SECTION B - SUPERIOR HEALTH COVER BENEFITS FEATURES
PRIVATE HOSPITAL - SURGICAL BENEFITS
1 We will reimburse You for the Usual, Customary and Reasonable expenses incurred for surgery in a registered Private Hospital in New Zealand, where You have been admitted upon referral by a Specialist , subject to a maximum for all related costs of $200,000 per Life Assured , per Policy Year . Any applicable excess is payable by You to the treatment provider.
Expenses We will reimburse in accordance with the terms above, include:
• Surgeon and Anaesthetist's fees • Theatre fees • Post-operative and ancillary charges • Perfusionist fees • High Dependency Unit charges • Nursing fees • Prosthesis (subject to the schedule of maximums) • Accommodation fees in a Private Hospital • Prescription drugs including: − Drugs listed on the New Zealand Pharmaceutical Management Agency ( PHARMAC ) Pharmaceutical Schedule and/or − Non PHARMAC subsidised Medsafe indicated Chemotherapy Medicines for the treatment of cancer administered to You while You are in a Private Hospital or prescribed upon Your immediate discharge from a Private Hospital for a maximum period of one (1) month. The drugs must be listed on the PHARMAC Pharmaceutical Schedule and/or be Medsafe indicated as being approved for the condition being treated, taking into account any restrictions where applicable. • Diagnostic Procedures and Specialist consultations during the twelve (12) months period prior to or after surgery provided they relate to the condition being treated and they have been recommended by a Specialist . 2 We will reimburse You for the Usual, Customary and Reasonable expenses incurred for ailments not requiring surgery, where You have been admitted to a Private Hospital in New Zealand upon referral by a Specialist , subject to a maximum of $100,000 per Life Assured , per Policy Year for: • Private Hospital or approved Day Stay Clinic or Facility charges for Chemotherapy Medicines for the treatment of cancer, Radiotherapy, Cancer Immunotherapy Medicines or Cancer Targeted Therapies. Treatment can be administered by oral, intravenous infusion, instillation, or intraoperative means. Oral treatment for Chemotherapy, Cancer Immunotherapy and Cancer Targeted Therapies where referred by a Specialist that does not require admission to a Private Hospital or Day Stay Clinic or Facility, will also be covered. Treatment is covered for prescription drugs including: − Drugs listed on the PHARMAC Pharmaceutical Schedule and/or − Non PHARMAC subsidised Medsafe Chemotherapy Medicines for the treatment of cancer. The drugs must be listed on the PHARMAC Pharmaceutical Schedule as being approved for the condition being treated and/or must be
PRIVATE HOSPITAL - NON-SURGICAL BENEFITS
PC-SHC-04/2022
Page 6 of 22
Powered by FlippingBook