Health Insurance
Health Insurance (AKA: Private Medical Cover) provides the funding to enable you to have private medical treatment whenever you require more immediate access or a broader range of treatment options than are available to you through the public health system in NZ.
Common Health Insurance Benefits
Hospitalisation Treatment
Health insurance policies will cover your hospitalisation costs should you decided to book into the private health system. This will cover both surgical & non-surgical treatments you require.
Australasian Treatment
Some health insurance policies will cover treatment that is undertaken in not only New Zealand but also Australia.
Non-PHARMAC Drugs
Some policies do not limit coverage of drug treatments to those funded by the government (PHARMAC). This allows you access to the most effective & up to date treatment options available that would otherwise be very expensive.
Excess Options
Health insurance policies have excess options ranging from $0, $250, $500, $1000 and beyond. An excess is the amount you pay during a claim before the insurer starts covering the rest. A larger excess means cheaper premiums.
Major Diagnostic Costs
If you require any expensive diagnostic tests (e.g. MRI, CT Scan, Angiogram, Colonoscopy etc.) your health insurance policy will most likely cover these costs. Note: Specialists & Tests coverage can be added to most policies for an additional fee which broadens this cover significantly.
Health Insurance FAQ’s
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Basic policies cover hospital treatment, including most surgical & non-surgical procedures.
Stronger policies also include coverage for specialist appointments that your GP refers you for, as well as diagnostics and scans (X-rays, CT scans, MRI’s, endoscopies etc.).
Some policies such as Southern Cross also have an option to include day-to-day coverage.
(Policies differ quite significantly between insurers, we will advise which insurer could be best for you.)
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The "excess" is the portion of the medical bill that you pay (e.g. if your claim is $5,000 and your excess is $250, you'd pay $250 and the insurer pays the rest).
You can change the level of excess to modify the cost of the insurance.
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Get into contact with us. We will start the claim process with the insurer on your behalf, making it super easy for you.
There are 2 ways to claim:
- Ask for prior-approval before your treatment or surgery occurs (recommended). This means the insurer will pay the healthcare provider directly. This keeps it simple for you.
Note: please allow 7 working days for insurer approval to be given.- Get reimbursed after if you didn’t get prior approval. Send us the invoice & receipt and we will get the insurer to reimburse you.
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Maybe. Depending on your current plan there might be benefit in changing whether it’s for price reasons or strength of cover.
However, do not cancel any current cover until your new cover is in place. If you have pre-existing conditions then this is especially critical as your new insurance may not cover them.
To make it easier, we can cancel your old cover on your behalf at the appropriate time.
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Yes!
Some common costs for procedures in NZ
Health Insurance Resources
Elan Client Story - Health Insurance
28/05/2023
Our 58 year old client Stuart, a farmer, was diagnosed August 2021 with superficial siderosis after noticing sudden hearing loss and having various tests and imaging completed.
Superficial siderosis is a very rare condition, affecting roughly 1 in 1,000,000 people and has no known cure. It involves slow bleeds into the brain and / or spine.
After researching, his neurologist advised that overseas there had been some success delaying progression by using Ferriprox ‘off label’ (the prescription of a drug for a condition other than that for which it has been approved). With no NZ government funding or assistance available, the only problem was the cost - $300/day.
While our client’s health insurance paid for all the specialist consultations and investigative tests to be done, as Ferriprox was being used off label and to quote, ‘is not Medsafe indicated or FDA approved for patients with siderosis’ our claim for reimbursement of the cost of the drug was declined – twice. (Note, this is beyond simply a non-PHARMAC funded drug claim and strays more into experimental treatment, hence the insurer's reluctance.)
We tried a 3rd time with presentation of overseas papers discussing the useful results of using the drug in the case of superficial siderosis, we got acceptance! Stuart is now getting reimbursed the cost of the drug for the next 6 months (totaling $55,000 worth), which otherwise he would not have been able to afford.
A perfect example of how having a persistent broker, that is actually willing to fight for their clients could be the difference between getting the treatment you need or not. We are very proud of this result and hope that the treatment proves useful for Stuart.
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“I felt like he genuinely cared and had my best interests at heart”
Kayla Craig
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“I could not reccommend these guys more - they made it easy & painless.”
Gina Brighouse
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“Easy to deal with, very professional & knowledgeable regarding insurance.”
Graeme Turner