Best health insurance in New Zealand 2022

Compare Best Health-Insurance

Why do 1.42¹m New Zealanders have private health insurance?

Elective surgery waiting times increase, leading to preventable illnesses, sometimes terminal illnesses. Unfortunately, COVID has only made things worse.

With private health insurance, New Zealanders can skip the public waiting lists. And get access to specialists, surgery or diagnostic procedure (such as an x-ray).

You can select a private hospital and a doctor at a time that suits you and get a second medical opinion if needed.

New Zealanders have options with private health insurance.

Your payroll taxes pay for emergency and acute care. But the public health system will put you on a waiting list. 

Most Common Health Insurance Claims

Here are the most common claims from Southern Cross in December 2021:

  1. Orthopaedic: $19.7m
  2. Imaging and tests: $11.4m
  3. General Surgery: $9.0m
  4. Specialist consultation: $8.5m
  5. Gynaecology: 7.3m

You have many policies to choose from, and finding the best health insurance can be confusing.

We’re going to dig deep into finding the best health insurance policy.

Compare-Best-Private-Health-Insurance

Compare best health insurance providers.

Find out what to look for in a health insurance policy and compare premiums for comprehensive health insurance plans.

Private Health insurance pays for your medical treatments. 

But life insurance pays out a lump-sum death benefit upon death.

So we’ve done the hard work for you by comparing the best health insurance companies in New Zealand.

We’ve looked at their:

  • credit strength,
  • market share,
  • excess options,
  • cancer cover and non-pharmac,
  • optional extras such as GP, Dental etc. and
  • how they deal with existing conditions.
Southern Cross Health Society

Ownership: 100 per cent New Zealand-owned, not for profit health insurance co-operative since 1961.

Credit Rating: A+ (Strong) Standard & Poor’s

Market Share62% (2021)

Excess Options: $500, $1,000, $2,000, $4,000

Pros

  • Ranked number one in the 2022 Reader’s Digest NZ Most Trusted Brands survey, winning the health insurance category for a sixth consecutive year.
  • Wide range of policies is available.
  • Mobile app online claims process.
  • Eighty-seven cents of every dollar received in premiums was paid out in claims.

Cons

  •  

Southern Cross was founded in 1961 and has since expanded its quality health insurance plans and offers. In the last financial year, the business paid impressively 73 per cent of all personal health insurance claims in New Zealand, significantly more than its 62 per cent market share. 

The company also includes 16 hospitals and six specialist centres across New Zealand, and people can purchase its health insurance plans directly through brokers. LifeCovered is an authorized broker for Southern Cross.

nib health insurance

Ownership: Established in 1952 and listed on the Australian Stock Exchange. 

Credit Rating: A- (Strong) Standard & Poor’s

Market Share: 16% (2017)

Excess Options: $250, $500, $1,000, $2,000

Pros

  • Wide range of policies is available.
  • Mobile app online claims process.
  •  

Cons

PartnersLife Private Medical Cover

Ownership: Established in 2010, privately owned by New Zealanders and minority shareholder Blackstone, New York based asset managers.

Credit Rating: A- (Excellent) A. M. Best

Market Share: ?

Excess Options: $250, $500, $1,000, $2,000, $5,000, $10,000

 

AIA Health Protection

Ownership: One of the largest insurers in the world since 1919 and listed on the Hong Kong stock exchange.

Credit Rating: AA (Very Strong) Fitch Ratings

Market Share: ?

Excess Options: $250, $500, $750, $1,000, $2,000, $4,000

 

Pros

  • Accepts credit/debit cards
  • Multi-benefit discount up to 15%

 

Cons

  •  

 

AIA looks after more than 39 million policies and customers worldwide, a global health and life insurance provider.

Accuro Health Insurance

Under the names SmartCover and SmartCover+, Accuro Health Insurance offers  

Ownership: 100 per cent New Zealand-owned, not for profit health insurance co-operative since 1971.

Credit Rating: B+ (Stable Outlook) A.M. Best

Market Share: ?

Excess Options: $250, $500, $1,000, $2,000, $5,000, $10,000

What Is Health Insurance?

Health insurance is a contract that requires an insurer to pay some or all of a person’s medical expenses in exchange for a monthly premium. It’s designed to prevent you from financial ruin should you need private medical care.

Going without health insurance coverage poses a risk to your potential to get the care and an even more significant risk to your personal finances. In addition, people who aren’t insured (or under-insured) tend to be hesitant to get the care and risk their health.

People who have health insurance are often more likely to go to the doctor when they need to because they know what it will cost. As a result, they tend to follow up on medical concerns their doctors flag, such as high blood pressure, before they become more significant problems. In addition, they’re more likely to get preventative care and medical treatments.

There are three main types of health insurance policies in New Zealand:

  1. Minor Medical, also called basic
  2. Major Medical
  3. Comprehensive

a) Minor Medical Insurance

Minor Medical Health Insurance NZ

products provide cover for day-to-day medical treatments but provide little or no cover for more significant major surgery or treatment costs.

b) Major Medical policies

Major Medical Health Insurance NZ

typically provide cover for elective surgery, major treatments and the cost of specialist visits, but do not cover day-to-day medical expenses such as GP visits.

c) Comprehensive Health Insurance

Comprehensive Health Insurance NZ

products provide cover for both major surgery and day-to-day medical expenses.

Major medical policies are most common, accounting for around 69 per cent of all policies².

These policies give the most value for money. They cover the cost of surgery, including hip replacement and knee operations. And imaging and diagnostics for tests such as colonoscopy and diagnostics.

Public vs private health insurance?

Living in New Zealand has its health benefits – ACC and the public health system provide a good level of healthcare support for accidents and acute care. In addition, local hospitals will look after you for any emergency treatment in the public health system. 

But public hospitals cannot provide everything for everyone.

Non-urgent care in the health system

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. 

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.

What is covered by private health insurance?

Health insurance policies differ from policy to policy. But some features are commonly included:

  • Hospital and Surgical procedures in a Private Hospital
  • Tests, diagnostics, x-rays and minor surgery
  • Home Nursing and Hospital Allowance
  • Consultations and therapy for  recovery and support

What is excluded from medical cover?

List of common exclusions:

  • HIV/AIDS and related medical conditions
  • Fertility Treatment
  • Cosmetic Treatment
  • Self-inflicted injuries
  • Gender Reassignment Surgery
  • Illness caused or contributed by drug or substance abuse
  • Senile Illness or Dementia
  • Any Sexually Transmitted Disease

a) Cancer Cover

Cancer affects the lives of far too many Kiwis and cancer is the leading cause of death in New Zealand.

With a private health insurance policy, you can be treated for cancer in a private hospital by your choice of doctor.

Cancer care is usually included in a Major- or Comprehensive policy, and will typically cover treatments like chemotherapy, radiotherapy, surgery, hormone therapy, psychological counselling and alternative treatments like acupuncture.

Other add-on options include

  • Specialist Option
  • GP Option
  • Dental & Optical
  • Serious Condition Financial Support
  • Proactive Health

b) Non-PHARMAC Drugs

Having a medical cover that provides non-PHARMAC cover can be beneficial when Medsafe has approved the drug as safe, but PHARMAC does not provide funding.

Cancer drugs can be prohibitively expensive without PHARMAC funding.

For instance, Christine Manins paid $70,000 for the first seven months of prescription medicine treatment in 2017 before dropping to around $5,000 a month.

Palbociclib (Ibrance) is a new treatment that is not yet funded and is used to treat breast cancer that has spread to other parts of the body (metastatic) in combination with an aromatase inhibitor as the first hormonal-based therapy in women who have gone through menopause or fulvestrant in women with disease progression following hormonal therapy.

c) Pre-existing conditions

Pre-existing medical conditions are, generally speaking, the health issues you’ve had in the past, whether treated or not.

The good news is some health insurers offer options to include pre-existing conditions, usually after a waiting period.

But some medical conditions are permanently excluded, typically:

  • Cancer
  • Cardiovascular conditions
  • Back conditions
  • Hip or knee conditions
It’s worth noting here staff medical insurance offered by an employer often covers pre-existing conditions.
Compare Health Insurance NZ Costs

How much does health insurance cost?

The cost of a medical health insurance policy depends on three main factors:

  • your personal circumstances, ie. age and gender
  • policy plan and if an
  • excess is selected.

For this particular health insurance cost comparison, I have sourced health insurance quotes from leading New Zealand insurers:

a) Quote for a 30-year-old male, non-smoker, fortnightly payment

  • Excess options $500 or $2.000
  • Basic health insurance policy: similar policies with unlimited outpatient care

b) Quote for a 50-year-old male, non-smoker, fortnightly payment

  • Excess options $500 or $2.000
  • Basic health insurance policy: similar policies with unlimited outpatient care

500 Kiwi's a week sign up for private health insurance

Although New Zealanders are covered by the public healthcare system, the reassurance of knowing they’re covered in the event of a medical incident is still one of the main drivers for people taking out private health insurance cover.

According to the Financial Services Council of New Zealand, in 2020, a record $1.38 billion was paid out in health insurance claims.

The total number of Kiwis with medical insurance policies is now (December 2021) 1.42 million – more than a quarter of the population. 

Elective Surgery Waiting List

Doctors and nurses report that waiting lists have never before been so bad as they are now. Covid has made bad, worse.

The media is frequently reporting about the failing NZ Healthcare system. And elective surgery waitlists are getting longer and longer.

Health Insurance NZ - Elective Surgery

Average Waiting Time to Surgery

People with private health insurance have their surgery on average 100 days quicker than those in the public system.

Health Insurance NZ - Average time to surgery

Discomfort, Suffering and impact on Lifestyle

We’ve all seen stories in the media about Kiwis waiting for surgery, often living in pain and discomfort.

Health Insurance NZ - change of lifestyle

How much do medical treatment costs?

The cost to access private medical treatments can significantly impact any family. And for many families, medical treatments are unaffordable.

Here’s a list of what medical treatments cost in New Zealand.

Courtesy of nib

  • Cataract surgery $4,300 – $5,200
    Removal of the cloudy lens from the eye affecting vision
  • Endoscopic sinus surgery $12,000 – $37,000
    Surgical repair of the facial sinuses
  • Wisdom teeth removal $3,000 – $5,500
    Surgical removal of wisdom teeth (third molars)
  • Thyroidectomy $11,000 to $15,000
    Surgical removal of the thyroid gland

Heart

  • Angioplasty $17,300 – $27,400
    Insertion of a catheter to unblock artery with a stent or balloon
  • Single valve heart operation $48,000 – $60,000
    Surgery to repair or replace a heart valve
  • Heart bypass $35,000 – $50,000
    An operation to rechannel blood flow to the heart

Body

  • Mastectomy $12,000 – $15,000
    Surgical removal of the breast
  • Spinal fusion $20,000 – $60,000
    Surgery to join two or more vertebrae together
  • Gastroscopy $1,100 – $1,600
    A diagnostic procedure to look at the mouth, throat and stomach
  • Cholecystectomy $8,500 – $13,000
    Surgical removal of the gall bladder
  • Colonoscopy $2,000 – $2,500
    A diagnostic procedure to look at the large bowel and sample tissue
  • Hysterectomy $13,000 – $19,300
    Surgical removal of the uterus
  • Appendectomy $6,000 – $10,300
    Surgical removal of the appendix
  • Hernia repair $7,000 – $18,000
    Surgical repair of the weakness in the abdominal wall

Leg

  • Total hip joint replacement $20,000 – $27,000
    Replacement of the hip joint with an artificial joint
  • Resection of endometriosis $9,000 – $25,000
    Surgical removal of the uterine cells from the pelvis or abdomen
  • Robotic Prostatectomy $30,000 – $45,000
    Robotic surgical removal of the prostate
  • Total knee joint replacement $22,000 – $30,000
    Replacement of the knee joint with an artificial joint
  • Varicose veins (both legs) $7,000 – $10,000
    Laser or surgical removal of varicose veins

Private Medical Cover: the conclusion

Your health is your greatest asset. It helps you earn an income, support your family and live your dreams.

People who buy private health insurance are often motivated because medical cover gives peace of mind, faster consultations, and quicker access to private treatment.

 

FAQs

  • Health insurance excess is paid if you make a claim.
  • Excess often applies only once per person per calendar year.
  • The higher excess you pay the lower your health cover payments.
  • Excess is optional and starts at $250.

More than 1.4M Kiwi’s have private medical cover and every month another 2,000 sign up. Private health insurance gives you control over which surgeon treats you, when and where you’re treated, and helps you pay towards the cost of your treatment – which otherwise might be unaffordable or significantly impact the lifestyle you’re used to.

It’s important to understand your cover, policies and premiums are in no way impacted regardless of your vaccination status.

In New Zealand, acute care is provided by the public health system so if treatment is needed urgently after receiving a vaccine, you should go directly to the Accident and Emergency unit at your nearest public hospital.

Vaccine-related treatment injury is excluded in private health insurance plans. Any adverse reaction to any vaccine is covered by ACC, which provides treatment and support. 

The price of medical care is the single most significant factor behind healthcare costs in New Zealand. These expenses reflect the price of caring for those with medical conditions, an aging population and the increased cost of new medicines, procedures and technologies.

Health Insurance Advice?

At LifeCovered, we passionately want to help and serve Kiwis for a better financial future.

Is there a fee?

No, our service is free of charge. 

For every policy sold, LifeCovered is paid a commission by the health insurer. The commission is used to pay for salaries, rent, administration, insurance and other business costs. 

We are health insurance experts.

And we do all the hard work of comparing the best health insurance for you.

Our health insurance advice and suggestions is tailored around who you are, what your needs are and your budget.

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