Previously EBS Health Care

 

Frequently Asked Questions & Other Information

 
Who is HealthCarePlus?

We were previously EBS Health Care.  Although we have changed our name, we are still the same, and you can contact us as you have before - it's just that when we answer the phone we will say "Welcome to HealthCarePlus!".

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. 

Fortnightly, monthly and annual direct debit options are available to all Members. Currently, we are unable to accept credit or debit card payments.

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. 

When does cover start?

Cover commences from the date of the first subscription 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.  You can only do this if you have not made a claim under the policy during this period.  If you wish to cancel the policy within the 14 day period please contact us. 

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 contributor.   If submitting your claim by email; please attach your scanned or photographed receipts/receipted invoices and retain these until claim settlement.  If submitting your claim by post; 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 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 far back can I claim?

All claims must be received by HealthCarePlus within 12 months of the date of the event.  The date of the event for Optical Benefit claims is the date of the prescribing eye examination.

Can my partner sign the claim form on my behalf?

Unless your partner has Power of Attorney you as the HealthCarePlus subscriber must sign the claim form.  

When will my claim be paid?

We aim to process a claim within 10 working days of receipt of the claim. Payment is by direct credit into your nominated bank account. Direct credit payments are authorised every two or three working days. This time frame may vary over holiday periods. Once your claim has been paid a Remittance 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 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. HealthCarePlus 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.

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 Subscriber 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 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.

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 or by calling 0800 800 441.

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 subscribe to HealthCarePlus. Costs within the country of exchange only are eligible.

How do I cancel my policy?

By writing or email to HealthCarePlus. Please talk to your HealthCarePlus Representative first or call 0800 268 3763 for your options.

 
 
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