Frequently Asked Questions & Other Information

 
 
Who is HealthCarePlus?

HealthCarePlus is the trading name for The Education Benevolent Society Incorporated (“EBS”). EBS was started in 1963 to enable teachers, education sector members, and their families to access competitive insurance products to support their families’ health and provide financial protection for unforeseen events. 

From 1 January 2019 HealthCarePlus assumed the role of marketing the HealthCarePlus insurance products which from that date are underwritten by Union Medical Benefits Society (UniMed).

 
Who is UniMed?

UniMed was established in 1979 and provides a comprehensive range of health insurance plans.  Like HealthCarePlus, UniMed was established by Unions to provide its members with health insurance benefits, is a New Zealand owned licensed insurer and a not-for-profit organisation.

UniMed is currently one of New Zealand’s top four health insurers when measured by both revenue and membership¹.  They are an established, professional health insurer with an excellent reputation and proven financial strength.  UniMed has an A (Excellent) Financial Strength Rating from AM Best Company.  To view the rating visit their website at www.unimed.co.nz/about-unimed/financial-strength/

¹Source: Health Funds  Association of New Zealand

 

What is My HCP?

My HCP is an online self service portal for our Members

We appreciate that not all our Members are able to contact us during business hours, and that sometimes you just need to know information about your policy there and then. We’ve created the My HCP online self service portal so that not only can you view your policy details, but you can lodge claims and carry out various administrative changes on your policy.

If you already have a login, please access My HCP by clicking on the 'My HCP Login' button, top right of your screen. If you’re a HealthCarePlus Member and don’t yet have a login, please fill out this form and we will send you an email link within two business days.

For further details please click here

 
What are my options for paying premiums?

If you are in the education sector payment can be made by fortnightly salary deductions. Note; Salary deduction is not available for PSA members, or anyone not in the education sector, ie; Family/Whanau, Trainee Teachers. 

Fortnightly, monthly and annual direct debit options are available to all Members. 

Fortnightly direct debits are deducted every second Wednesday in conjunction with HealthCarePlus payroll dates. Monthly and annual direct debits are deducted on the first business day of the month.

Credit and debit card payment options are available to all Members. 

 
When does cover start?

Cover commences from the date of the first premium payment and after prerequisite Waiting/Qualifying Periods have been served.

 
What if I change my mind

If you are joining HealthCarePlus for the first time and are not satisfied with the policy during the first 14 days after the date that you received your policy document and your Membership Certificate, you can cancel the policy and we will provide a refund of all premiums paid. If you wish to cancel the policy within the 14 day period please contact us on 0800 600 666, or sales@unimed.co.nz

 
I have upgraded from Primary Care to Primary Care Extra.  When can I claim the extra benefits?

Waiting Periods apply,  Please refer to the Terms and Conditions here

 
How do I make a claim?

Claims may be submitted by email or by post.  The claim form must be completed in full and signed by the Member.  

If submitting your claim by email, to claims@unimed.co.nz; please attach your scanned or photographed receipts/receipted invoices and retain these until claim settlement.  

If submitting your claim by post, to PO Box 1721, Christchurch 8140; please attach to your claim form all original receipts/ receipted invoices. 

If claims are subject to reimbursement by another source, then evidence of the amount received from the other source must accompany claims.

 
What is my claims year?

HealthCarePlus policy benefits are calendar year benefits. Your claim year is from 1 January through to 31 December.

 
When can I claim?

As soon as you have accrued $10 or more of eligible expenses you can submit a claim.

 
How long do I have to claim?

All claims and supporting documents should be lodged as soon as possible and within a year after your treatment.

 
Can someone else sign the claim form on my behalf?

Unless that person has Power of Attorney you as the Member must sign the claim form.  

 
When will my claim be paid?

We aim to process a claim within 3 business days and if you have given us a bank account number we can direct credit the reimbursement to you on the same day we process the claim. This time frame may vary over holiday periods. Once your claim has been paid a Claim Advice will be sent by email or mail to you outlining how your claim has been assessed.

 
If I exhaust my year’s entitlement can I submit receipts in the following year?

No, claims occurring within a given year are deducted from that year’s entitlement. They can not be submitted to be deducted from the following year’s entitlement.

 
What prescription drugs are covered?

All drugs prescribed for a medical condition, by a registered medical practitioner and purchased from a pharmacy are covered. A maximum limit of $10 per item applies for Primary Care and #care4U.  A maximum of $20 per item applies for Primary Care Extra.  

 
I have a linked and approved HealthCarePlus Hospital Cover policy, how do I claim the excess?

Claims must be supported by a receipt for the excess paid by you, evidence of the amount paid by your hospital cover provider (claims assessment advice/payment advice letter), copies of invoices from the surgeon, anaesthetist (if applicable) and hospital. Through you HealthCarePlus policy we may reimburse 50% of net expense up to a maximum excess reimbursement of $500.

Excess reimbursement for oral surgery is applicable under Primary Care Extra, but excluded under Primary Care and #care4U.

 
Can I claim for dentistry?

A Dental Benefit is available under Primary Care Extra and #care4U (50% of net expenses up to a calendar year entitlement of $250 applies).  Dentistry is excluded under Primary Care.

 
Up to what age can children be included under my policy?

Children can be covered under your membership up to 21 years of age. Cover terminates at the end of the calendar year (31 December) following their 21st birthday. However, over 21 year old children may now be covered under their own membership at a Whanau/non union member rate!

 
Can my children join HealthCarePlus?

Children of a current Member who are aged 18 (or over) are eligible to join under 'Family/Whanau' Membership no matter how old they are, where they live (In NZ), even if they were never on the policy and can add their partner and children.  Membership is by direct debit, credit or debit card, at a non union member rate.

 
How do I add or remove family members from the policy?

If you wish to add or remove family members please advise in writing, or complete an application form. Forms can be downloaded from our website here.

 
My bank account has changed, where can I get a new direct debit form?

A new direct debit form can be downloaded from the website here, or by calling 0800 600 666.

 
Will my premiums change?

Premiums may alter with age and inflation pressure. They won't increase just because you have made a claim. We review our premium structure annually.

 
Can I put my cover on hold?

Yes, if you are travelling overseas, your cover may be suspended from three months to up to one year over the life of the policy. Evidence of travel plans will be required for each case ie; tickets.

 
Am I covered while I'm overseas?

No. Our plans only provide cover for costs incurred within New Zealand, unless you are on approved overseas exchange or study leave, continue to have NZ salary paid to you and continue to pay your HealthCarePlus premiums. Costs within the country of exchange only are eligible.

 
I am retiring/changing schools/taking a break from work, can I still have cover?

Your cover can continue, but you do need to contact us ASAP as we may need to amend your premium rate or arrange an alternative method of payment.

 
How do I cancel my policy?

By writing to: UniMed, PO Box 1721, Christchurch 8140.  By email to: sales@unimed.co.nz. Please talk to your HealthCarePlus Representative first or call 0800 268 3763 to discuss your options.

 
Where can I find competition terms and conditions?

To view competition terms and conditions, please click here

 

Insurance transfer FAQ's, click here to view

 

 
 

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