The following are not covered by Police Health Plan.
- Pre-existing conditions, unless disclosed and accepted on entry to the Health Plan.
- Examinations and reports for disengagement or discharge from Police, or in respect of any other insurance claim.
- Any treatment or operation outside the scope of the benefits, or subject to an exclusion, and related expenses such as anaesthetist, hospital or x-ray.
- Maintenance examinations or medical check-ups including mole mapping or dermatological surveillance, health screening, physicals for life insurance, driver’s licence or other third party requirements.
- Acute hospital admissions – unplanned admissions or a planned admission if the 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, prophylactic healthcare and/or unapproved healthcare services and vaccinations, unless otherwise authorised in writing by Police Health Plan.
- 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 conditions arising from them, or any other sexually transmitted disease.
- Congenital conditions other than those existing in children who become a member of Police Health Plan within three months from their date of birth. Congenital conditions will be covered after three years of continuous cover.
- Expenses recoverable from a third party or under any contract of indemnity or insurance.
- Any costs for cosmetic treatment, although remedial treatment may be considered if such treatment relates to correction of previously qualifying treatment under Police Health Plan.
- Sterilisation reversal.
- Contraceptives, whether prescribed or non-prescribed.
- Any treatment required due to an accident.
- Pregnancy, childbirth or consequences.
- Homeopathy, naturopathy, herbal medicine or any other alternative medicinal treatment.
- Cardiac pacemakers, implantable defibrillators, nerve appliances, hearing aids, cochlear implants and any other appliances (surgical, medical or dental) other than surgically implanted prostheses approved by Police Health Plan.
- The implantation of teeth or costs of implants with the exception of impacted wisdom teeth or those costs covered under the Surgical Loyalty Benefit.
- Chelation therapy or similar treatment as defined by Police Health Plan.
- Refractive surgery for the correction of short sight or long sight, including astigmatism.
- Treatment for obesity (an ex-gratia payment may be made towards the cost of bariatric surgery. Conditions apply contact Police Health Plan for details).
- War injury or disability.
- Self-inflicted injuries or illnesses, including a disability or illness arising from the use of alcohol or drugs, including prescription medication.
- Any costs not referred to under a particular plan option in the Police Health Plan brochure.
- Management and treatment of snoring.
- Surgery designed to assist or allow the implementation of orthodontic services.
- Breast reduction procedures performed for any reason (an ex-gratia payment may be made towards the cost of breast reduction surgery. Conditions apply contact Police Health Plan for details).
- Sexual dysfunction.
- Treatment provided by any person outside New Zealand except as agreed by Police Health Plan.
- No claim shall be payable for technologies, pharmaceuticals or medical procedures that have not been approved by Police Health Plan.
- No claim shall be payable for cost in excess of Usual Reasonable and Customary charges (see definition under Terms & Conditions).
- Gender reassignment surgery and directly related healthcare services.