysis
      • Hemiplegia
      • Diplegia
      • Paraplegia
      • Quadriplegia
      • Tetraplegia
    • Stroke*
  • Cancer
    • Cancer – life threatening*

* If any of these conditions occur within 90 days of the commencement date, effective date or join date of this option (whichever is applicable), or the date cover is reinstated, no amount is payable.

Proactive Health Option

This option encourages you to look after your health, whether you want to check any hereditary medical concerns, or just want to stay fit and healthy.

The premium for this option is one set price, regardless of your age, gender or smoking status. Plus you’ll get up to a maximum of $1,400 worth of cover a year.*

  • Health screening: up to $750 each policy year for:
    • Breast screening
    • Cervical screening
    • Prostate screening
    • Bowel screening
    • Mole mapping
    • Eye and visual field tests
    • Hearing tests
    • Heart tests
    • Bone screening
  • Allergy testing and vaccinations: up to $100 each policy year
  • Dietician / nutritionist consultations: up to $300 each policy year
  • Gym membership, weight loss management programmes and quit smoking programmes: up to $100 each policy year
  • Routine health check benefit: $150 for each person after each two years of continuous cover on this option to put towards a medical examination by a GP.

* Covers 80% of the cost up to the above benefit maximums. A waiting period of six months applies.

Insurance documents

Excludes any pre-existing conditions that relate to any cardiovascular condition, cancer, hip or knee condition, back condition, transplant surgery, reconstructive or reparative procedures or surgery, and any pre-existing condition under the Serious Condition Lump Sum option. Please refer to Page 52 in this policy document for further information.