“Southern Cross said no,” Gault said.
Chef Simon Gault. Photo / Supplied
Gault said he ultimately had to pay in full to have the recommended procedure done privately.
“I thought paying all those years meant I’d be looked after when I needed it,” he said.
Southern Cross Health Insurance chief sales, marketing and customer experience officer Regan Savage said Mohs surgery was covered when clinically appropriate and it met the insurer’s eligibility criteria.
“Health insurance is designed to fund medically necessary healthcare, and our eligibility criteria therefore focuses Mohs cover on circumstances where there is a clinical need for the procedure,” he told the Herald.
“Where the Mohs eligibility criteria are not met, standard surgical excision remains available as an established treatment for skin cancer, subject to the member’s policy.”
Southern Cross Health Insurance chief sales, marketing and customer experience officer, Regan Savage. Photo / Southern Cross Health Insurance
Gault said in a video that from what he had read, it looked like he would have qualified for Mohs surgery before Southern Cross changed the rules in December 2025.
He urged people, particularly younger New Zealanders, to check their insurance coverage and understand the fine print.
“Here’s the catch. Once you’ve had a health problem, a new insurer might not cover it.
“That’s why I’m staying with Southern Cross. I am definitely not telling anyone to cancel their insurance,” he said.
Savage said health insurance eligibility criteria may change more regularly than policy documents as clinical evidence, medical technology and healthcare practice evolve.
“Our policy documents direct members to check the eligibility criteria that apply when treatment is being considered.
“When we communicate with policyholders about changes to their policy document, we also remind them that eligibility criteria are kept up to date online and encourage members to check these if they are considering or planning treatment.”
Gault’s career has included working in restaurants overseas and in Aotearoa, cooking for billionaire Larry Ellison on his superyacht and judging five seasons of MasterChef New Zealand.
He opened his first restaurant at 22 years old.
His surgery comes after health insurers were found to be increasingly unwilling to cover all the costs associated with expensive medical treatments.
Health insurance premiums have been soaring over the past couple of years, with the annual premium inflation rate reaching 19% in the year to the June quarter, according to Stats NZ’s Consumers Price Index.
The Insurance and Financial Services Ombudsman managed 170 health insurance-related disputes in the year to June – 91% more than the previous year.
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