CANCER TREATMENT BENEFIT – SURGICAL AND MEDICAL TREATMENTS
2 We will reimburse up to $500,000 per Life Assured per Policy Year, the amount for Usual, Customary and Reasonable expenses incurred in an Approved Facility where the Life Assured has been diagnosed with cancer by a Registered Medical Specialist . An Annual Excess applies.
Cancer treatment includes but is not limited to: Surgery Oncologist consultations Diagnostic imaging and tests Chemotherapy/Immunotherapy Radiotherapy Prostate brachytherapy
Breast Reconstruction approved by us and performed by a Registered Medical Specialist in an Approved Facility Prophylactic mastectomy and/or oophorectomy surgery (‘Prophylactic Surgery’) where the Life Assured has: been diagnosed with breast or ovarian cancer; and where the Prophylactic Surgery is directly related to an acceptable breast or ovarian cancer claim under the Cancer Treatment Benefit - Surgical and Medical Treatments of this policy, or where a claim for breast or ovarian cancer would have been acceptable had the treatment not taken place in a Public Hospital ; and tested positive for the BRCA1 or BRCA2 gene mutation after the Policy Commencement Date . The Prophylactic Surgery does not need to be medically necessary, but prior approval must be obtained before the surgery takes place. Under no circumstances is a claim payable under this Benefit for Prophylactic Surgery where the Life Assured has an exclusion on this policy for either breast cancer and/or ovarian cancer, or where the Life Assured has an exclusion on this policy for any disease or disorder of the breast and/or female genital tract where this relates to a personal history and/or a family history of breast or ovarian cancer .
We may approve additional treatments at Our sole discretion.
PHARMAC Medicines and Non PHARMAC Chemotherapy Medicines (including Cancer Immunotherapy Medicines ) are covered in New Zealand, subject to Our prior approval, meeting Our criteria and Benefit maximums.
Post Cancer Treatment We will cover post cancer treatments for a maximum of five (5) years for a claim that has been paid under this Benefit , per Life Assured per Policy Year , of up to $5000. This must be medically necessary treatment and referred by a Registered Medical Specialist . Usual, Customary and Reasonable costs of such treatments will be covered.
This Benefit does not cover Routine Screening .
REAL Health – 0324
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