Protecting access to healthcare while keeping premiums within reach
Regan Savage, Chief Sales and Marketing Officer at Southern Cross Health Insurance, shares an update on upcoming policy changes designed to protect members’ long‑term access to healthcare.
Tuesday, February 3rd 2026, 7:29PM
- Policy changes for a sustainable future
As New Zealand’s largest health insurer we believe health insurance plays an important role in empowering people to live well for longer. That’s why we regularly review our health insurance plans, so they continue to provide value and remain affordable over the long term.
We know advisers are hearing from their clients who are concerned about premium increases across the sector.
Rising healthcare costs, higher utilisation, and ongoing pressure on the public health system are affecting every insurer.
Southern Cross members are certainly using their policies more often. In the year to 30 June 2025, Southern Cross paid 3.8 million claims, a 16% increase on the previous financial year. For every dollar received in premium in FY25, 94 cents went back into paying members’ claims.
Seeing more members using their cover more frequently is positive, but it also means we need to act to manage costs responsibly, to ensure premiums remain as manageable as possible.
From 1 April, updates will be made to some of our health insurance plans. Our members have clearly told us what they need from their plans – and we have listened. Our members need affordable premiums along with certainty they maintain access for the important and significant healthcare services.
We are committed to fully covering eligible healthcare services up to the reasonable charge or the actual charge, depending on the plan. In the vast majority of cases, this means our members’ treatment is covered in full. While we offer some products where members can choose a co-pay option, we believe it is important to do what we can to protect 100% funding for our collective membership.
The changes we have made respond to our members’ needs and are designed to keep cover affordable for while also responding to the increasing use of cover and rising healthcare costs. Ultimately, we aim to protect access to private healthcare for the collective Southern Cross membership.
Key policy changes
- We’re changing how we cover and define tooth extraction, including extending the period of continuous cover required and clarifying eligibility for surgical treatment.
- We are updating the ‘Skin lesion services’ benefit and introducing a sub‑limit for cryotherapy.
- We have added a requirement for three years’ continuous cover before approving varicose vein procedures (legs).
- We are simplifying parent accommodation cover and adding physiotherapy to the ‘Palliative care and treatment’ allowance.
- We are removing the ‘Being active’ benefit and moving some items from the list of policy variations into the main policy document.
- We’re clarifying how we determine and apply ‘reasonable charges’.
- We are expanding cover for annual health checks, specialist consultations, hearing tests, and some day‑to‑day mental health services, to allow cover for services provided by additional types of health services providers.
These changes sit alongside broader initiatives to tackle escalating healthcare costs and manage the level of premium increases for members. These include increased monitoring to ensure claims align with policy terms and ensure procedure costs remain sustainable through our Affiliated Provider programme.
We’re focused on making sure Southern Cross remains here for the long haul. That means making decisions that ensure we keep delivering value and peace of mind for members. Our priority is to ensure Southern Cross remains New Zealand’s most trusted health insurer by being clear about the changes we are making that balance value and affordability, while also supporting more of the health workforce to deliver the care they are qualified to provide.
We encourage advisers to reach out to their Southern Cross contacts for support in communicating these changes to clients.
For more information on the policy changes, visit: Click here
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