Healthcare99
Healthcare99
Healthcare99
Contact Healthcare99

Phone: 0800 65 34 73 EXTN 2
Email: NZ.HEALTHCARE99@GBTPA.CO.NZ

Option A Benefits

Benefits – what you are covered for

​Your Healthcare 99 policy provides cover for each member for the reasonable charges of the following:

BENEFIT MAXIMUM COVER
GENERAL SURGERY

(with the exception of the below listed benefits)

$60,000 per operation

Covers the costs associated with surgery. Surgery must be performed in an approved facility by the appropriate registered Specialist/Surgeon.

This includes:

  • Surgeon fees
  • Anaesthetist fees
  • Private Hospital fees/Day Stay Facility
  • Accommodation fees for up to 7 nights (does not include TV hire, visitor meals/drinks, alcoholic beverages, additional personal costs)
MINOR SURGERY $3,000 per person per 12-month period

Covers the cost of minor surgery or treatment at an approved facility and must be carried out by a General Practitioner.

CARDIAC CARE
Coronary Angiogram and/or Coronary Angioplasty ​$20,000 per person per 12-month period
Cardiac Surgery $40,000 per person per 12-month period

Covers the costs associated with surgery and procedures. Must be performed in an approved facility by the appropriate registered Specialist/Surgeon.

This includes:

  • Surgeon fees
  • Anaesthetist fees
  • Private Hospital fees/Day Stay Facility
  • Accommodation fees for up to 7 nights (does not include TV hire, visitor meals/drinks, alcoholic beverages, additional personal costs).
CANCER CARE $50,000 per person per 12-month period

Covers the costs associated with Cancer Care. These must be performed in an approved facility by the appropriate registered Specialist/Surgeon.

This includes:

  • Surgery
  • Chemotherapy performed with PHARMAC drugs that are approved for the treatment of the cancer diagnosed (Drugs cannot be in clinical trials)
  • Radiotherapy

This does not cover any reconstructive procedures, cosmetic procedures or prophylactic procedures.

JOINT REPLACEMENT / RECONSTRUCTION SURGERY $20,000 per operation

Covers the costs associated with surgery where a bone joint is replaced with an Orthopaedic Prosthetic or a Reconstruction to a tendon, muscle, ligament and soft tissue that is part of the musculoskeletal system. Must be performed in an approved facility by the appropriate registered Specialist/Surgeon.

This includes:

  • Surgeon fees
  • Anaesthetist fees
  • Private Hospital fees/Day Stay Facility
  • Accommodation fees for up to 7 nights (does not include TV hire, visitor meals/drinks, alcoholic beverages, additional personal costs).

This does not include crutches hireage, aid appliances or rehabilitation equipment.

IMPLANTED PROSTHETIC DEVICES $10,000 per operation
WISDOM TOOTH SURGERY $6,000 per person once per policy

Covers the costs associated with the surgical extraction of impacted/unerupted wisdom teeth. Surgery must be performed in an approved facility by the appropriate registered Oral Surgeon or suitably qualified Dental Surgeon.

This includes:

  • Surgeon fees
  • Anaesthetist fees
  • Private Hospital fees/Day Stay Facility
  • Accommodation fees for up to 7 nights (does not include TV hire, visitor meals/drinks, alcoholic beverages, additional personal costs).
BREAST REDUCTION SURGERY $25,000 per person, once per policy

Covers the costs associated with Breast Reduction surgery that is deemed to be medically necessary due to symptoms as proven by your treating medical providers. Surgery must be performed in an approved facility by the appropriate registered Specialist/Surgeon.

This includes:

  • Surgeon fees
  • Anaesthetist fees
  • Private Hospital fees/Day Stay Facility
  • Accommodation fees for up to 7 nights (does not include TV hire, visitor meals/drinks, alcoholic beverages, additional personal costs)

You must meet certain eligibility criteria to qualify for this benefit. Please contact us for further information.

WELLNESS BENEFIT $500 per person per 12-month period

This covers health checks where there are no symptoms such as skin checks, cervical smears, mammograms, colonoscopies etc.

REHABILITATION BENEFIT ​$500 per person per 12-month period

This covers physiotherapy following an approved surgical procedure. The physiotherapy must be directly related to the surgical procedure.
This is in addition to the cover provided under Option A for Alternative treatment.

MAJOR DIAGNOSTIC BENEFIT SPECIALIST & TEST BENEFIT MAXIMUM COVER
  • CT Scans
  • MRI Scans
  • PET Scans
  • Myocardial perfusion imaging
  • Cholescintigraphy
  • Colonoscopy
  • Gastroscopy
  • Capsule Endoscopy
  • Hysteroscopy
  • Cystoscopy
  • Mammography
  • Ultrasound
  • X-rays
  • Scintography
  • Laboratory tests
  • Nuclear Stress Test
  • Thermal Imaging
  • Myleogram
  • Urodynamic assessments
  • Colposcopy
  • Allergy Testing
  • Holter monitoring/24 Hour Ambulatory monitoring
  • Exercise/Stress ECG
  • Specialist consultations with a Registered Specialist
$5,000 per person per 12-month period

Must be performed at an approved facility when referred by a General Practitioner or Registered Specialist irrespective of whether surgery occurs.

Prior approval can be obtained for the above procedures. Prior approval cannot be obtained for the above procedures under $500. ​You will need to pay for these and seek reimbursement from us.
BENEFIT MAXIMUM COVER
General Practitioner fees with a Registered GP $500 per person per 12-month period
Registered Nurse or Nurse Practitioner fees $300 per person per 12-month period

  • Where the treatment/test/investigation would ordinarily be performed by a Registered GP such as cervical smears, blood tests, prescriptions, removal of ear wax.
Prescriptions Charges $1000 per person per 12-month period

  • Covered for medications covered under the New Zealand Pharmaceutical Schedule (PHARMAC) and any amendments at the time of any claim.
Alternative Treatment fees $400 per person per 12-month period

On referral from a Registered GP or Registered Specialist for treatment of a condition where you have symptoms (maintenance consultations not covered) for the following:

  • Physiotherapy
  • Chiropractor
  • Osteopath
  • Acupuncture.
Optometrist Consultation Fees $200 per person per 12-month period

  • Corrective lenses not included with this benefit.
Healthcare 99 is not an Insurance Plan. ​12-month period means 12 months from the date the claim was first paid.

Option A – Costs

AGE ANNUAL MONTHLY FORTNIGHTLY
Under 19 $619.01 $51.58 $23.74
19-24 ​$1,063.13 $88.59 $40.78
25-29 $1,167.22 $97.27 $44.77
30-34 $1,666.51 $138.88 $63.92
35-39 $1,770.58 $147.55 $67.91
40-44 $1,913.90 $159.49 $73.41
45-49 $2,087.37 $173.95 $80.06
50-54 $2,492.30 $207.69 $95.59
55-59 $2,908.67 $242.39 $111.56
60-64 $3,549.17 $295.76 $136.13
65-69 $4,614.00 $384.50 $176.97
70+ $5,306.25 $442.19 $203.53