Benefit
Benefit entitlement
Maximum cover
Private Health Cover and Private Health Plus
All payments made under this benefit will be in New Zealand dollars and will be credited directly to the bank account nominated by the policy owner . We will not accept responsibility for costs associated with any complications during or following any treatment or procedure covered under this benefit that arise as a direct or indirect result of the treatment, procedure, consultation, test, diagnostic imaging, support or care. No Medical Misadventure benefit is payable in relation to any treatment, procedure, consultation, test, diagnostic imaging, support or care covered under this benefit.
Prior approval must be obtained before the treatment, procedure, consultation, test, diagnostic imaging, support or care takes place.
The excess applies to any claims under this benefit.
Treatment in Australia
This benefit covers the costs for the approved treatment, procedure, consultation, test, diagnostic imaging, support or care, subject to the maximum cover under this policy for the applicable benefit in New Zealand dollars, at a health service facility approved by Sovereign.
Maximum cover for the applicable benefit, subject to the additional limits, exclusions and requirements set out in this section
VOLUNTARY TREATMENT OVERSEAS
Treatment outside Australia
This benefit covers the costs for the approved treatment, procedure, consultation, test, diagnostic imaging, support recommended by a New Zealand registered medical specialist .
Cover is also provided for the cost of a single return economy class airfare for the life assured and one support person.
The total amount payable under this benefit is 85% of the reasonable charges , subject to the maximum cover under this policy for the applicable benefit in New Zealand dollars, at a health service facility approved by Sovereign.
Treatment in and outside Australia
Following the treatment, procedure, consultation, test, diagnostic imaging, support or care, a receipt in English needs to be provided to Sovereign, together with any other information reasonably required by Sovereign from the health service provider. Where applicable, any translation services must be provided by an appropriate registered translator in New Zealand acceptable to Sovereign.
This benefit covers the cost of any translation services provided by an appropriate registered translator in New Zealand acceptable to Sovereign, where translation of any receipt or information into English is required by Sovereign to support a claim under the Voluntary Treatment Overseas Benefit.
$500 per life assured , per policy year
TRANSLATION COSTS
712 PH-UMB version 9 Effective 8 April 2022
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