Why get private health cover?

In New Zealand, our public healthcare system provides many essential services, and all children under 14 receive free healthcare. But some conditions—especially those needing specialist care or ongoing treatment—can involve long waiting lists or high costs not fully covered by the public system.

For non-urgent procedures, public wait times can be long, which can add stress and delay treatments that may improve your quality of life. To avoid these wait times, you have two main options:

• Paying out of your pocket: Even minor surgeries can add up quickly. To give you an idea, according to recent stats, grommet surgery for recurring ear infections can cost between $2,500 – $3,200, tonsil removal between $5,200-$7,800, and fusion to treat scoliosis around $90,000. Covering these costs independently can be a significant financial strain.
• Getting private health insurance: With health cover, you pay a regular premium and a one-time excess per claim, instead of covering each procedure out of pocket. In return, insurance often covers much of the cost of specialist visits and procedures, reducing the financial strain of unexpected medical bills.

Many families choose private health insurance to better manage healthcare costs and ensure timely access to care. So, how can you find the right fit for your family?

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Here’s what to think about

1. What type of cover do you need?

Depending on the level of coverage and flexibility your family needs, you can choose between a comprehensive policy or an everyday policy. A comprehensive policy covers a wide range of hospital, specialist, and elective surgery costs, offering higher protection but at a higher premium. An everyday policy covers more routine health expenses, like GP visits or basic prescriptions, at a lower premium.

2. What’s your budget?

Make sure you choose a plan that fits your long-term budget. It’s also about finding a balance between premiums and excess (the amount you pay out of your pocket when you claim). Opting for a higher excess can lower your premiums, but you need to have that amount at hand at claim time.

3. Do you have any pre-existing conditions?

It’s important to disclose any past or current medical conditions. Some insurers cover pre-existing conditions with a waiting period or a premium increase, while others exclude them entirely. Full disclosure is key, as non-disclosure can lead to declined claims or canceled cover.

4. Just had a baby?

Consider adding your baby to your policy within the first three months of birth. Many insurers will automatically cover certain pre-existing conditions for babies added within this period, setting up early access to essential care.

5. Would you like cover for non-Pharmac medications?

Some medications, including specialised treatments, may not be covered by Pharmac (New Zealand’s subsidised medicine system). Health insurance with non-Pharmac cover can help with these costs, giving you access to a wider range of treatment options if needed.

6. Looking for optical care?

Optical cover can help cover costs for annual eye exams, prescription glasses, and contact lenses. This add-on can be especially helpful for families with multiple members who need corrective eyewear, reducing out-of-pocket expenses.

7. Need dental care?

Basic dental care is free for children under 18, but orthodontics and adult dental care are not covered by public health. Dental add-ons in health insurance can help cover these additional needs, easing the cost of braces and other specialized treatments.

8. Any extra benefits you might be interested in?

Some health plans offer extra perks like access to wellness programs, discounts on gym memberships, and complementary health services like physiotherapy or acupuncture. Would these extras fit with your family’s lifestyle and goals?

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Get in touch: we can help

Choosing the right health cover can be simple with the right guidance. Your Insurance Link adviser can walk you through the options, helping you find a plan that suits your family’s specific needs, budget, and health priorities. Reach out today to explore appropriate health cover for your family’s future.

Disclaimer: Please note that the content provided in this article is intended as an overview and as general information only. While care is taken to ensure accuracy and reliability, the information provided is subject to continuous change and may not reflect current development or address your situation. Before making any decisions based on the information provided in this article, please use your discretion and seek financial advice.

A full disclosure statement for each Insurance Link Adviser is available on request and free of charge.