Question

Wellbeing One vs. Wellbeing Two: Comparison

What is the difference between Wellbeing One and Wellbeing Two?

Learning Centre | Insurance | Wellbeing one vs Wellbeing two

Answer

Wellbeing One is different from Wellbeing Two in that it covers specialist consultations, diagnostic imaging, and tests if done within six months of surgery, chemotherapy, or radiation therapy. But Wellbeing Two offers the same benefits as Wellbeing One, but the six-month rule doesn’t apply.

Wellbeing One vs. Wellbeing Two

Wellbeing One and Wellbeing Two are Southern Cross’s two most popular health insurance plans because they accommodate a wide range of needs, from major medical surgery to routine checkups and peace of mind. Unfortunately, pre-existing conditions are not covered.

What’s covered by Southern Cross’ Wellbeing One policy?

Wellbeing One is a broad surgical and healthcare plan by Southern Cross, and the policy will reimburse 100% of expenses, up to the specified policy limit, for eligible healthcare services.
 
The six months rule applies to Wellbeing One, which means the policy also covers diagnostic imaging and tests within six months of related eligible surgical treatment.
 
Some of these policy benefits include:
  • Chemotherapy or unlimited radiotherapy
  • Unlimited Surgical treatment
  • Specialist consultations
  • Diagnostic imaging and tests within six months of related eligible surgical treatment.

What is the 6 months rule?

To be covered under Wellbeing One, all specialist consultations, diagnostic imaging, and cardiac and diagnostic tests must take place within six months of related eligible surgical treatment or cancer care.
 
If the treatment date is more than six months after the related eligible surgical treatment, the specialist consultations, diagnostic imaging, and cardiac and diagnostic tests may not be covered by Wellbeing One. 
 
The “6-months” rule does not apply to Wellbeing Two.
All about the 6 month rule

What’s covered by Southern Cross’ Wellbeing Two policy?

Wellbeing Two is a popular broad surgical and healthcare plan by Southern Cross, and the policy will reimburse 100% of expenses, up to the specified policy limit, for eligible healthcare services.

The six months rule does not apply.

Specialist consultations, diagnostic imaging, and tests are covered within the policy limits whether or not you undergo surgical treatment, chemotherapy, or radiotherapy.

  • Chemotherapy or unlimited radiotherapy
  • Unlimited Surgical treatment
  • Specialist consultations
  • Diagnostic imaging and tests.
  • Obstetrics allowance available after one year of continuous cover

What’s the difference?

Wellbeing Two provides the same cover as Wellbeing One but covers Specialist consultations, diagnostic imaging and tests whether or not you undergo surgical treatment, chemotherapy or radiotherapy. 

The Obstetrics benefit of $750 per claims year is available after one year of continuous cover.

How does excess on Wellbeing One and Wellbeing Two work?

Excess on Wellbeing One and Two is paid once every policy year, no matter how many times you claim. Therefore, the excess applies to each person on your policy once per claims year.

Which Wellbeing One and Two benefits does the excess apply to?

  • Surgical treatment
  • Surgical allowances
  • Chemotherapy
  • Radiotherapy
  • Recovery
  • Psychiatric hospitalisation
  • Obstetrics allowance (Wellbeing Two only)

Your excess does not apply to any other benefits. Please see your policy document for full terms and conditions

Who is Southern Cross Health Insurance?

New Zealand’s largest health insurer, Southern Cross Health Insurance, is wholly owned by the non-profit Southern Cross Medical Care Society and covers a wide range of health insurance plans from Surgery and Specialists, Cancer care, Diagnostic imaging and tests.

FAQ's

What is excess?

An excess is an amount you will need to pay before SouthernCross will reimburse you or pay your health services provider for the eligible healthcare service you have received. You will pay the excess amount directly to your health services provider. The higher the excess amount, the lower your premiums will be.

Which excess options?

The Wellbeing annual excess is available on the Wellbeing One and Wellbeing Two plans. You can choose the level of excess:

  • $500,
  • $1,000,
  • $2,000 or
  • $4,000.
Excess options may not be available if you’re in an employer work scheme.

How does the excess apply?

The excess applies to each person on your policy once per claims year. So, if there are three members on your policy, all three will need to pay the excess each claims year before being reimbursed for any eligible healthcare services they receive. Once the full amount of each member’s excess has been applied, no excess will apply to any further claims by that member in that particular claims year.

What is a claims year?

Your claims year is the 12 months following your policy start date and every 12 months from your policy anniversary date. You can check this date in “My Southern Cross” and your Membership Certificate.

The claims year that applies to a particular claim is based on the date you received the healthcare service, not when you send Southern Cross your claim or when Southern Cross pay your health services provider.

At the beginning of each member’s new claims year, their excess will be reset to its original, full value.