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 that 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 healthcare without the stress of waiting and having your surgery dates constantly moved.
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.
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).
The strong growth in claims paid recorded over recent quarters has seen annual claims paid climb to the $1 billion mark in the first quarter of 2015.
NZ Private Medical Insurance Claims Paid
NZ Claims Paid in Millions
- 1.34 Million kiwis have private health insurance
- Average time to surgery from GP Visit 177 Days for Public System and 76 Days Private
- Indicative costs of Surgery Jan 2013
- Cardiac bypass $35,000 – 57,000
- Prostate removal $10,000 – $31,600
- Excision of cancerous skin lesion $500 – $6,000
- Radical mastectomy $15,000 – $27,000
- Total hip replacement $15,000 – $24,900
- Total knee replacement $15,300 – 28,000
- Knee arthroscopy $3,100 – 6,000
Source: Health Funds Association
Major diagnostic costs
If you require any of the expensive diagnostic tests listed, whether they lead to the need for further treatment or not, your Private Medical Insurance will pay the costs of these diagnostic tests up to a maximum of $200,000 per year for each life assured (certain exclusions apply).
- MRI Scans
- CT Scans
- Dilation and Curettage
- Nuclear Stress Test
- PET Scans
When you are admitted to a public hospital
If you are admitted to a public hospital for longer than three nights your Private Medical Insurance will reimburse you $300 per night for each additional night you stay up to a maximum of 10 nights per admission for each life assured (certain exclusions apply). No excess will be deducted from this public hospital cash grant.
Emergency transport costs
Your Private Medical Insurance will reimburse you for the costs of any emergency transport you require (certain exclusions apply). No excess will be deducted from this transfer costs benefit.
Your Private Medical Cover includes reimbursement for hospice costs of $300 per day for up to a maximum of 10 days for each admission (certain exclusions and limits apply). No excess will be deducted from this hospice benefit.