Southern Cross Health Insurance has announced that ADHD and autism will be covered again after previously making the decision to exclude them.

RNZ reported last month Families were blindsided by the decision and were unable to obtain funds for treatment.

At the time, the insurer said this was not a policy change, but a “clarification.” ADHD and autism were considered mental health conditions and therefore fell under the mental health exclusion and therefore were not eligible for compensation.

However, after reviewing the diagnostic classification system, RNZ has now been told that the condition is actually classified as a neurodevelopmental condition rather than a mental health condition, and therefore the mental health exclusion does not apply.

Regan Savage, chief sales and marketing officer at Southern Cross Health Insurance, said the review was undertaken after feedback from clinicians, members and industry stakeholders highlighted uncertainty about how the November guidance for healthcare providers was being interpreted in practice.

“That feedback inspired a more detailed review to ensure our guidance is clear, consistent and in line with both clinical understanding and our policy,” he said.

“We appreciate the constructive engagement with our members and experts who have helped inform this review, and we are currently reviewing any claims that may have been affected.”

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