Positive Health
Positive Health is a support scheme to assist people living with HIV to pay for medical fees and associated healthcare costs. The scheme is available to anyone living with HIV in New Zealand.
What is the Positive Health Scheme?
Body Positive understands the importance of everyone living with HIV being able to visit their doctor whenever they need too, however for some the doctors consultation fee can act as a barrier as their disposable income may be limited.
To help with this problem, we started the Positive Health Scheme, so that members on a benefit or with a limited income within the scheme can go to their doctor at any time without having to stress or worry about the cost.
Under the scheme, a member simply presents their current Positive Health ID Card at the doctors to have the consultation charge (to a max of $40 per visit) referred to Body Positive for payment.
If your current doctor charges a consultation fee of more than $40, you will need to pay them this additional cost directly to the doctors clinic, Positive Health will still pay $40 of the bill - So if your doctor charges $46, you will need to pay $6 and Positive Health will pay the remaining $40.
What doctors and service providers are part of the scheme?
We understand that many people have a close longstanding relationship with their existing doctor. Because of this there is no restrictions within the scheme as to which doctor you can use.
Most doctors and pharmacies will happily forward consultation fee and dispensing fee charges to Body Positive for payment, however there may be a few who will require payment be directly. If you doctor or pharmacy requires a direct payment, simply make the payment and forward us the receipt so that we can arrange a reimbursement.
Pharmacy Dispensing Fees
As it is also very important that people living with HIV collect and take their medications as prescribed, the scheme also covers all Pharmacy Prescription Dispensing Fees (usually $5 per medication) for prescription medications either from their doctor or HIV Specialist.
Important:
- The scheme DOES NOT cover any other over-the-counter pharmacy purchases other than the standard prescription dispensing fee.
- The scheme DOES NOT cover any non government subsidised medications that you might be prescribed by your doctor.
Does Positive Health cover any other costs?
The primary aim of the scheme is to cover:
- Doctors Consultation Charges (to a max of $40 per visit)
- Pharmacy Prescription Dispensing Fees (usually $5 per medication)
- Podiatrist Treatment (2 appointments annually)
- Massage Treatment (4 massages annually)
- St Johns Ambulance Fees (1 callout annually)
Body Positive understands the importance of everyone living with HIV being able to visit their doctor whenever they need too, however for some the doctors consultation fee can act as a barrier as their disposable income may be limited.
To help with this problem, we started the Positive Health Scheme, so that members on a benefit or with a limited income within the scheme can go to their doctor at any time without having to stress or worry about the cost.
Under the scheme, a member simply presents their current Positive Health ID Card at the doctors to have the consultation charge (to a max of $40 per visit) referred to Body Positive for payment.
If your current doctor charges a consultation fee of more than $40, you will need to pay them this additional cost directly to the doctors clinic, Positive Health will still pay $40 of the bill - So if your doctor charges $46, you will need to pay $6 and Positive Health will pay the remaining $40.
As it is also very important that people living with HIV collect and take their medications as prescribed, the scheme also covers all Pharmacy Prescription Dispensing Fees (usually $5 per medication) for prescription medications either from their doctor or HIV Specialist.
Important:
- The scheme DOES NOT cover any other over-the-counter pharmacy purchases other than the standard prescription dispensing fee.
- The scheme DOES NOT cover any non government subsidised medications that you might be prescribed by your doctor.
The scheme DOES NOT cover any other over-the-counter pharmacy purchases other than the standard prescription dispensing fee.
The scheme DOES NOT cover any non government subsidised medications that you might be prescribed by your doctor.
The primary aim of the scheme is to cover:
Doctors Consultation Charges
(to a max of $40 per visit)
Pharmacy Prescription Dispensing Fees
(usually $5 per medication)
As an additional bonus for members, the scheme currently covers limited costs of some other associated health expenses, including:
Podiatrist Treatments
(2 appointments annually)
Massage Treatments
(4 massages annually)
St Johns Ambulance Fees
(1 callout annually)
Please see the Important Info section or full details on what is covered for each of the above.
We understand that many people have a close longstanding relationship with their existing doctor. Because of this there is no restrictions within the scheme as to which doctor you can use.
Most doctors and pharmacies will happily forward consultation fee and dispensing fee charges to Body Positive for payment, however there may be a few who will require payment be directly. If you doctor or pharmacy requires a direct payment, simply make the payment and forward us the receipt so that we can arrange a reimbursement.
The Positive Health Scheme is available to anyone living with HIV in New Zealand.
For more information or to join simply contact us and we will take care of all the arrangements for you.
The annual fee to join the scheme is $200, this can either be paid privately via a one off payment or may be available through Work and Income via a redirection of your benefit, depending on your circumstances. For premium users, Body Positive reserves the right to discuss a premium fee in addition to the regular fee charged.
Positive Health vs Healthcare Insurance
It is important to make the distinction that the Positive Health Scheme IS NOT a form of Healthcare Insurance.
Positive Health is a fund managed by Body Positive to designed to assist people on a benefit or with limited income to seek basic medical treatment when needed.
So that the fund is sustainable and does not open Body Positive to undue risk, it cannot run at a loss.
Members who's bills greatly exceed their payments into the scheme will be asked to move to a High User Premium account to continue using the service.
High User / Premium Account
Some members have more serious medical conditions, that require a lot more medical attention.
If you make many and regular visits to your doctor then it may pay to discuss this with Body Positive who could check that your WINZ Disability allowance is sufficient to meet this extra expense.
In these situations Body Positive will assist you to ask WINZ to increase your Disability Allowance to meet this cost and accordingly increase your redirection to Body Positive from $5 per week to $10 per week.
For those who pay privately for the scheme, this increases the annual payment from $200 to $400 per year.
Positive Health ID Card
After we have received the annual fee and the completed documentation you will be issued with your Positive Health ID Card.
Use this card at any of the participating healthcare providers listed in this publication for your costs to be referred back to Body Positive for payment, subject to any special conditions associated with the provider or service as detailed.
Important Information
Once you select a Medical Clinic that you will be comfortable with- the first step will be to register with that clinic as this will entitle the clinic to secure the appropriate subsidy for your visits.
On your first visit go a little early (say 15 minutes) so you can complete the registration forms.
If you want to change doctors then please discuss this with Body Positive and let us know of any concern you may have.
Visiting any other Medical Clinic may result in an additional fee which will not be covered by the scheme.
Body Positive does not wish to restrict members in being able to access their doctor of choice however in allowing this Body Positive has had to introduce a maximum consultation fee payable under the scheme of $40. If your doctor charges over this maximum, you will be required to pay this difference to the clinic directly.
Body Positive agrees to meet the consultation fee up to the predetermined ceiling limit of $40 for members visits to doctors. This does NOT include medical procedures, e.g. Skin Cancer Treatments, Vaccinations, Biopsies etc. Often an application to the Wellness Fund may assist Members with these special medical expenses and a quote should be secured in the first instance and discussed with Body Positive.
The scheme will cover prescription fees pharmacy dispensing fees (where they exist) for HIV Antiretroviral Medication or any other general prescription fees.
Some medications are not subsidised or only partial subsidised and will not be covered in the Positive Health agreement and must be paid by the member.
The scheme DOES NOT cover any over-the-counter pharmacy purchases other than the standard prescription dispensing fee.
The scheme DOES NOT cover any non-government subsidised medications that you might be prescribed by your doctor.
In most cases the need to use an ambulance falls into two categories: 'emergency' and 'non-emergency'.
If you have a critical health 'emergency' issue and need to call an ambulance then you should do so immediately. Later when the account from the St. Johns Ambulance Service arrives please bring it in to us at Body Positive for review. If we are unable to meet the total expense we will make a contribution to the cost.
Any 'non-emergency' use of an ambulance will not be covered by the scheme.
All Positive Health members are entitled to 4 annual massage treatments free of charge (up to $50 per massage).
In Auckland we have a weekly massage clinic at Body Positive House for members. If the timing of this clinic is not convenient for you, or if you live outside Auckland, you are free to find an alternative Massage Therapist and Positive Health will contribute $50 towards the cost of each massage (up to 4 times per year).
All Positive Health members are entitled to 2 annual treatments with a Podiatrist (foot doctor) free of charge.
For members in Auckland, please call Speight’s Podiatry on 09 306 4006 to book an appointment (remember to mention you are a member of the Positive Health Scheme when you book).
Members outside Auckland are free to source a local podiatrist and Positive Health will contribute $50 towards the cost of each treatment (up to 2 times per year).
Sometimes a healthcare provider will not enter in to an agreement with Body Positive and the member will be required to pay up front to the medical health provider.
In this instance Body Positive will reimburse the member expenses incurred provided those expenses:
- are not older than 3 months
- are within the period of their current Positive Health Scheme
- are within the criteria detailed the Positive Health terms.
We are keen to add value to our Positive Health scheme and if you know of a saving or service that could benefit Body Positive Members we would love to hear about it from you.
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