Find out why many Kiwis are taking out this kind of coverage
About 1.2 million of New Zealand’s estimated 5.2 million residents are covered by private health insurance, according to the Financial Services Council’s (FSC) latest industry snapshot, a figure that is equivalent to almost a quarter of the entire Kiwi population.
Overall, the country’s top health insurance providers have written $948.7 million worth of premiums and paid out $697.3 million in claims in the first half of 2022, a slight drop from the $950.2 million in premiums written and $741 in claims paid in the same period last year.
Despite the dip, these numbers still indicate a thriving private health insurance market in a nation where the public health system, along with the Crown entity Accident Compensation Corporation (ACC), already provides a good level of support for accident and acute care.
What are the benefits of taking out private health insurance?
Although covered by the public healthcare system, a considerable number of Kiwis are taking out private health insurance because of the reassurance in knowing they’re covered in the event of a medical incident. Despite the benefits offered by New Zealand’s public health system, especially for emergency medical treatments, public hospitals cannot provide everything for everyone. If a condition is non-emergency, you will usually need to go through an assessment process and qualify for ‘elective’ treatment in the public system.
Data gathered has shown that unmet demand for elective surgery has reached an estimated 174,000 Kiwis in recent years, and also those with public health insurance can have their surgeries 100 days earlier on average compared to those relying on the public health system.
Common elective treatments include hip or knee replacement, heart surgery, hysterectomy, cataract removal, cancerous tumour removal, and diagnostic services such as endoscopy, laparoscopy, MRI scans, tonsillectomy, and grommets.
Private health insurance covers the cost of many non-urgent procedures and allows patients to receive treatment at private hospitals more quickly. When you don’t have to wait for treatment in the New Zealand health system, you can get back to work faster and live a better life.
How much does medical care cost in New Zealand?
Medical care in New Zealand can be very expensive, especially for those who do not have sufficient coverage. Here’s how much Kiwis need to shell out for common medical procedures, according to Southern Cross, the nation’s largest private health insurance provider. The costs are based on the insurer’s claims data for the 2020-21 financial year.
| Medical Procedure | Average Cost Range |
|---|---|
| Skin cancer removal Colonoscopy (with or without associated procedure) Grommet surgery Tonsil removal Squint correction Varicose veins Endometriosis surgery Prostate cancer surgery Hip replacement Knee replacement Heart valve replacement surgery |
$200 to $400 $1,500 to $3,200 $2,100 to $2,500 $4,400 to $6,400 $5,100 to $7,800 $6,300 to $7,800 $8,400 to $21,000 $18,600 to $25,800 $22,400 to $27,300 $23,100 to $27,700 $63,100 to $80,400 |
How does private health insurance work in New Zealand?
In general, there are three types of health coverage that New Zealanders can access. These are:
- Minor health insurance: This type of policy covers “day-to-day” medical treatments and costs, including consultations with medical professionals, but does not provide coverage for major surgeries and associated treatment expenses.
- Major health insurance: The most popular type of coverage, major health policies pay out for major surgeries and treatment costs – from diagnosis to recovery – as well as special visits. Medical conditions covered include cancer and heart disease.
- Comprehensive health insurance: Comprehensive plans include everything that minor and major health policies cover. Because of this, it is also the most expensive type of coverage.
When looking for a health policy that best suits your needs, consumer website Top Reviews NZ advised Kiwis to consider the following policy benefits:
- Cancer care: This covers all cancer-related expenses with the inclusion of Pharmaceutical Management Agency (Pharmac) and non-Pharmac-funded chemotherapy drugs.
- Surgical treatment: This covers minor and major surgery expenses.
- Non-surgical treatment: This includes allergy treatments, IV infusions, psychiatric confinement, counselling, and consultations.
- Diagnostic testing: This covers diagnostic testing and health screening procedures such as mammograms and biopsies.
- Pre-existing conditions: This provides coverage for the possible discomfort or illness that could ensue from a pre-existing condition.
- Overseas treatment: This covers the policyholder when getting treatment in a foreign country.
What does private health insurance cover?
Health insurance coverage varies between policies, but some of the most common inclusions according to LifeCovered are:
- Hospital and surgical procedures in a private hospital
- Tests, diagnostics, x-rays, and minor surgery
- Home nursing and hospital allowance
- Medical consultations
- Therapy and rehabilitation
On the other hand, private health insurance typically excludes:
- HIV/AIDS and related medical conditions
- Fertility treatment
- Cosmetic treatment
- Self-inflicted injuries
- Gender reassignment surgery
- Illnesses caused by drug or substance abuse
- Senile illnesses or dementia
- Any sexually transmitted disease
What are the top private health insurance providers in New Zealand?
Affinity+Co offers coverage from the top private health insurance companies including NIB, Southern Cross, Accuro, AIA and Partners Life. Call Affinity+Co today or click here to make a time to catch up!
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