Same here with Southern Cross. Kel was with them on our family policy from the day she was born so was covered when diagnosed at 15 months. It does disturb me that although we pay them for doctor and prescription cover, they won’t pay for anything that isn’t on the Pharmac schedule. So theres very little point really and we’re currently reviewing that policy – we paid around $150 a month for Lantus for several years and as soon as it was on the Schedule and we paid only $3 per prescription, we were covered..WOW!
I sat beside a man from another company at a conference once – he said that anyone with diabetes was a high risk after 10 years so premiums naturally increased. He said that ruling would also apply to my daughter who was 12 at the time.. he was a seriously scary man!

I’m also with SX and so far I’ve been cheap as chips for them too. Like Chris, before Lantus was covered and while I was on a ‘pump break’ I had to pay for my Lantus too – ouch… so SX have it made really IMHO – we’re “covered” but actually we’re not are we? Pumps and any drugs not on the schedule that might help us are still at our expense. Sovereign sound marvellous if they actually have the foresight to see the benefit of covering some T1s “properly” (ish – I don’t know if they cover supplies).

Hey Nic

You might want to check how robust that SthX cover is for any medical expenses relating to T1 complications. My parents got Life & Medical Insurance cover for my brother and I when we were born in the late 60’s & early 70’s with Sth X when I turn 18 I developed T1 – no history in the family or any other medial claims. Upon investigation with Sth X Medical they declined to cover ANY future T1 medical related expenses or pay out Life for any diabetes related complications causing death. I cashed up my Life Insurance & cancelled my Medical Insurance with them a few years later when I turned 21. (So did my brother) We (our family) were pretty disappointed with them given that our parents had been paying premiums for over 20 years at the time of cancellation. I then got ‘pre-existing’ cover insurance through HSWS – Health & Social Workers Society (now Tower owned) and had to pay higher premiums with a 5 year stand down on any claims to get proper cover but its worth it as it has comprehensive medical & surgical cover – never used it yet not for prescriptions or anything but good to know its there as I have had T1 for over 25 years now and could need it soon. Southern Cross in my experience are not a safe bet.

Dee’s other half here – she’s asked me to comment as I’m a financial advisor and so deal with insurance companies on a very regular basis.

I’m not too sure as far as companies that have forked out for pumps go, but certainly Southern Cross will, as a rule, be the hardest to get anything out of for any condition. Unfortunately they ride on the fact that they’re the name everyone knows for medical insurance and so their product is not the greatest.

For companies that will be more open to things that, in the long run, are actually likely to save them money (a pumping diabetic is much less likely to run up huge bills for complications) Sovereign are good (though they don’t have to pay for anything not Pharmac funded), but ING are the ONLY company in New Zealand that have it written into the policy that they will fund non-Pharmac treatment. Not that this matters if you’re not insured on diagnosis, but if you are looking at cover for kids or have a non-diabetic partner it’s something to bear in mind.

Cheers,

Jonathan

I want to get medical insurance but my husband is anti it – he says you pay premiiums for years then when you need them they find a way out of paying. He says we’ll save the money each month and then if we need it we can pay – but of course they money disappears! We did look into it ages ago and I think Tower was recommended for me (but that is from my rusty memory so may not be correct). The premiums were pretty high and so many exclusions for me – because of my T1 they wouldn’t cover ANY heart problems and other stuff that I cant remember. I have had back problems and fertility issues in the past too so anything related to those was excluded too.
My husband said ‘thats not insurance’ and refused it again. I would like it in case of cancer or needing an operation or something and we are going to talke to a friend who is a financial advisor but the high rates and long list of exclusions are extremely annoying.

Ryan – again fairly typical of Southern X.

Alison – for good policies what matters is your state of health at the time the policy is issued, not any problems further down the track. Unfortunately if you already have diabetes you will have a very hard time getting worthwhile cover. Regarding forcing people out when they actually need cover, the most common reasons people give up their cover are that it doesn’t live up to expectations (make sure you know what you’re getting read the full policy wording) and that the premiums become to expensive as they get older (get quotes done as if you were 10/20/30 years older than you are to get an idea what you’re up for in the future). This is another area Southern X fall down in – recently I had clients apply for cover who were 65 and 70, they were going to be spending $1800 less per year by switching away from a Southern X policy they’d had for 30+ years – unfortunately they were declined due to pre-existings, which for their age is not uncommon.

Just a little note about Southern Cross.My husband and I (T1 for 38 years) are insured through my husbands work and they will cover anything,also Diabetic related, even pre existing conditions

Not sure i understand the relevance … are you saying you are insured with Sth X or with someone else through or through you husbands work?? – where is it he works … Sth X?

Sorry about that, My husband is insured through his work and that automaticly includes me and because it is a work scheme they accept al previous conditions for my husband and for me.

Ineke, that is because it is a group scheme – they have slightly different rules to individual policies. Also will they pay for a pump? I had a Southern X adviser tell me when I was applying for a group scheme that after the stand down period I could get some cover, but only for items on the pharmac list. And to me it’s not worth it – I can get the pharmac items through the public system, maybe I get to have elective surgery faster, but thats it.

Accepting people with pre-existing conditions is different to actually offering cover for the pre-existing condition. I had a job with insurance cover and was told they accepted pre-existing conditions – but when I got the policy there were so many exclusions – I wrang them up because I was sure they had made a mistake and they told me that they accept you with the condition but don’t actually cover the condition!
Just worth understanding when you looking at policies.

We’re on an employer paid group scheme too – Dee, the surgery doesn’t necesarily happen faster with insurance. My husband had to have surgery recently – we paid $280 for the specialist as we got to see him faster for an initial visit but he then put us back on the public list for the actual op, which he did. For him to do the same op privately could have taken an additional 3 months. And we only got part of that $280 reimbursed as SX have capped specialist visits..might start that savings account I think and lose the insurance.

Chris that is insane – makes me realise how poor SX are, I know that ING will, if there is an unreasonable wait for private care, send you overseas, unfortunately they don’t do group schemes!