Compare Best Private Health Insurance

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Compare Best Health-Insurance

How we found the best health insurance

I interviewed health insurance experts and people wanting to buy the best health insurance for themselves, their family and their workplace.

With so many medical policies to choose from, health insurance can be confusing and hard to compare.

You will pay a monthly fee that covers all of the costs (minus excess if any) of treatment for conditions that develop after your health insurance policy has begun.

The level of cover you get will depend on the policy you take out. 

We compare the 3 levels of private health insurance available in New Zealand: Minor, Major and Comprehensive.

I looked at five things to sort out the best medical cover in New Zealand.

How Health Insurance in New Zealand works​

Health Insurance covers the costs of private healthcare, from diagnosis to treatment and gives quicker access to specialists and treatment. You pay a monthly fee that covers all of the costs (minus excess if any) of treatment for conditions that develop after your health insurance policy has begun.

We’re going to dig deep into health insurance, but feel free to jump to any section that interests you:

Compare-Best-Private-Health-Insurance

Compare Best Private Health Insurance NZ

Health insurance covers the cost of private medical treatment, with or without excess. When you and I buy health insurance, it is with the expectation of faster consultation, private treatment or surgery, than going through the local DHB. Because there’s no “best” health insurance policy for everyone, ie. one policy cannot cater to everyone’s needs, I have put together this best health insurance NZ guide. What is important is choosing a health insurance policy that covers you for what you are likely to need. And this is where the policy fine print matters the most.

Is Health Insurance Confusing?

Yes, for many people we speak to at LifeCovered, we hear the same story:

health insurance is so complicated and confusing.

 

Here at LifeCovered, simplifying health insurance is something we think about a lot.

Transparency and uniformity is key to making health insurance policies easier to understand.

The challenge is for the NZ healthcare system and health insurance companies to improve and simplify things.

Not to forget the medical policy wordings. The if’s and but’s.

The small print, you know?

Comparing health insurance policies and understanding some terminology will help clarify and make buying health insurance simple.

1. 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% (2018)

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

– discount: unknown

Pre-existing Conditions: qualifying pre-excisting conditions will be covered after 3 years.

Southern Cross Health Society

2. nib health cover

Ownership: Established in 1952 and listed on the Australian Stock Exchange. Underwrites Done by Fairfax Media New Zealand and AA Health Insurance.

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

Market Share: 15% (2016)

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

– discount: unknown

Pre-existing Conditions: qualifying pre-existing conditions will be covered after 3 years.

nib health insurance

3. Sovereign Private Health

Ownership: Since 2018 owned by AIA Insurance

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

Market Share: 6.9%(2017)

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

– discount: 17%, 26%, 32%, 40%, 55% and 70%

Pre-existing Conditions: A pre-existing medical condition can be accepted with or without an extra premium – individual evaluation.

Sovereign Health Insurance

4. Partners Life Medical Cover

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

Credit Rating: B++ (Good) A. M. Best

Market Share: ?

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

– discount: unknown

Pre-existing Conditions: A pre-existing medical condition can be accepted with or without an extra premium – individual evaluation.

PartnersLife Private Medical Cover

5. 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) Standard & Poor’s

Market Share: ?

Excess Options: $250, $500, $750, $1,000, $2,000, $4,000, $10,000

– discount: unknown

Pre-existing Conditions: A pre-existing medical condition can be accepted with or without an extra premium – individual evaluation.

AIA Health Protection

6. Accuro Health Cover

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

– discount: 10% – 64%

Pre-existing Conditions: A pre-existing medical condition can be accepted with or without an extra premium – individual evaluation.

Accuro Health Insurance

How to choose the best health insurance

a) Cancer Cover: Surgical and Medical Cancer Treatment

Cancer affects the lives of far too many Kiwi’s 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 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) Excess affects the price of health cover

As with every type of insurance, NZ private health insurance policies use an excess to help control claims.

The insurer’s thinking is that if you and I, have to pay the first part of a claim, then we are more careful about incurring a claim at all and only really do it when we have to.

Their fear without an excess would be that people would claim regularly as there would be no cost to them.

Excesses are typically charged either per year (i.e. you pay the first say $250 of claims in any one year and then no more, regardless of the number or value of claims) or per claim (i.e. you pay the first say $500 of each claim that is made).

All insurers give some flexibility on the excess you have on your policy.

Most typical is $250, $500, $1,000, $2,500 and some insurers offer option for $10,000 in excess.

The excess has an impact on cost – a high excess makes premiums cheaper.

d) Guaranteed benefits and future upgrades

e) Private Health Insurance & 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 many health insurers offer options to include pre-existing conditions.

But some medical conditions are permanently excluded, typically:

  • Cancer
  • Cardiovascular conditions
  • Back conditions
  • Hip or knee conditions
Compare Health Insurance NZ Costs

Factors affecting the cost of NZ private medical insurance

  • Your age
  • Gender
  • Your health: do you smoke? Your weight?
  • Cover levels and health insurance plans
The cost of private health care depends on three main factors: your personal circumstances, policy plan and if an excess is chosen.

How much does health insurance cost?

The cost of your policy will depend entirely on the cover you take out and the amount of excess you agree to pay, in the event of a claim. For this particular health insurance cost comparison, I have sourced health insurance quotes from leading New Zealand insurers and used the following:

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
Insurer / Excess$500 Excess$2.000 ExcessHealth Insurance Policy Plan
Southern Cross Health Insurance$20.57$14.53Wellbeing
nib health insurance$26.52$19.44Ultimate Health Max Base Cover
Accuro Health Insurance$23.54$16.39SmartCare+
Sovereign Health Insurance$27.74$17.98Private Health
Partners Life Health$28.13$20.47Private Medical
AIA Health Insurance$27.98$24.74Real Health
  • Excess options $500 or 2.000
  • Basic health insurance policy: similar policies with unlimited outpatient care
Insurer / Excess$500 Excess$2.000 ExcessHealth Insurance Policy Plan
Southern Cross Health Insurance$40.65$28.70Wellbeing
nib health insurance$48.64$35.67Ultimate Health Max Base Cover
Accuro Health Insurance$50.02$34.70SmartCare+
Sovereign Health Insurance$52.62$33.11Private Health
Partners Life Health$49.93$34.48Private Medical
AIA Health Insurance$52.18$45.72Real Health

Comparing NZ Health Insurance Plans

There are three main types of health insurance in New Zealand.

a) Minor Medical Insurance

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

b) Major Medical policies

typically provide cover for elective surgery, major treatments and the cost of specialist visits, but do not cover day-to-day medical expenses. 
Major Medical Health Insurance NZ

c) Comprehensive Health Insurance

products provide cover for both major surgery and day-to-day medical expenses Major medical policies are the most popular, accounting for around 69 per cent of all policies. These typically cover only health conditions which require surgical treatment and related expenses. This means you still pay for day-to-day costs like doctor’s visits and prescription charges.

Comprehensive Health Insurance NZ

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

500 people a week taking out 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 Health Funds Association of New Zealand, (HFANZ) in 2017, a record $1.207 billion was paid out in health insurance claims, up 4.8% compared to the previous year.

The total number of Kiwis with health insurance policies is now (Sept 2018) 1.4 million – more than a quarter of the population.

Around 18,500 of the 26,500 additional lives covered were in the 20-64 age group, with almost half (11,000) being aged 25-39.

174.000 Kiwi's on Elective Surgery Waiting List

Research from the Health Funds Association of New Zealand showed that 280,000 Kiwis are waiting for elective surgery, with 170,000 of these not even on a waiting list.

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

New Zealand's Healthcare Challenges

Health care workers are burning out and patients are missing out on treatment due to serious underfunding, a public services campaign organiser says. The PSA’s Yes We Care campaign was in Taranaki this week highlighting the issues they claimed underfunding was causing the country’s health care system.” The headlines are from nzherald.co.nz and stuff.co.nz I believe these headlines give an indication of the problems kiwi’s experience when dealing with local hospitals and district health boards in New Zealand.

This week was the first in about four and a half weeks that Nelson Hospital hadn't been at over 100 per cent occupancy.

Peter Bramley, Nelson Marlborough Health chief executive Tweet
Source: stuff.co.nz
Waiting times: research from Health Funds Association of New Zealand indicates the private sector has shorter waiting times for elective surgeries. This reduction in waiting times means people experience less pain and suffering, incur fewer care-related expenses and need to take less time off work.

Hutt was down three full-time radiologists, although waiting times were much better, with people waiting about a month for a non-urgent MRI scans, and roughly three weeks for CT scans.

Ashley Bloomfield, CCDHB interim chief executive Tweet
Source: stuff.co.nz

 

According to OECD, New Zealand has the third highest prevalence rate of obesity in the world.

Obesity is a key risk factor for major chronic illnesses such as cardiovascular diseases, type 2 diabetes and some cancers.

Health spending accounted for 11% of GDP in 2014, slightly more than the OECD average of 8.9%

Similar to other high-income countries, New Zealand faces the challenges posed by an ageing population, health inequities as well as the growing burden of chronic lifestyle diseases.

How much will it cost without health insurance?

The cost of waiting for an operation can have a huge impact on the patient’s family life and employment. Accessing treatment through private health insurance gives you control over when and where you’re treated. And the surgeon who treats you, and health insurance helps you pay the cost of your treatment – which otherwise might be unaffordable or significantly impact the lifestyle you’re used to. Here’s a medical treatment price table. Courtesy of nib.

Head

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 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 – $45,0000
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: All you need to know

Your health is one of your greatest assets – it helps you earn an income, support your family and live your dreams. Often people who buy private health insurance are motivated because medical cover gives peace of mind, faster consultations and quicker access to private treatment. Here are a few tips for the best health insurance in NZ.

1. The NZ Public Health System may be sufficient for your needs

The Ministry of Health (MoH) oversees and funds 20 District Health Boards (DHBs) and offers free or subsidised medical treatment to eligible New Zealanders, for accidents and acute care.

For any urgent or emergency treatment, you will be looked after in the public health system via a visit to a GP or A&E.

The private medical cover makes perfect sense for those who want faster access to treatment by avoiding public hospital waiting lists.

But with the luxurious hospital conditions also comes choice over when and where to receive treatment for medical conditions.

2. What is typically included under a private health insurance policy?

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

  • Tests, diagnostics, x-rays and minor surgery
  • Home Nursing and Hospital Allowance
  • Consultations and therapy for  recovery and support

3. What is typically excluded from health insurance?

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

4. Self-insuring can be financially challenging

Rather taking out health insurance, some people believe they could afford to pay for private treatment themselves. With many hospital procedures now costing over $20,000, self-insuring can prove really tough. Having to pay for hospital treatment yourself can often mean:
  • taking out or increasing a loan
  • Using savings or retirement funds
  • Selling assets
  • Borrowing from family

5. Accident Compensation Claims (ACC) only goes so far

Many people mistakenly believe that ACC will take care of them if they become ill. ACC doesn’t provide for treatment associated with illness or ageing or for conditions that are considered to be due to gradual deterioration or wear. only provides treatment associated with

Learn about health insurance and its benefits

Private Hospital Cover

Dental Health Insurance NZ

In New Zealand, basic dental care is free and available up until the age of 18 for eligible children. Dental health insurance in NZ is often an add-on to a wider health insurance plan rather than stand-alone dental plans.

Physiotherapy cover

 

People Often Ask

What is excess in Health Insurance?

  • 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.

Is Private Health Insurance NZ worth it?

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.

What about Health Insurance for non-NZ-residents?

NZ Visitors, non-residents and immigrants on a less than 2-year work visa may not be eligible for free healthcare in New Zealand and are required to pay for their healthcare. Tourist should have travel cover from their own home country.

If you like specialist advice, contact a LifeCovered broker

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

Is there a fee?

LifeCovered gets paid commission by the insurer. And we do not charge any fees.

Therefore our service and health insurance advice to you is free.

We are experts at what we do.

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

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

Because we have connections with various insurers, we might also be able to offer you a better deal than if you went direct, or online with a comparison site.

I think you will like it.

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