Health Insurance 

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 for accident or emergency health issues is provided by public hospitals.

You can read a general overview of health insurance on the Sorted website.   

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Who needs health insurance?

The New Zealand health system provides free or subsidised health care to eligible people. Health insurance is an option you might consider if you want easier access to a wider range of health services.

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) at a private clinic sooner than if you waited to have  the surgery at a public hospital. 

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I’m visiting from overseas for a year – can I get health insurance for the time I am here?

If you are visiting New Zealand then it is travel insurance with health cover that you need rather than health insurance.

It’s generally preferable (and is a requirement for some working holiday visa holders) to obtain suitable travel insurance before you leave your own country. However it is possible to get travel insurance that is aimed at visitors like you, when you arrive in New Zealand. Make it clear to the insurer that you are a non-resident visiting temporarily, so that you are sold the appropriate type of insurance.

The insurer may send you home if you become ill or injured while in New Zealand, if this is less expensive than paying for your medical costs here – so read your policy carefully.

Note that if you are injured in an accident while you are in New Zealand you will be covered by ACC, and - depending on what your country of residence is - you may be eligible for some types of publicly funded healthcare.

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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 those conditions from your cover;
  • limiting your cover for those conditions; 
  • charging a higher premium to cover them; or
  • excluding them until your policy has been going for a minimum period of time.

You might still benefit from having medical insurance, for example if you need treatment for a medical condition that the insurer is satisfied is unrelated to any pre-existing medical condition you had before the start of the insurance policy.

Talk to a few insurance providers, visit their websites or talk to an insurance broker about what might be the most suitable policy for your situation. There are websites which compare health insurance policies which can help you in your research.

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 make a claim, because non-disclosure of such information can invalidate your claim and/or your policy (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.

More information about pre-existing conditions and health insurance, is on this Insurance & Financial Services Ombudsman factsheet.

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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:

  • Get it while you’re young - health insurance premiums are usually cheaper when you’re young and increase in cost as you get older.
  • Consider getting a basic policy which covers only the really costly treatments, such as elective surgery, rather than one that also incudes cover for things like GP visits and prescription costs.
  • 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.
There are websites which compare the health insurance policies from different providers (e.g. search on “compare health insurance”). These can give you an idea of the range of cover and premiums.

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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 & Financial Services Ombudsman factsheet.