\u201cSouthern Cross said no,\u201d Gault said.<\/p>\n
Chef Simon Gault. Photo \/ Supplied<\/p>\n
Gault said he ultimately had to pay in full to have the recommended procedure done privately.<\/p>\n
\u201cI thought paying all those years meant I\u2019d be looked after when I needed it,\u201d he said. <\/p>\n
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\u2019s eligibility criteria.<\/p>\n
\u201cHealth 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,\u201d he told the Herald.<\/p>\n
\u201cWhere the Mohs eligibility criteria are not met, standard surgical excision remains available as an established treatment for skin cancer, subject to the member\u2019s policy.\u201d<\/p>\n
Southern Cross Health Insurance chief sales, marketing and customer experience officer, Regan Savage. Photo \/ Southern Cross Health Insurance<\/p>\n
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.<\/p>\n
He urged people, particularly younger New Zealanders, to check their insurance coverage and understand the fine print.<\/p>\n
\u201cHere\u2019s the catch. Once you\u2019ve had a health problem, a new insurer might not cover it.<\/p>\n
\u201cThat\u2019s why I\u2019m staying with Southern Cross. I am definitely not telling anyone to cancel their insurance,\u201d he said.<\/p>\n
Savage said health insurance eligibility criteria may change more regularly than policy documents as clinical evidence, medical technology and healthcare practice evolve.<\/p>\n
\u201cOur policy documents direct members to check the eligibility criteria that apply when treatment is being considered.<\/p>\n
\u201cWhen 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.\u201d<\/p>\n