NZ Police Health Plan Ltd

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Police Health Plan

Member of "Health Funds Association of NZ"

	Who can join and what do I pay?
	Types of cover
	Benefits Schedules
	Common Questions
	Membership Conditions
	Non Medical Benefits
	Surgical Claims Pre-approval
	Administration Fee
	Principal Exclusions
	Healthplan Application Form

Cover you and your family can trust, when you need it most.

For over 20 years we have been protecting the health of our members. Police Health Plan is independently owned and operated by Police Health Plan Limited, a subsidary of Police Welfare Fund Limited. The plan is non-profit and all surpluses are devoted to ensuring that members have access to one of the best value health insurance packages in New Zealand.

Who can join Police Health Plan?

Membership to Police Health Plan is open to current and former sworn and non-sworn employees of New Zealand Police, who are members of Police Welfare Fund Limited. Their spouses (this includes defactos/partners), dependant or non-dependant children, grandchildren and daughters/sons-in-law are also eligible for membership.

What do I pay?

Current rates and terms are available on our website: www.policeassn.org.nz or call our Member Services Centre on 0800 500 122. Members insuring themselves and their dependant children (of 18 years of age or under) with Police Health Plan, pay for the first two children only. Any subsequent children will be covered for free, providing they are insured for the same or lesser level of cover that your first two children are insured for.

If you wish to insure both your children and grandchildren, they will be insured together on their own separate Police Health Plan policy.

Membership and Premium information

Print a Health Plan Membership Form

What is the Benefit Year?

The benefit year runs from 1 July to 30 June. For further details please refer to the Membership Conditions

What types of Health Plan cover can I choose from?

There are three different levels of cover available depending on your family needs.

Surgical Plan provides for the costs of surgery

Both the Basic and the

Comprehensive

Plans include all of the

Surgical Plan

benefits

Basic Plan covers the cost of surgery and up to 80% of basic general medical costs

Comprehensive Plan provides for surgery, general medical costs and optical, dental and audiology treatment

Common Questions

Q.	*I’m about to be admitted to a private hospital, will Police Health Plan cover me?*
A.	Surgical costs need to be pre-arranged and members should submit a 'Surgical Approval Form'. Forms can be found on the forms section of our website or call 0800 500 122 8 am to 5pm, Monday to Friday. After receiving the returned completed form, Police Health Plan will promptly forward you an acceptance of liability letter. Police Health Plan requires notification of proposed surgery at least 7 days prior to admission to a private hospital.
Q.	*When should I lodge a claim with Police Health Plan?*
A.	Members can claim at any time when receipts total $100 or more. All claims however must be submitted for settlement within 18 months of incurring the charge. Any claims received that are over 18 months old, will not be reimbursed by Police Health Plan. Each total claim submitted attracts a $20 administration fee.
Q.	*How long does it take to settle a claim?*I
A.	We aim to have all claims received processed within 10 working days, usually faster.
Q.	*I’m going overseas, will Police Health Plan cover me?*
A.	Police Health Plan will reimburse treatment costs incurred outside New Zealand, but only to the New Zealand fee standards, in other words, the standard costs should the treatment have been received in New Zealand. Members are strongly urged to take out some form of Travel Insurance cover, (a competitive cover is available through Police Welfare Fund Insurances Limited) prior to departure.

Application of Benefits

All benefits for all plans apply for treatments from 1 July 2008.
These will be reviewed from time to time at the discretion of the Police Health Plan Board. Any changes will be placed on the Police Association website.

Non-Medical Benefits

Waiver of contributions
In the event of death of the Primary Member, the surviving spouse and/or dependants, who are also named on the policy will continue to receive cover free of any premium charge for a period of 12 months.

Surgical Claims

All surgical claims must be pre-approved prior to surgery. Once surgery is decided necessary, pre-approval should be arranged by completing a 'Surgical Approval Form'. Forms can be found on the forms section of our website. For urgent cases or to have a form posted call 0800 500 122.

Administration Fee

Each total claim submitted under all plans, attracts a $20 administration fee.

Principal Exclusions

No claim will be accepted for, or in association with, the following exclusions, unless specifically provided for in the Plan paid for:

Any diagnosed condition, or signs/symptoms of a condition, pre-existing at the time of commencement of a Member’s Membership of the Police Health Plan unless disclosed and specifically accepted by Police Health Plan Limited on the Member’s entry to the Health Plan.
Maintenance examinations or medical check-ups including mole mapping or dermatological surveillance, physicals for life insurance, travel insurance, driving licence or any other third party requirements.
Acute Hospital Admissions – "Acute" means an unplanned admission or a planned admission if the admission date is less than 48 hours after the date on which the decision to admit was made.
Treatment where a condition detrimental to health is not evident, including preventative medicine and vaccinations unless otherwise authorised in writing by Police Health Plan Limited.
Mental disorders as defined in the Mental Health (Compulsory Assessment and Treatment)

Act 1992.

Geriatric care including geriatric hospitalisation and pre-senile dementia.
AIDS or HIV infection or any condition arising from the presence of AIDS or HIV infection as well as other sexually transmitted diseases.
CongenitaI conditions other than those existing in children who are enrolled in Police Health

Plan within three months from their date of birth.

Expenses recoverable from a third party or under any contract of indemnity or insurance.
Any treatment for cosmetic purposes as defined by Police Health Plan Limited.
Sterilisation reversal.
Any treatment required due to an accident, unless written evidence from ACC declining payment is provided to Police Health Plan Limited, prior to the treatment being undertaken.
Pregnancy, childbirth, except for those costs covered under the Pre-natal/Ante-natal Loyalty Benefits.
Homeopathy, naturopathy, herbal medicine or any other alternative medicinal treatment.
Cardiac pacemakers, implantable defibrillations, nerve appliances, hearing aids and cochlear implants and any other appliances (surgical, medical or dental) other than surgically implanted prostheses, which have been approved by Police Health Plan Limited.
The extraction of teeth, implantation of teeth or costs of implants with the exception of impacted Wisdom Teeth, see Surgical Loyalty Benefit.
Chelation therapy or similar treatment as defined by the Police Health Plan Limited.
Refractive surgery for the correction of short sight or long sight including Astigmatism.
Treatment for obesity.
War injury or disability.
Self-inflicted injuries or illness.
Any costs not specifically provided for under any benefit section contained in the plan selected.
Management and treatment of snoring.
Surgery designed to assist or allow the implementation of orthodontic services.

Print a Health Plan Membership Form

For more information contact our Member Services Centre on Freephone 0800 500 122 or Email - healthplan@policeassn.org.nz

Police Health Plan Ltd
Box 12 344, Wellington
Facsimile (04) 496 6819