What is Health insurance?
Health insurance (also known as medical insurance) gives you choice and control and ensures you have prompt access to the best healthcare services when you need them. None of us know what kind of health problems will affect us but it’s reassuring to have choice and control when the unexpected happens.
You can choose a variety of policy types according to your budget and needs. Some people choose ‘hospital and surgical only’ cover, to make sure they’re covered for the big things. Others prefer to take a policy that provides doctor, dentist and optometrist cover. Some policies allow you to ‘mix and match’ covers to suit your personal needs.
If you have health insurance you don’t need to worry about the public system. You can avoid the waiting lists all together and choose when and where you will have your treatment and who will provide it. Some health insurance policies allow you access to services, treatments and drugs that are not available through the public health system. For example Herceptin is available to breast cancer suffers through one particular policy.
Possible benefits of health insurance
- You choose who provides your treatment, where you receive it and when
- Have your surgical costs including surgeon's fees and anaesthetist fees paid
- Hospital charges in relation to your confinement paid
- Specialist visits paid for
- Diagnostic tests paid for
- Overseas treatment paid for if the required treatment is unavailable in New Zealand within six months
- Caregiver accommodation paid
- Outpatient care paid
Typical costs of surgery
Please note these costs are indicative only as charges for individual cases vary (source: Sovereign Claims Statistics - 2008).
| Procedure | Price range |
| Angiogram (diagnostic test) | $3,000 - $3,200 |
| Angioplasty with drug eluding stents | $26,000 - $28,000 |
| Valve Replacement (coronary surgery) | $47,000 - $65,000 |
| Cardiac bypass (heart surgery) | $44,000 - $55,000 |
| Cataract removal per eye (eye surgery) | $2,600 - $3,000 |
| Colonoscopy (diagnostic test) | $1,400 - $3,000 |
| Hip Replacement | $28,000 - $30,000 |
| Knee Replacement | $24,000 - $26,000 |
| Brachytherapy (prostate cancer treatment) | $26,000 - $32,000 |
| Radical Mastectomy (breast cancer surgery) does not include reconstruction |
$12,000 - $14,000 |
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How much does health insurance cost?
For two non-smoking adults health insurance can cost less than one cappuccino per day. Premium costs are calculated mostly on age and health.
The best way to find out how much health insurance is likely to cost you is to talk to one of our specialists. They have the power to advocate on your behalf to New Zealand’s leading insurance companies and find the best possible deal to meet your needs. Your age, health status, the types of benefits you choose, along with the level of excess (and other factors), will influence the cost of your premium.
The following information is general in nature as individual cases vary, however, it was accurate on 11 March 2008.
| About the adults | Children | Some of the benefits | Excess | Approximate cost per month |
| Male 40 years and female 39 years – non smokers | Two preschoolers | Full cover for cost of surgeons and anesthetist, and hospital charges in relation to stay required for medical illness or surgery. Visits to specialist covered along with diagnostic testing. | none | $150 |
| As above | As above | As above | $300 | $122 |
| Male 30 years, female 32 years – non smokers | None | Full cover for cost of surgeons and anaesthetist, and hospital charges in relation to stay required for medical illness or surgery. Visits to specialist covered along with diagnostic testing. | none | $96 |
| As above | As above | As above | $300 | $78 |
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When is the best time to take out health insurance?
The best time to take out health insurance is when you are healthy. If you are healthy when you take out health insurance your premiums will be less. If you suffer a sickness or an injury before getting cover, that condition may be excluded from insurance cover for the rest of your life, or you may have to pay an additional fee to have it covered. The younger and healthier you are the less it will cost you.
Can I get health insurance cover for a pre-existing medical condition?
Pre-existing conditions are usually handled one of three ways:
- They may be excluded from your cover
- You may be charged an additional fee to receive cover for the condition
- Or an offer may be made to you to cover the condition after a set period of time (if it does not cause any health problems within this time)
Who doesn’t need health insurance?
If you have tens of thousands of dollars available for medical treatment you don’t need health insurance. If you are happy to rely on the public health system and negotiate the waiting lists you don’t need health insurance.
Who should have health insurance?
People who want or need choice and control when it comes to:
- Scheduling treatment at a convenient time
- Where treatment occurs
- Choosing who will provide the treatment