This includes leukaemia, lymphomas, Hodgkin’s disease, malignant bone marrow disorders, but excludes the following: Malignant Melanoma with less than 1.5 mm maximum thickness as determined by histological examination based on Breslow thickness, and Malignant Melanoma with a Clark Level less than 3. A growth histologically described as Carcinoma-in-Situ. All hyperkeratosis or basal cell carcinomas of the skin. All squamous cell carcinomas of the skin unless there has been spread to other organs. All tumours of the prostate unless histologically classified as having a Gleason score greater than six (6) or having progressed to at least a clinical TNM classification T2N0M0 as defined by AJCC 6th Edition 2002. Tumours treated by endoscopic procedures alone. We will allow cover for Carcinoma-in-Situ of the breast where it results in the entire removal of the breast specifically to arrest the spread of malignancy. This procedure must be the appropriate and necessary treatment. 9 We will reimburse You the Usual , Customary and Reasonable expenses incurred should you be admitted to an approved Private Hospital , upon referral by a Registered Medical Specialist for non- surgical and/or non-cancer treatment, subject to a maximum for all related costs of $500,000 per Life Assured , per Policy Year . Cover is provided (subject to prior approval by Us ) for:
HOSPITAL MEDICAL BENEFIT (NON- SURGICAL/NON- CANCER)
Hospital accommodation fees
Registered Medical Specialist’s fees
Diagnostic fees Ancillary charges
An Annual Excess applies.
NON-PHARMAC SUBSIDISED DRUGS BENEFIT
10 Covers the Usual, Customary and Reasonable expenses incurred for accessing the most effective treatment available, irrespective of whether that treatment qualifies for PHARMAC funding. We will reimburse the costs of all medicines registered by Medsafe , provided they are used according to Medsafe indications for use in New Zealand (subject to Our prior approval) and meeting Our criteria where: The treatment has been recommended by a Registered Medical Specialist as the appropriate medical treatment for the condition; and The cost of the medicine is covered under the Hospital Surgical Benefit (Non Cancer); and The medicine is being prescribed within the guidelines set by Medsafe . All costs under this Non-PHARMAC Subsidised Drugs Benefit are included within the benefit maximums that apply to the Hospital Surgical Benefit (Non Cancer).
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