Southern Cross to fund preventative treatment
Southern Cross is adding an allowance for prophylactic treatment and increasing the surgical claim limit on most of its plans.
Tuesday, January 26th 2016, 3:29PM 
1 Comment
Prophylactic treatment is undertaken to prevent a disease or illness from occurring where there’s an identified high risk – recently made prominent by Angelina Jolie, who had her ovaries removed and a double mastectomy due to the BRCA1 gene mutation linked to breast and ovarian cancer.
Southern Cross Health Society is the first New Zealand insurer to offer this benefit as part of its plans.
Head of product and marketing Chris Watney says, “Genetic testing can identify a person’s increased risk for developing a life-threatening condition and is changing the way people look at their health.
“If it’s highly likely a condition – such as breast cancer or ovarian cancer – will develop, prophylactic surgery can be recommended as the best course of action. We want to support members in this difficult decision and give them more options.”
The prophylactic benefit is a lifetime allowance that ranges from $30,000 to $50,000, depending on the member’s plan.
To be eligible for the prophylactic treatment allowance, a genetic mutation leading to prophylactic treatment needs to be discovered after someone has signed up for a policy.
The presence of a gene, or family history, will not be used to exclude cover for a developed condition.
Gift of Knowledge, a national charity and support network for New Zealanders affected by hereditary breast and ovarian cancers, has called the new benefit a “big step forward in recognising prophylactic surgery can be life-saving”.
“Every day we see families deeply affected by illness and loss from these cancers. While prophylactic surgery is never an easy decision for anyone to make, we applaud Southern Cross for supporting their members and leading the way in offering this as an option,” said founder Nicola Coom.
The other major change announced by Southern Cross is the removal of the $100,000 surgical treatment limit on selected plans.
Southern Cross has said it was uncommon for the business to receive a six-figure claim. In the last two years Southern Cross funded 325,000 surgical procedures and just 15 exceeded $100,000.
Watney said: “Despite this, the $100,000 benefit is frequently touted as insufficient on comparison websites. So removing this limit will give our members peace of mind and make it easier for people looking to join Southern Cross to compare our plans and benefits with those of other health insurers.
“We also want to reassure our 815,000 members that with provider contracts in place covering over half of all our claims costs, we don’t expect this change to materially impact Southern Cross premiums.”
Changes take effect April 4.
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Southern Cross surely must have thought about this so there is no doubt much small print to come (restrictions, exclusions, qualifying criteria etc). It will be revealed for what it is when we see who might actually qualify.