Affiliated Provider-only healthcare services

Effective 22 October 2024

The list of Affiliated Provider-only healthcare services forms part of your Southern Cross health insurance policy, except for UltraCare or HealthEssentials policies. The healthcare services (including where the healthcare service is the same healthcare service as that listed but has an alternative name) listed below must be performed by an Affiliated Provider to be eligible for cover under your policy. This list may change from time to time as we continuously review cover for healthcare services.

The policy terms and conditions, including any applicable eligibility criteria, need to be met in order for the healthcare service to be covered. For full details, please refer to your policy document.

Important: The Wellbeing Starter plan does not provide cover for surgical treatment or other healthcare services for gynaecology, urology and orthopaedics (referred to in the policy document as restricted specialties), unless they are directly required for the treatment of cancer.

Please be aware that not all healthcare services are available from all Affiliated Providers or in all areas. To find an Affiliated Provider or to see the types of services they offer, visit our Healthcare finder or contact us.

Specialist consultations

All consultations, except for psychiatrist consultations.

Diagnostic imaging

  • 2D or 3D mammography
  • Computed tomography (CT scan)
  • CT angiogram (CTA)
  • Nuclear medicine scan (scintigraphy)
  • Ultrasound (excludes ultrasounds related to obstetrics and varicose veins (legs))
  • X-ray (excludes X-rays performed by a dentist or chiropractor)
  • Cone beam computed tomography (CBCT) 
  • CT coronary angiogram (CTCA)
  • Magnetic resonance imaging (MRI Scan)
  • Magnetic resonance angiogram (MRA)
  • Myocardial perfusion scan
  • Positron emission tomography / computed tomography (PET/CT) for specific diagnosed cancers and cardiac conditions

Cardiac tests

  • Advanced electrocardiogram (A-ECG)
  • Resting ECG
  • Exercise ECG
  • Holter monitoring
  • Echocardiogram
  • Stress echocardiogram
  • Dobutamine stress echocardiogram
  • Transoesophageal echocardiogram (TOE)

Diagnostic tests

  • Ambulatory blood pressure monitoring (ABPM)
  • Caloric reflex test
  • Colposcopy with or without biopsy under local anaesthetic or no anaesthetic 
  • Corneal topography
  • Endometrial biopsy under local anaesthetic or no anaesthetic
  • Fractional exhaled nitric oxide (FeNO) test
  • Fluorescein angiography
  • Heidelberg retinal tomography (HRT)
  • Intraocular pressure (IOP) test
  • Optical coherence tomography (OCT)
  • Retinal photography
  • Scanning laser polarimetry (SLP)
  • Single fibre electromyogram (SFE)
  • Vestibular evoked myogenic potential (VEMP)
  • Video-assisted head impulse test (vHIT)
  • Visual field test
  • Vulvoscopy with or without biopsy under local anaesthetic or no anaesthetic

Chemotherapy for Cancer
This includes the Cancer Cover Plus upgrade.

All chemotherapy treatment for cancer.

Radiotherapy

All radiotherapy planning and treatment.

Allergy services
This applies to all services under this benefit unless provided by a General Practitioner who has an Easy-Claim agreement with us.

All allergy services, including desensitisation, drug challenge testing, food challenge testing, allergy injections, or skin testing.

Skin lesion services
This applies to all services under this benefit unless provided by a General Practitioner.

  • All consultations related to skin lesions.

The following treatments for skin lesions when performed under local anaesthetic or no anaesthetic:

  • Biopsy
  • Cryotherapy
  • Curettage and diathermy
  • Excision

Surgical procedures

Cardiac

  • Ablation of cardiac arrhythmias
  • Bentall procedure
  • Coronary angiogram and/or angioplasty
  • Coronary artery bypass graft surgery (CABG)
  • Drug-eluting balloon angioplasty for in-stent restenosis
  • Electrophysiology studies
  • Intravascular lithotripsy for coronary artery disease
  • Left atrial appendage occlusion
  • Pacemaker surgery
  • Percutaneous atrial septal defect (ASD) closure
  • Percutaneous patent foramen ovale (PFO) closure
  • Transcatheter aortic valve implantation/replacement (TAVI/TAVR)
  • Transcoronary ethanol septal ablation (TESA)
  • Valve replacement
  • Valvuloplasty

Ear, nose and throat (ENT)

  • Adenoidectomy
  • Balloon sinuplasty
  • Botulinum toxin for laryngeal dystonia
  • Cochlear implant surgery
  • Endoscopic modified Lothrop procedure
  • Functional endoscopic sinus surgery (FESS)
  • Insertion and/or removal of grommets in theatre
  • Laser ear surgery

    • Laser mastoidectomy
    • Laser revision mastoidectomy
    • Laser tympanoplasty
    • Laser second look tympanoplasty
    • Laser middle ear adhesiolysis
    • Laser stapedectomy
    • Laser medial canalplasty
    • Laser myringotomy
  • Laser treatment for pharyngeal, laryngeal and oesophageal conditions
  • Nasal cautery
  • Removal of exostoses
  • Robot-assisted transoral surgery (TORS)
  • Septoplasty
  • Tonsillectomy

Gastroenterology

  • Balloon enteroscopy
  • Colonoscopy
  • Endoscopic ultrasound
  • Flexible sigmoidoscopy
  • Gastroscopy
  • Peroral endoscopic myotomy (POEM) & Zenker's peroral endoscopic myotomy (Z-POEM)
  • Radiofrequency ablation for Barrett’s oesophagus
  • Wireless pH capsule and wireless capsule endoscopy

General Surgery

  • Contrain biofeedback and electrostimulation for faecal incontinence
  • Femoral hernia repair
  • Hiatus hernia repair
  • Inguinal hernia repair
  • Laparoscopic fundoplication
  • Liposuction for secondary lymphoedema following an oncological intervention
  • Open and laparoscopic cholecystectomy
  • Robot-assisted ventral hernia repair
  • Sacral nerve stimulation for faecal or urinary incontinence (no reimbursement will be made towards the cost of the stimulation device used to treat faecal or urinary incontinence)
  • Thyroid nodule ablation
  • Umbilical hernia repair

Gynaecology

  • Bartholin's cyst/abscess surgery under local anaesthetic or no anaesthetic (in rooms)
  • Cautery of cervix under local anaesthetic or no anaesthetic (in rooms)
  • Cervical polypectomy under local anaesthetic or no anaesthetic (in rooms)
  • Cone biopsy of cervix under local anaesthetic or no anaesthetic (in rooms)
  • Excision of vulval/vaginal cyst or lesion under local anaesthetic or no anaesthetic (in rooms)
  • Hysteroscopy under local anaesthetic or no anaesthetic (in rooms)
  • Insertion and/or removal of intrauterine device under local anaesthetic or no anaesthetic (in rooms)
  • LLETZ loop under local anaesthetic or no anaesthetic (in rooms) (Large loop excision of the transformation zone)
  • Robot-assisted hysterectomy (with or without oophorectomy or salpingectomy, or both)
  • Robot-assisted sacrocolpopexy
  • Vaginal biopsy under local anaesthetic or no anaesthetic (in rooms)

Interventional radiology

  • Adrenal vein sampling (AVS)
  • Basivertebral nerve ablation
  • Image-guided ablation for bone tumours or metastases (including cementoplasty)
  • Microwave ablation of lung tumours
  • Percutaneous medial branch thermal radiofrequency neurotomy
  • Peripheral sensory nerve ablation for cancer-related pain

Neurosurgery

  • Endoscopic third ventriculostomy

Ophthalmology

  • Bleb needling
  • Cataract surgery
  • Corneal cross-linking (CXL)
  • Correction of ptosis
  • Cyclodiode laser cyclophotocoagulation
  • Entropion and ectropion repair
  • Excision of pinguecula
  • Excision of pterygium
  • Implantation of prosthetic iris device (including custom-made artificial iris)
  • Intravitreal injection: Only $100 is available towards the cost of the drug used for each injection, regardless of the type of drug used
  • Laser iridoplasty
  • Laser iridotomy
  • Laser trabeculoplasty
  • Macular laser
  • Minimally invasive glaucoma surgery (MIGS) (Kahook Dual Blade goniotomy, iTrack canaloplasty, implantation of trabecular bypass microstent - Glaukos iStent, implantation of minimally invasive subconjunctival filtration device (microshunt) - Allergan XEN or Glaukos PreserFlo, micropulse transscleral cyclophotocoagulation)
  • Minor eyelid surgery
  • Panretinal laser
  • Photocoagulation of the retina
  • Posterior vitrectomy
  • Probing/syringing of lacrimal passage
  • Removal of tarsal cyst
  • Upper eyelid blepharoplasty
  • YAG laser capsulotomy

Oral and maxillofacial

  • Extraction of unerupted or impacted teeth (cover not available on RegularCare and KiwiCare plans)
  • Lingual or labial frenectomy/frenotomy
  • Total temporomandibular joint (TMJ) replacement

Orthopaedic

  • Carpal tunnel release
  • Image-guided percutaneous carpal tunnel release
  • Image-guided percutaneous trigger finger release
  • Primary total or partial knee joint replacement
  • Primary total hip joint replacement
  • Radiofrequency ablation of benign bone lesions
  • Robot-assisted primary knee replacement

    • Johnson & Johnson: VELYS procedures for total knee arthroplasty
    • JZimmer Biomet: ROSA procedures for total and partial knee arthroplasty
    • JSmith + Nephew: CORI procedures for total and partial knee arthroplasty
    • JStryker: Mako procedures for total knee, and partial knee arthroplasty
  • Robot-assisted primary total hip replacement

    • Stryker: Mako procedures for total hip arthroplasty
    • Smith + Nephew: CORI procedures for total hip arthroplasty
  • Synthetic ligament repair and reconstruction

Skin surgery
 (when treatment for skin lesions is performed under general anaesthetic or sedation).

  • Biopsy
  • Cryotherapy
  • Curettage and diathermy
  • Excision
  • Mohs surgery (including excision and closure)

Vascular

  • Peripheral angiogram and/or angioplasty
  • Sclerotherapy or embolisation of simple vascular malformation
  • Thoracic endovascular aortic repair (TEVAR)

The following treatment for varicose veins (legs):

  • Cyanoacrylate embolisation
  • Duplex vein mapping for varicose veins
  • Endovenous laser treatment (EVLT)
  • Endovenous radiofrequency ablation (EVRFA)
  • Ultrasound guided sclerotherapy (UGS)
  • Varicose vein surgery

Urology

  • Circumcision
  • Laparoscopic or percutaneous renal cryoablation
  • Laparoscopic prostatectomy
  • Laser resection of prostate
  • Nephrectomy
  • Open enucleation of prostate
  • Periurethral injection for incontinence
  • Perineal prostatectomy
  • Prostate biopsy
  • Prostate brachytherapy
  • Prostate cryotherapy
  • Radical retropubic prostatectomy
  • Resection of bladder tumour
  • Robot-assisted laparoscopic prostatectomy
  • Robot-assisted partial nephrectomy
  • Transurethral resection of prostate (TURP)
  • Ureteroscopy