Medical Insurance

This cover provides the funding to enable you to have private medical insurance treatment whenever you require more immediate access or a broader range of treatment options than are available to you  through the public health system.

This cover will help you avoid waiting lists and allow you and your family to access private health care without the stress of waiting and having your surgery dates constantly moved. One of the biggest things to consider is the Government Agency – Pharmac. Pharmac subsidises certain medications. For example there are 2 non-chemo cancer drugs (Herceptin & Keytruda) that are not subsidised by Pharmac. Some insurance companies will not cover drugs that are not subsidised by Pharmac.

At the latest count, 1.34 million New Zealanders have opted for health insurance – close to 30% of the country according to the Health Funds Association. Not sure of this figure.

Surgical treatment

If you require a surgical procedure (including lithotripsy), whether in hospital or day stay, and you choose to have the procedure completed privately, your Private Health Insurance will pay the costs (including prosthetics) up to a maximum of $300,000 per year for each life assured (certain exclusions apply). If your required surgery is as a result of a heart attack, stroke, coronary artery disease or critical cancer then the excess will not be deducted from this benefit.

Non-surgical hospital treatment

If you require non-surgical treatment in a hospital and you choose to be admitted to a private hospital your Medical Insurance will pay the costs up to a maximum of $300,000 per year for each life assured (certain exclusions apply). If your admission to hospital is as a result of a heart attack, stroke, coronary artery disease or critical cancer then the excess will not be deducted from this benefit.

Life-threatening illness treatment

If you suffer a potentially life-threatening illness such as cancer, which requires drug treatment to arrest or cure but doesn't necessarily require hospitalisation, you are still covered.  The additional costs of these drugs over and above any government subsidies are included in the non-surgical cover detailed above.  We want to help ensure you have access to the most effective drug treatments available, irrespective of whether those drugs attract a government subsidy or not (certain exclusions apply).

Before and after hospitalisation costs

If you have surgery or treatment in a private hospital all of the related specialist consultations and tests in the six months before and after the hospitalisation are covered. Post-hospitalisation costs including prescriptions and sundries, physiotherapy, hyperbaric oxygen therapy or rehabilitation costs, which occur in the six months following your discharge, are also covered. These costs are included in the surgical and non-surgical covers detailed above (certain limits and exclusions apply).