Benefits
Effective 1st April 2025
- New members can access benefits after the first 90 days of membership.
- All applications for benefits must be lodged within 12 months of receiving the treatment.
- Benefits apply to the cost of medical treatment or hospitalisation incurred within New Zealand.
- Per annum means the financial year from 01 April to 31 March, benefit limits relate to this period.
- On exceeding annual benefit limits, you may hold your receipts and access benefits in the next financial year subject to the 12 month claim period.
- Under Family membership, your natural and adopted children are included until they reach 19 years of age
after which they may take up their own single membership. - Children of partners who are not the employee's natural or adopted children can apply under a single membership.
- If you do not have a medical scheme or insurance, Koruhealth may refund up to 2/3 of the total invoice cost
(subject to benefit limits). GP fees and prescriptions may be refunded up to 100% (subject to benefit limits). - If you have a medical scheme or insurance, Koruhealth may refund the remaining balance of each invoice
up to 2/3 of the total invoice (subject to benefit limits). However, the remaining balance of GP fees and
prescriptions may also be refunded to 100% (subject to benefit limits). - Koruhealth is a Provident Society and all benefits are at the ultimate discretion of the Board.
Alternative Treatments
Examples of some of the alternative treatments covered are as follows
– Homeopathy, Naturopathy, Herbal and Acupuncture. A NZ Registered provider must be seen.
Birth
Claims must be received within 12 months of birth and a certificate must be supplied with the claim. The birth benefit may only be covered if fees are being paid whilst on leave without pay. If membership is suspended or the member is in their stand down period, this cannot be claimed.
Funeral
Claims must be received within 12 months of death and a certificate must be supplied with the claim.
Health Services
Examples of some of the costs covered are as follows – equipment hire, medical tests such as ECG, lab tests such as blood work, ambulance / ambulance subscription, occupational therapy, dietitian, varicose vein stockings, mole mapping and skin surgeries.
Laser Eye/Refractive Lens Treatment
This is a per eye benefit, every 5 years.
Hearing Aids
This a per aid benefit, every 5 years.
Orthodontic – NZ Registered ONLY
The total benefit limit is for a maximum of $800 per dependant, up to the age of 19.
KoruHealth members are required to use NZ Registered Orthodontic Specialists.
Optical
Claims are limited to spectacles and contact lenses purchased in New Zealand. Specialist-NZ Registered ONLY
Xrays
Dental xrays are not covered.
Medical / Hospital
Examples of some of the costs covered are as follows – surgery and associated costs performed by an NZ Registered Specialist. This is a per illness benefit and not an annual limit.
Skin Cancer treatments and associated costs please refer to the Skin Cancer policy under Latest News.
Examples of some of the costs NOT covered are as follows:- Cosmetic and oral treatments/surgeries, including Dental surgery, Fertility and Weight Loss treatments/surgeries.
Specialist – NZ Registered ONLY
Examples of Specialists are Oncologists, Dermatologists and Endocrinologists.
| Benefit Type | Cover Period | Cover |
|---|---|---|
| GP Fees* | Per annum | $600 Single $1000 Married/Family |
| Prescriptions* | Per annum | $400 Single $600 Married/Family |
X-Rays** (Including Ultrasounds) | Per annum | $500 Single |
| MRI/CT** | Per image | $500 |
| Specialist NZ Registered** | Per visit | $180 |
| Medical / Hospital | Per illness | $3,500 surgery performed by NZ Registered Specialist ONLY |
| Osteopathy** | Per annum | $300 Single |
| Chiropractic** | Per annum | $300 Single |
| Physiotherapy** | Per annum | $300 Single |
Alternative Treatments** NZ Registered | Per annum | $300 Single |
| Podiatry** | Per annum | $300 Single |
| NZ Registered Orthodontic** | Per dependant | $800 total benefit limit |
| Optical (NZ Purchases Only) | Every 3 years | $180 for first claim |
| Hearing Aids**/*** | Every 5 years | $500 per aid |
| Laser Eye/Refractive Lens Treatment**/*** | Every 5 years | $500 per eye |
Health Services** E.g. Surgeries performed by NZ GP's at Skin Clinics | Per annum | $300 Single |
| Counselling** | Per annum | $400 Single |
| Psychology/Psychiatry** | Per annum | $600 Single |
| Birth Benefit | Per child | $50 must claim within 12 months |
| Funeral | Per person | $1,000 per member (Current Employee) |
| Misc. Discretionary | On application to the board |
GP Fees*
Per annum
$600 Single
$1000 Married/Family
Prescriptions*
Per annum
$400 Single
$600 Married/Family
X-Rays**
(Including Ultrasounds)
Per annum
$500 Single
$750 Married/Family
MRI/CT**
Per image
$500
Specialist NZ Registered**
Per visit
$180
Medical / Hospital
Per illness
$3,500 surgery performed by NZ Registered Specialist ONLY
Osteopathy**
Per annum
$300 Single
$450 Married/Family
Chiropractic**
Per annum
$300 Single
$450 Married/Family
Physiotherapy**
Per annum
$300 Single
$450 Married/Family
Alternative Treatments**
NZ Registered
Per annum
$300 Single
$450 Married/Family
Podiatry**
Per annum
$300 Single
$450 Married/Family
NZ Registered Orthodontic**
Per dependant
$800 total benefit limit
Optical (NZ Purchases Only)
Every 3 years
$180 for first claim
$120 every 3 years
Hearing Aids**/***
Every 5 years
$500 per aid
Laser Eye/Refractive Lens Treatment**/***
Every 5 years
$500 per eye
Health Services**
E.g. Surgeries performed by NZ GP's at Skin Clinics
Per annum
$300 Single
$450 Married/Family
Counselling**
Per annum
$400 Single
$600 Married/Family
Psychology/Psychiatry**
Per annum
$600 Single
$900 Married/Family
Birth Benefit
Per child
$50 must claim within 12 months
Funeral
Per person
$1,000 per member (Current Employee)
$400 per Spouse/Dependent (includes 19+ and Other Child)
$400 per member (Past Employee/retiree)
Misc. Discretionary
On application to the board
NB Dental and fertility benefits are not covered. All payments are at the discretion of the Board.
*GP and prescription fees may be refunded up to 100% within annual limits.
**Koruhealth may refund other benefits up to 2/3's of the invoice within annual or maximum limits – refer to guidelines.
***Every 5 years