Best health insurance in New Zealand

Willi Olsen
Willi Olsen

Willi Olsen is a financial adviser and life insurance expert, and father of two who loves reading and listening to podcasts about philosophy, health, finances and history.

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Below are the top 5 Health Insurance providers in New Zealand. Health insurance gives you priority with private healthcare providers so you can get access to the fastest and best medical treatment of the highest standard when you need it the most.

Health insurance pays your private medical admission: general surgery, diagnostic procedures, cancer treatment and more.

Comparing life insurance with health insurance, you or your loved ones receive the payout from life insurance. Whereas with health insurance, you typically don’t see any money, but the health insurer pays for your treatments.

There are several important points to keep in mind when choosing the best health insurance including:

  • value for money,
  • customer service,
  • claims service,
  • financial strength,
  • policy offerings and
  • cover benefits.

There is no one best health insurance policy, but the best one for you will depend on the type of health insurance you need and your budget.

Finding the best health insurance can be troublesome and confusing because there are so many medical policies to choose from.

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 three levels of private health insurance available in New Zealand:

  • Minor,
  • Major and
  • Comprehensive.
Health insurance is not to be confused with trauma insurance or critical illness insurance. There are similarities but are two uniquely different policies.

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

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

Compare Best Health Insurance Guide 2021

Compare-Best-Private-Health-Insurance

Which is the best health insurance in NZ?

Which are the best health insurance companies in New Zealand? It’s hard to know how to select the right private health insurance cover when there are so many options to select from.

We’ve done some of the hard work for you by examining which health insurance companies in New Zealand are in the top.

We’ve looked at their: 

  • credit strength,
  • market share,
  • excess options,
  • cancer cover,
  • optional extras such as GP, Dental etc and
  • how they deal with existing conditions.

To find the best health insurance for you and your family, it’s is important to the question: what do you want health insurance to do for you? Because there is no one best health insurance policy for everyone, ie. one policy cannot cater to everyone’s needs, it is important to get specialist health insurance advice from a broker to sort out the best health insurance for you.

1. Southern Cross Health Society

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.

2. nib health cover

nib health insurance

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.

3. Partners Life Medical Cover

PartnersLife Private 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.

4. AIA Health Insurance

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.

5. Accuro Health Insurance

Accuro Health Insurance

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.

How to choose the best health insurance

Simplifying health insurance is something we think about a lot.

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

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 the best health insurance simple.

a) Cancer Cover: Surgical and Medical Cancer Treatment

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 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) What is excess in health insurance

Most health insurance policies include an optional excess starting from $250.

Excess or a copayment is a fixed dollar amount you have to pay, if you make a claim on your health insurance policy. The higher the excess, the greater discount you receive on our health insurance premiums. 

It’s a way of you accepting a small portion of the risk yourself.

Excess is 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 excess is charged 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 Common Excess/copayment options: 

  • $250,
  • $500,
  • $1,000,
  • $2,500
  • $4,000
  • $6,000 and some insurers offer option for
  • $10,000 in excess.

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?
  • Cover levels and health insurance plans
  • Excess or co-pay

The cost of private health care depends on three main factors: your personal circumstances, policy plan and if an excess is selected.

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:

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+
Partners Life Health$28.13$20.47Private Medical
AIA Health Insurance$27.98$24.74Real Health

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
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+
Partners Life Health$49.93$34.48Private Medical
AIA Health Insurance$52.18$45.72Real Health

Comparing NZ Best 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 medical 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.

  • 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: All you need to know

Your health is 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 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

4. Self-insuring can be financially challenging

Rather taking out medical 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. Have you considered your own income protection insurance policy?

Learn about health insurance and its benefits

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.

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.

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 is tailored around who you are, what your needs are and your budget.

Because we have partnered 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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