What is health insurance?
Who needs health insurance?
I'm not in good health. Is health insurance still an option for me?
How can I lower the cost of my medical insurance?
Does the insurance company have access to my medical records?
What is health insurance?
Health insurance provides cover for medical costs, and makes it easier for you to access health services which are not publicly funded.
In general, health insurance policies cover non-urgent medical treatment; treatment of accident or emergency health issues is provided by public hospitals.
You can read 
this brochure from the Health Funds Association of New Zealand, for a general overview of health insurance.
Who needs health insurance?
The New Zealand health system provides free or subsidized health care, however not all health services are covered, and not everyone is eligible.
Health insurance is an option if you are not eligible for publicly-funded health care, or if you want additional cover.
For example, even if you are eligible for publicly-funded healthcare, having health insurance can enable you to have elective surgery (e.g. a hip replacement) sooner than if you waited to have the surgery at a public hospital. Or, if you have children, you might consider getting health insurance which covers all of their visits to the doctor.
I'm not in good health. Is health insurance still an option for me?
If you have pre-existing medical conditions, then the insurance company is likely to deal with it by:
- excluding them from your cover or
- charging a higher premium to cover them or
- excluding them until your policy has been going for a set period of time.
You might still benefit from having medical insurance, for example if you develop a condition unrelated to any pre-existing medical condition you might have had before the start of the insurance policy.
It’s best to talk to a few insurance providers (or an insurance broker) about what might be suitable for your situation.
It’s important to be upfront about your medical history, as this will affect what kind of cover you can expect and how much your premiums would be. It will also avoid potential problems in future if you have to claim, because non-disclosure of such information can invalidate your claim (more about this is on our General Insurance Issues page.
The insurance company may request a medical report from your doctor or require a medical inspection through their appointed medical expert, to be satisfied that you qualify for health insurance.
More information about pre-existing conditions and health insurance, is on this Insurance & Savings Ombudsman factsheet.
How can I lower the cost of my health insurance?
Below we have listed a few factors which can lower the cost of your health insurance premiums:
- Consider getting a basic policy which might cover only the really costly treatments, such as surgery. Adding on cover for things like GP visits and prescription costs can almost double the amount of your premium.
- As for insurance in general, agreeing to a higher excess will generally bring down the amount of the premium.
- Some policies have lower premiums for people who lead a ‘healthy’ lifestyle e.g. people who exercise regularly and don’t smoke.
- Some insurers offer a discount if you take out more than one insurance policy with them e.g. health insurance plus home and contents insurance.
- If your workplace has a group insurance scheme for employees, the premiums may be lower than for similar insurance cover which you get as an individual. The group scheme may also have extra coverage e.g. for pre-existing conditions
- Check whether the policy has a no claims bonus. If it does, you might decide to avoid claiming for the relatively affordable or minor health treatments.
Does the insurance company have access to my medical records?
It depends on whether you signed an agreement giving them access to your medical records, when you signed up to your health insurance policy.
An insurer can only access a client’s medical records if the client has given them the authority to do so, and they may only collect enough information to make a decision about the client’s insurance. If they access a client’s medical records unnecessarily, they may be in breach of the Health Information Privacy Code.
If your health insurer has asked for authority to access your medical records, ask them to clarify how much access they are asking for, when they would use it, and how they would use the information. It’s also a good idea to have a look at those records yourself, so you are aware of what information you would be allowing your insurer to see.
More information about disclosure of information and health insurance is on this Insurance & Savings Ombudsman factsheet.