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Anyone experience with claiming anything with insurer Cove? (lemmy.nz)
submitted 10 months ago by [email protected] to c/[email protected]
33 comments fedilink hide all child comments

We're currently with AA, who decided to increase prices by almost 10% for our upcoming renewal. Cove is much cheaper and has got good reviews, mainly about their website and sign up process. However I can't find any reviews about their claims process. In the past AA has been very good for us whenever we had a claim. Anyone got experience claiming something with Cove?

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[-] [email protected] 1 points 10 months ago

Do you know what the criteria are for accessing unfunded medicines privately? Is it good enough that a doctor says it would be a good idea, or does it need to be a necessary part of treatment?

I'm keen for cover for the extra but I've found it hard to get info on what exactly is covered.

[-] [email protected] 2 points 10 months ago

Yes, interesting question! I've asked Bing as I'm tired of reading all policies :)

For Southern Cross Wellbeing One, the eligibility requirements for non-pharmac medicines are:

  • The medicines must be prescribed by a registered medical practitioner for the treatment of a covered condition.
  • The medicines must be Medsafe approved but not funded by PHARMAC.
  • The medicines must be administered in a recognised private hospital or by an Affiliated Provider.
  • The medicines must be covered under the Cancer Assist benefit, which has a limit of $10,000 per claims year and is subject to prior approval.

A doctor prescription is not sufficient to claim for non-pharmac medicines. You also need to obtain prior approval from Southern Cross before you receive the treatment.

[-] [email protected] 1 points 10 months ago

It doesn't really answer the question does it ๐Ÿ˜„. The way I read it, the medicines covered are the ones that Southern Cross agree to when you apply prior to recieving them.

[-] [email protected] 2 points 10 months ago

I've read their policy for cancer cover and it's mainly talking about which types of cancer they cover.

[-] [email protected] 1 points 10 months ago

I guess the idea is that if it's a doctor recommended treatment for a type of cancer that is covered, then you can have it covered (up to the limit). I'd be happy to not have to find out myself though ๐Ÿ˜†

[-] [email protected] 2 points 10 months ago

Yep not willing to find out.

Some cancers are excluded though like skin and prostate cancer, unless it meets certain requirements.

[-] [email protected] 1 points 10 months ago

Oh that's interesting. Though I could guess why. Most skin cancers are squamous cell, they chop it out and you're good, takes 5 mins and 99% survival rate (but if you're in the 1% it can get really bad). NZ has high rates of melanoma and other skin cancers as well, so I'd guess there's a seriousness threshold to meet for the simple ones but the bad ones are probably covered well.

Prostate cancer is present in something like 50% of males over the age of 50, but most of the time it's not an issue. The world is actually pulling back on treating it because the treatment can be worse than the disease if it's not aggressive. So I can understand that one as well.

[-] [email protected] 2 points 10 months ago

Thanks for the insights! Makes sense indeed. Guess we'll switch to SC :)

[-] [email protected] 1 points 10 months ago

I wish I didn't know all this ๐Ÿ˜†

[-] [email protected] 2 points 10 months ago

Sorry!

I just found out that Bing was wrong. Cancer Assist is a different addon, which is paying out an amount when you have a qualifying cancer, e.g. to take care of family. It's paid out directly to you. That's why they only cover certain cancers...

[-] [email protected] 2 points 10 months ago

Ah I see, thanks for the update ๐Ÿ™‚

this post was submitted on 03 Nov 2023
14 points (88.9% liked)

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