Smart Care + Benefits
SMARTCARE+ PLAN: SCHEDULE OF BENEFITS
Building your plan
Central to the SmartCare+ range is our Hospital and Surgical+ base plan, which covers you for the larger expenses, including surgery and private hospital admission. Tailor your plan by adding one or more of these modules to the comprehensive base plan: Specialist+, GP+, Natural Health+ or Dental and Optical+. Hospital and Surgical+ base plan The Hospital and Surgical+ base plan covers you for the larger expenses, including surgery (an operation or procedure to treat a disease or an illness) and private medical admission (treatment in a private hospital without the need for surgery).
You are covered for procedures including private hospital costs, surgeons’ fees, pre-operative and post-operative diagnostics, consultations and tests up to $300,000 per person per policy year.
Non-surgical cancer treatment
If you are diagnosed with cancer, you will be covered up to a maximum of $200,000 under the private hospital medical admission benefit per policy year.
Major diagnostic procedures
Your general and oral surgery benefit covers up to $300,000 per person per policy year and includes major diagnostic procedures such as angiograms, endoscopies, MRI scans, CT scans and/or MP scans, with or without admission to a private hospital.
You are covered for non-PHARMAC drugs, which are covered up to the benefit maximums.
Cover while in Australia
This benefit reimburses medical costs for non-acute medical conditions that are incurred and treated in Australia under either the surgical or non-surgical benefit.
Funeral support grant
If you pass away from illness between the ages of 21 and 65, your estate will receive a cash payment of $10,000. Overseas waiting list benefit If you require medical treatment that is available privately in New Zealand but cannot be provided within six months of the recommended time, the overseas waiting list benefit will reimburse you the costs of obtaining the treatment overseas.
Your family can be added to your plan
SmartCare+ allows you to add dependants or wha-ngai to your plan. Dependants and wha-ngai remain on your plan until their 25th birthday. You can also add your parents and spouse to your plan. Modules that can be added to help tailor your plan
The Specialist+ plan covers you for specialist consultations and a wide range of diagnostic tests that do not result in hospital admission.
You are covered for specialist consultations such as visits to cardiologists, gynaecologists and ear, nose and throat specialists up to $4,000 per policy year.
You are covered for diagnostic testing such as ultrasounds, bone density scans, mammograms and allergy testing up to $4,000 per policy year.
With our Specialist+ plan, there is no stand-down period, so you are able to make claims as soon as your plan is in place.
Second opinion benefit
For when you’d like to consult an alternative specialist for a second opinion.
You are rewarded for three years of continuous cover including cover for complications of pregnancy, melanoma checks, mammograms and prostate checks.
Our GP+ plan is ideal for those seeking cover for more frequent healthcare costs. It covers you for doctor and nurse visits as well as prescriptions. There is no limit on the number of times you can visit.
You can visit your doctor or even have your doctor visit you with this plan, allowing you up to $55 per clinic visit or $70 for each after-hours GP visit.
You are covered for the cost of prescriptions up to $20 for each prescription, up to $400 per year.
Practice nurse visits and lab tests
You are covered for the costs of a practice nurse visit up to $35 per visit, as well as lab tests as ordered by your GP or specialist, up to $80 per year.
You are rewarded for three years of continuous cover including preventative mammograms and prostate checks. A stand-down period of 90 days applies.
Natural Health+ plan
Our Natural Health+ plan covers you for treatments by other health practitioners such as osteopaths, natural therapists and nutritionists.
Chiropractic and osteopath consultations
You are covered for the costs of chiropractor and osteopath visits up to $45 per visit, up to $240 per policy year.
Other health practitioners
You can have treatment from a number of health practitioners including physiotherapists, podiatrists, homeopaths, acupuncturists and nutritionists up to $45 per visit, up to $200 per policy year.
You are rewarded for three years of continuous cover including flu vaccinations, and a sick leave benefit up to $100 per week, up to $500 per policy year. A stand-down period of 90 days applies.
Dental and Optical+ plan
This plan is ideal if you make regular trips to your dentist or optometrist and covers 80% of the costs.
With our Dental and Optical+ plan, you are covered for dental treatment for 80% of the cost up to $500 each policy year.
You are covered for 80% of the costs of optometrist consultations up to $300 each per policy year as well as 80% of the costs of prescription glasses or contact lenses up to $300 per policy year.
You are rewarded for three years of continuous cover with the dental benefit being extended to include orthodontic treatment. A stand-down period of 90 days applies.