Top Private Hospital Cover Plus

Top Private Hospital Plusfrom $11.56/week*

What is it?

Top Private Hospital Cover Plus provides simple and affordable yet comprehensive cover. With all the benefits of Basic Private Hospital Cover and Mid Private Hospital Cover Plus, this product also includes cover for additional conditions such as hip, knee and heart, and some pre-existing conditions after three years**.

Planning a family? Top Private Hospital Cover Plus includes benefits for complications during pregnancy, pre-existing conditions for newborns, and suspension of cover for parental leave.

Click on 'join now' to get started.

Why is it worth it?

  • Easy sign up – no health questions at application
  • Cover for most pre-existing conditions after three years**
  • $300,000 surgical cover per person each year
  • $200,000 medical and cancer cover per person each year
  • Your choice of nil, $250, $500, $1,000 or $2,000 excess per person each year

What will I be insured for?

  • Conditions

  • Benefits

Covered conditions under this plan

The list of what is and is not covered by each nib cover is called the Hospital Category List (see insurance documents). To save your megabytes, we've tabled the details for Top Private Hospital Cover Plus below for you.

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 Top Private Hospital Cover Plus

These benefits apply to the conditions covered by Top Private Hospital Cover Plus (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 Top Private Hospital Cover Plus 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.

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.

PHARMAC funded chemeotherapy drugs for the treatment of cancer at home are covered under the Cancer Treatment at Home Benefit, for which we pay up to $10,000 each year.

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

For claims accepted by ACC, we cover the difference in cost between what ACC pays for a physical injury and the actual costs of surgery.

A one day waiting period applies.

Specialist consultations

Covers registered specialist consultation, whether or not it relates to an admission in a recognised private hospital.

We pay for 12 consultations each year, with no limit for consultations during cancer treatment.

Diagnostic investigations

Covers diagnostic investigation when requested by a GP or registered specialist, whether or not it relates to an admission in a recognised private hospital.

We pay up to $15,000 each year, with no limit for diagnostics during cancer treatment.

CT, MRI and PET scans are covered under the CT, MRI and PET Scan Benefit, for which we pay up to $5,000 each year.

Post-hospital physiotherapy

Physiotherapy consultation and treatment up to six months after admission to a recognised private hospital.

We pay up to $750 each year.

Post-hospital home nursing care

Covers home nursing care up to six months after an admission to a recognised private hospital.

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

Travel and accommodation

Travel and accommodation costs for you and a support person when you need to travel further than 100km from where you live for surgery, medical or cancer treatment.

We pay up to $5,000 each year.

Ambulance transfer
Road ambulance transfer from a public or private hospital to the closest 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 redundancy; or
  • up to 24 months for travel outside New Zealand; or
  • up to 12 months for parental leave.
Waiver of premium
We cover the cost of all premiums on the policy for a period of time if a policyowner dies.
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

Any minor surgery performed by a GP, including one pre and one post consultation and any related biopsy.

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 recognised provider (not limited to leg varicose veins).

There is no limit to the number or procedures we will pay for.

Non-surgical hospitalisation

Covers medical treatment (not involving surgery) in a recognised 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 addition, this benefit covers less invasive procedures as an alternative to surgery.

Public hospital cash grant
Major diagnostics (not related to hospitalisation)

See Diagnostic investigations. Includes CT, MRI, PET and other major diagnostics.

Parent accommodation

Accomodation costs for a parent or legal guardian accompanying an insured person age 20 and under who is being treated in a recognised private hospital.

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

Post-hospital therapeutic care

Includes osteopathic and chiropractic treatment, speech and occupational therapy, and dietitian consulations up to six months after an admission in a recognised private hospital.

We pay up to $250 each year.

Overseas treatment
Cover in Australia
Intravitreal eye injections

Intravitreal eye injections administered by a registered specialist, after referral by a GP or 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, after referral by a GP or registered specialist for assessment and monitoring of recognised risk factors.

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

Loyalty benefit – sterilisation

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

We pay up to $1,000 per person.

Loyalty benefit – wellness
ACC Treatment Injury

Covers the cost of surgical treatment for injury which occurred during an ACC treatment.

Delayed Care
Medical misadventure
Pre-existing cover for newborns

Cover for pre-existing conditions (other than congenital conditions) for dependent children when added to the policy within four months of birth.

Non-PHARMAC drugs

Covers the cost of chemotherapy drugs that are Medsafe approved but not subsidised by the government (as detailed in the policy document) for the treatment of cancer.

We pay up to $10,000 per year.

Premium waiver extension

Insurance documents