Marram - A legacy of care

Healthcare Benefits

Terms and Conditions

  • Accounts and receipts must be originals or certified copies (not photocopies);
  • Accounts and receipts must show full payment;
  • Accounts and receipts must be lodged within 12 months of the treatment provided;
  • Accounts and receipts must show clearly who received the treatment;
  • Accounts and receipts must show what the treatment was and the date the service was received;
  • You must supply your own bank account details every time a claim is submitted;
  • The claim form must be signed by the Contributor;
  • Only claims for medical expenses incurred in New Zealand are considered for reimbursement;
  • There is a three month stand down period for claiming healthcare assistance. This begins on the date your first contribution payment is received by Marram;
  • Marram's healthcare assistance programme does not have an excess as we are not an insurance company;
  • Insurance policy excesses are not covered by Marram;
  • The healthcare benefits programme complements the medical insurance provided by Southern Cross, TOWER, Sovereign and others.  You must lodge a claim with your medical insurer first and send in the remittance advice from them with your original receipts or insurer-certified copies;
  • The maximum amount you or your dependants can claim for expenses incurred as a result of any one illness/condition in a two year period is $1250. This includes consultation fees, surgery costs, medication costs and surgical appliances related to the illness/condition;
  • The maximum amount that you or your dependants can claim under the Healthcare Grant in any 12 month period is $1500. See Healthcare Grant Guidelines for full details;
  • Medical practitioners must be registered on the Medical Council of New Zealand’s Medical Register (www.mcnz.org.nz). Specialists and anaesthetists must be registered under their specialty profession.
  • Our auditing requirements prevent us from returning original receipts and accounts after payment has been made. If you wish to maintain a record of your claims, we suggest you photocopy your receipts before submitting the originals.
  • If you leave your employer, you must contact Marram immediately and submit your claim.

 

You can claim healthcare expenses for:

  1. Your spouse or partner living in a de facto relationship with you for at least one year.
  2. Your or your partner's dependent child who is totally or substantially dependent on your earnings and is one of the following:
    • 18 years or under
    • Over the age of 18 who is a full time student attending a tertiary educational institute/university.
    • Irrespective of age who is physically or intellectually handicapped.

 

We recommend that your receipts should total $50.00 or more before claiming for reimbursement.

All healthcare benefits are provided at the absolute discretion of the Board of The Marram Trust and special conditions and exemptions may apply.  Below is an overview of what benefits can be claimed for.   Marram is not limited to just these benefits, so if you are unsure of anything you may contact us for further details.  Please bear in mind that this is an assisted healthcare programme only - giving basic healthcare support.  

Marram updates its website regularly - however there are always new treatments and medications coming into circulation that may not be detailed below. Please refer to a comprehensive list of exclusions at the bottom of the page.

Benefit Description Percentage Paid Maximum Payment Notes
GP consultation fees Consultation with a registered medical practitioner. 60% $50 per visit
Prescription charges Prescriptions by a registered medical practitioner. 60% $1,250 per condition, per person for a two year period

 

Specialists Consultation and treatment with a registered medical specialist. 75% $1,250 per condition, per person for a two year period
X-ray Cost of x-rays. 60% $1,250 per condition, per person for a two year period
Scan costs Cost of MRIs, CAT scans, digital molemaps and ultrasounds. 75% $1,250 per condition, per person for a two year period
Travel expenses If you require treatment that is approved treatment and is not available  in your home town; such as a specialist's  appointment or a hospital admission you are elgible for travel costs. There is a flat rate of $30 per trip.  $1,250 per condition, per person for a two year period Conditions:
  • Claims will only be considered if the treatment is not available in your own hometown and the traveling distance exceeds 100kms return
  • This cover is only for the patient receiving the treatment.
Minor surgery fees Cost of a minor operation if performed by a registered medical practitioner e.g. skin excisions, liquid nitrogen treatments, etc.
60% $1,250 per condition, per person for a two year period
Alternative therapists Consultation fees for: osteopath, chiropractor, naturopath, dietician/nutritionist, audiologist, homeopath, psychologist, podiatrist, acupuncturist, iridologist, therapeutic massage, Chinese medicine. N/A up to $20 per visit to a maximum of 10 visits per family per calendar year

 

Hospital costs Costs for treatment and stay at a hospital.

 


75% - Specialist fees

75% - Anaesthetist fees

60% - Hospital Charges

100% - Television Hire

60% – Hospital and Bed Charges ($120 max per day)

$1,250 per condition, per person for a two year period
Laboratory costs Costs for laboratory analysis. 60% $1,250 per condition, per person for a two year period

 

Physiotherapy costs

Costs for physiotherapy treatment. 60%

 

 

 

Surgical appliance costs Cost of personal medical equipment and prosthetics. 100% $1,250 per condition, per person for a two year period

 

  • Must be prescribed by a registered medical practitioner
  • Orthotics. Please support your claim with a statement from your G.P. or an Orthopedic Surgeon confirming the referral to the podiatrist, including the medical reasons necessitating orthotics. Sports related and temporary orthotics are exempt
  • Corsets, stockings, belts, calipers, artificial limbs & joints, surgical shoes, diabetic syringe & needles, insulin pump & lines, blood sugar meters, asthma nebulisers
  • Wigs and hairpieces are considered on their own merit.

Please note that batteries, accessories and maintenance costs are not covered.  

 

Hearing aid costs Cost of a hearing aid. N/A $250 grant per aid Please Note: Hearing tests are covered under approved therapist benefit.
Convalescent holidays Reimbursement of a rental week in a Marram holiday home. N/A Conditions:
  • The holiday home must be booked and paid for before making a claim
  • Claims are considered on a case by case basis.
Home help To assist with costs of home help. N/A $260 per year Conditions:
  • Claims are only considered if you require home help due to you or your partner being ill or for multiple births
  • A medical certificate is required.
Optical care Costs for optometrist consultation fees and purchase of contact lenses or glasses. 100%

$250 per person for a two year period

Conditions:
  • Claims are considered whether or not a change of vision has occurred
  • Check with your employer, they may have a health and safety / VDU agreement that covers eyesight correction. If so you must lodge a claim with them first. You can then lodge a claim for the difference, up to a maximum of $250.
Oral surgery costs

Costs of specific dental work, performed by a dentist or oral surgeon.

 

 

 

Costs of specific oral surgery performed by an oral surgeon. 

60%

 

 

 

 

 60%  

or max $250 per tooth

 

 

 

or max $250 per surgery

Conditions:
  • The surgical removal of impacted or unerupted wisdom teeth
  • Root canal therapy
  • A note from your oral healthcare provider must state which tooth number has had work done on it.

 

  • The treatment of abscesses, cysts, tumors, and ulcers. (Please note that this excludes the extraction of teeth related to these treatments.)

 

 

Orthodontic fees Costs of orthodontic treatment. 60% $600 per person Conditions:
  • Teeth realignment
  • Straightening
  • Adjustment
  • Extraction related to realignment.
Adoption fees Costs for the adoption of a child. N/A $250 per completed adoption
Maternity costs Costs for obstetric care including ante and post natal care, and delivery fees. 75% $1,250 per condition, per person for a two year period IMPORTANTensure you pay your Marram contributions in advance before you take maternity leave. If you let your contributions lapse, you will not be able to claim for these or any costs.
Special schooling Costs of special education needs, e.g. autism, dyslexia, attention deficit. 60% $1,250 per condition, per person for a two year period Notes:
  • Claims are considered on a case by case basis.
  • Supporting documentation from the school is required.
Ambulance Cost of transportation by ambulance. 60%
Healthcare Grant A grant to assist with looking after you and your family during difficult times. N/A Up to $1500 grant per person, per year

Healthcare Grant covers:

  • Contributor, dependent child or partner
  • Terminal Illness Grant, $1000
  • Funeral Grant, $1000
  • Distant Treatment Grant, $500
  • Holiday Grant, 1 week's stay in a Marram holiday home

Documentation required:

  • Documentation confirming terminal illness
  • Death certificate / copy of funeral account
  • Documentation confirming hospital stay
  • Documentation confirming absence from work

Healthcare Grant guidelines

Please read the following before completing the Application Form.

For the purpose of these guidelines, Marram Community Trust is referred to as 'Marram' throughout.

Marram, at its discretion, will approve the payment of a Healthcare Grant. The Healthcare Grant covers the contributor, partner and any dependent children. To assist with each application Marram, for the time being, has adopted the following guidelines.

  1. Terminal Illness Grant of $1,000. To be eligible for this payment, a letter from your Doctor confirming your illness must be received.
  2. Funeral Grant of $1000. Copy of Death Certificate or funeral letter is required. If the grant is for the contributor 'Estate' details must be provided.
  3. Distant Treatment Grant of $500. Claims will only be considered if the treatment is not available in your hometown and the travelling distance exceeds 100 kms return plus a minimum of one week's stay in hospital.
  4. Holiday Grant for one week's free rental in a Marram holiday home. Holiday Grant will only be considered for illness involving at least 4 weeks of absence from work.

Where a contributor meets one or more of the above guidelines, Marram must be satisfied before approving an application for a Healthcare Grant.

The maximum you can claim in any one year for a Healthcare Grant is $1,500 per person and up to one week's free tenancy in a Marram Holiday home recovering after illness.

The guidelines set out above are those current at this time. From time to time the Trustees may review and, as a result, change the guidelines. Whilst every effort is made to keep this web page up to date, every application for a Healthcare Grant will only be considered based on Marram's current guidelines.

To apply for a Healthcare Grant you will need to fill out a Marram Claim Form. You will also need to provide adequate supporting documents such as:

  • Documentation confirming terminal illness
  • Death Certificate/copy of funeral account
  • Documentation confirming hospital stay
  • Documentation confirming absence from work

 

EXCLUSIONS SUMMARY


Marram Healthcare benefits do not cover all healthcare or healthcare related expenses.  Below is a list of the items that are excluded.  This is not a complete list; if you cannot find what you are looking for, please phone Customer Services for clarification..

Abortion
Additional costs of sterling silver or gold medical alert bracelets
Administration charges and fees
Anti-smoking treatments
Anti-snoring mechanisms
Blood and Hair tests relating to heavy metals
Breast reduction surgery
Chelation (removing heavy metals from the body)
Chiropractor X-rays
Contraception
Cosmetic treatment and plastic surgery – regardless of medical necessity
Dental work relating to:
• All treatment relating to dentures
• Crowns
• Examinations
• Extractions
• Filling of Cavities
• Hygienist
• Periodontal Treatment
• Prescriptions
• X-rays
Drugs
• Anti-Smoking
• Anti-Malarial
• Bulk Forming
• Contraception
• Elective
• Non-prescribed drugs
• Over the counter drug purchases
• Propecia
• Sexual enhancement
• Tamiflu
• Weight Loss/Control
Elective treatment and surgery
Extraction of teeth relating to:
• Abscesses
• Cysts
• Tumours
• Ulcers
Family planning treatment
Fax Charges
Fertility Treatment
Food and dietary supplements
Gastric Bands – weight reducing mechanism
Guest meals – while in hospital
Hearing Aid:
• Accessories
• Maintenance
• Repairs
• Replacement Batteries
Herbal/natural remedies
Hireage
• Blood Pressure Machine
• Breast Pump machines
• Crutches
• Nebulisers
• Surgical heart monitors
Immigration checks/medicals
Insurance Excess
Laboratory Administration fees
Laser Treatment
Laser red vein treatment
Laser eyesight correction
Medications purchased from a Medical Centre
Missed appointment charges
Natural remedies
Obstetrics
• Baby milk formula
• Birth after-care
• DVD
• Elective tests and treatment before and after births
• Maternity serum scans
• Nuchal translucency measurement scan
• Post-natal accommodation
Ointments from Alternative Therapists
Online/overseas drug purchases
Online purchases
Orthotics for sports shoes
Overseas Purchases
Overseas medical treatment
Over the counter drug purchases
Pharmacy Charges
Physiotherapy:
• Gels and ointments
• Neck rolls
• Tape
• Incidental materials 
Special Schooling for under 5’s
Special Schooling pre-assessment tests
Sterilisation – Vasectomies, Tubal Ligation
Surgical appliance costs relating to:
• Batteries
• Accessories
• Maintenance costs
Telephone accounts incurred in hospital
Therapist’s accessories
Travel vaccinations
Treatment provided more than 12 months ago
Treatment incurred within the three month stand-down period
Unpaid accounts
Unspecified Injections
Vaccinations (except ‘Flu)
Visitor's travel expenses
Waterproof casts
Weightloss Treatment
Wheelchair purchases