Health (Medical) Insurance pays for medical costs incurred. Medical costs covered may include surgery and non-surgical hospitalisation expenses, specialist consultations, day-to-day (GP) treatment, dental and optical treatments, arising from the recommendation of a registered medical practitioner.

More than 1.35 million New Zealanders have health insurance. The New Zealand public health system does not cover all treatments and costs, and with no control over the timing or choice of care, the correct health insurance cover can take away the uncertainty of future health concerns. The focus of the New Zealand Public Health system is on acute (emergency) services, while private health insurers are essential in complementing the system by covering the cost of elective procedures (non-acute medical conditions).

Surgical Hospitalisation Benefit

Surgical hospitalisation benefit will cover costs which have occurred as a direct result of surgical treatment of a Non-acute Medical Condition. Examples of surgery often included are: General surgery (e.g. hip or knee replacements), Cardiac surgery, Urological surgery, Peripheral vascular surgery, Non-cosmetic plastic surgery, Gynecological surgery, Ophthalmological surgery, Oral surgery, day surgery performed by a specialist. Other expenses covered:

• Surgeon’s and anesthetist’s fees
• Operating theatre fees
• Private Hospital accommodation fees
• Diagnostic procedures
• Prostheses
• Outpatient fees for day surgery
• Surgical sundries including intravenous fluids, irrigating solutions, dressings, and prescriptions.

Non-Surgical Hospitalisation

Non-surgical hospitalisation benefit will cover costs which have occurred as a direct result of the diagnosis of any Non-acute Medical Condition.
The non-surgical hospitalisation benefit will cover the costs incurred during the period of hospital admission and may include:

• Private Hospital accommodation fees
• Specialists fees
• Treatment costs e.g. chemotherapy or radiotherapy.
• Diagnostic procedures
• Sundries including intravenous fluids, dressings and prescriptions.

Specialist Consultations

Medical cover may include all specialist consultations, tests and treatment undertaken, post-surgical home nursing care and diagnostic procedures.

Optional benefits are available for alternative health providers such as, Chiropractors, Osteopaths and Accupuncturists.

Diagnostics Investigations

Diagnostic procedures such as X-rays, MRI Scans, CT Scans, Cardiac Tests, Arthroscopy, Dilations & Curettage, Laparoscopy, Cytoscopy, Hysteroscopy, Colonoscopy and Gastroscopy can also be covered by the Health insurance policy.
Vision Care & Dental Treatment

A few selective Medical Insurance companies offer options for Dental Treatment, Optometrist’s Consultations, including spectacle and contact lenses.

Diverse benefits

Health policies may include many additional benefits, for example air or road ambulance transfer costs, support person accommodation costs, sterilisation and overseas treatment benefit.

Excess payments

The medical insurance policy may have an option of an excess payment that is applied to the treatment costs. Selecting an excess option reduces the premiums paid.