All PWF members and their families are welcome to apply for cover – this includes your partner, children and grandchildren.
We offer a range of health plans for you and your family – Surgical Only, Basic (Surgical and General Medical) and Comprehensive (Basic plan plus optical, dental and audiology). Every member’s situation is different, so we like to offer a range of options, regardless of whether you need a day surgery, have regular GP visits and prescriptions or often see specialists, such as podiatrists, opticians and audiologists.
For medical receipts that you have paid for and wish to claim back under your chosen plan, fill out the medical claim form.
Membership to Police Health Plan Limited for yourself and your family can continue on leaving NZ Police, provided you have been a member for at least 12 months.
Check out our competitively priced premiums for our Retired Members:
Cover applies to all plans
Private medical hospital (non-surgical admissions) includes admission daily bed charge (excludes geriatric hospitalistion) and up to $6000 per year (voluntary excess does not apply).
General, laparoscopic and day surgery (must be performed in a licensed private surgical hospital) - maximum of 15 nights for any one admission and up to $11,250 per operation.
Angiogram and angioplasty – 100 per cent refund of Usual Reasonable and Customary charges (URC). Refer to ‘Conditions of Membership’ for further definition.
Public Hospital Cash Benefit Covers all nature of admissions - adults $20 per night, children $10 per night (voluntary excess does not apply).
Added benefits over Surgical for Primary Healthcare Basic and Plus plans include:
Cardiac/diagnostic procedures, eg, treadmill, Holter monitor, echocardiogram tests, $800 for basic and up to $1000 for plus.
Imaging, CT/MRI and PET Scan up to $4800 for basic and up to $6000 for plus.
CT/MRI scan up to $1600 for Basic and up to $2000 for plus.
PET scan up to $2000 for basic and up to $2500 for plus.
Physiotherapist fees – $360 for basic and $450 for plus per year.
PLUS plan additional benefits:
Home aid after surgery (must be approved by PHP) up to $3000.
Hearing aid/consultation – you can accumulate your annual allowance for a maximum of five years from July 2018 (total $5000). This means you may have very little, if anything, to pay upon receipt of new hearing aids.
Optician (cost of frames is excluded) – consultation, $70 worth of lenses including contact lenses (prescribed by an optician) up to $300.
Sleep study (on referral from a registered medical specialist) – $1500 per annum.
Osteopathic, chiropractic (xrays excluded) and acupuncture costs up to $450 per year.
Non-Pharmac funded prescriptions: A voluntary payment may be made toward the cost of pharmaceuticals not funded by Pharmac. Conditions apply. The pharmaceuticals must be Medsafe approved for treatment of your condition and they must be prescribed by a registered medical practitioner as the appropriate medical treatment for your condition. Contact us for details
Premium subscribers under a family group are able to have different levels of cover.
The premium rate for a child turning 19 years increases to an adult rate on the first premium due following their birthday. We will inform you of the new rate.
Apart from congenital conditions, Police Health Plan Limited will accept liability for all existing conditions for members who enroll at the first opportunity; that is, within three months of permanent appointment with NZ Police. Family additions will be covered from birth or marriage (this includes de facto partners) provided an application form is lodged within three months of the event. Members transferring from a similar health insurance provider in New Zealand will not be subject to the 90-day “no claim” period, but will be required to complete a medical declaration and existing conditions may be excluded. Evidence of previous health insurance cover will also be required. Children who are joined within three months of birth will have congenital conditions covered as per their policy.
If you leave and apply to rejoin Police Health Plan Limited or do not join at the first opportunity, you will be subject to a 90-day “no claim” period and all existing conditions will be excluded.
Surviving spouses, separated spouses and their children can continue membership of Police Health Plan Limited by arrangement of appropriate premium payments.
Membership to Police Health Plan Limited for yourself and your family can continue on leaving NZ Police, provided you have been a member for at least 12 months. Call Member Services on 0800 500 122 for information.
Benefit year runs from 1 July to 30 June. Annual maximums apply within this period.
All claims will be debited against the benefit maximums for the benefit year in which
the treatment was incurred. All benefits are calculated including GST.
If you upgrade your cover – from Surgical to Basic or Comprehensive, or from Basic to Comprehensive – you will be required to complete a medical declaration, will face exclusions and a 90-day “no claim” period for the enhanced benefits provided under the superior cover. If an excess has been selected on Surgical cover the excess applies from the date the new premium is paid. If you select a voluntary excess and then choose to switch to a lower or no-excess option, a 90-day stand-down period will apply before the lower or no-excess option commences, and all conditions that were existing under the previous higher voluntary excess, will still incur that excess, regardless of when any procedure on this condition is done. If you cancel your policy, it will take up to 14 days to complete this cancellation.
Any costs related to surgery, as specified by the surgeon, will be covered for a period of four months before and four months after the date of surgery (this does not include consultations with a GP).
For any claim to be valid, all treatment must be for a medical condition, and be performed by or under the supervision of a registered medical practitioner – registered with the Osteopathic Council of NZ (OCNZ), a NZ registered physiotherapist, a NZ registered chiropractor, a specialist oral surgeon, or a NZ registered psychologist.
Claims can be submitted by post or electronically. See: www.policeassn.org.nz or the claim form for details.
All surgical claim costs must be pre-approved by Police Health Plan.
Other Medical Claims
All details must be entered on the Police Health Plan Claim Form (insert link) or by calling Member Services on 0800 500 122.
Questions about benefits or claiming
If you cannot find the answer on this website, email: [email protected] or 0800 500 122.
All claims will be settled to the premium payer, unless the payer has specified otherwise. Claim refunds will be paid to either the payer’s nominated bank account or, if not specified, to their Police and Families Credit Union account. Claim refunds cannot be paid when a Health Plan policy is in arrears.