Health Insurance in New Zealand
Faster treatment, more choice, better care
Health insurance gives you access to private healthcare, shorter wait times, and a choice of specialists. While New Zealand's public health system is good, private health insurance means you can get treatment when you need it, not when the waitlist allows.
DBI LTD — Financial Adviser (FSP 1007984), operating under AIA Thrive Limited (FSP 665291).
Key Facts
Why Health Insurance in NZ?
Public healthcare in NZ (including ACC for accident-related injuries) is free, but it has major limitations—especially for non-ACC medical conditions, cancer treatment access, and specialist wait times.
Public System Wait Times (2024):
- Hip replacement:12–18 months
- Cataract surgery:6–12 months
- Specialist appointment:3–6 months
- Non-urgent surgery:6–24 months
Cancer treatment challenges:
- •Some treatments require long waits
- •Access to non-Pharmac cancer drugs is limited
- •Specialist referrals may be delayed
With Private Health Insurance:
- Hip replacement:2–6 weeks
- Cataract surgery:1–3 weeks
- Specialist appointment:Within days
- Non-urgent surgery:Weeks, not months
Cancer treatment benefits:
- •Access to non-Pharmac cancer medications
- •Wider choice of specialists
- •Faster diagnostics → early intervention
Health insurance lets you skip the queue and get treated on your timeline. Pair health insurance with trauma insurance for comprehensive medical protection.
What Health Insurance Covers
Typically Covered (Hospital & Surgical Plans):
- Specialist consultations (surgeons, cardiologists, orthopaedics)
- Diagnostic testing (MRI, CT, PET scans, ultrasounds)
- Surgical procedures (cancer, cardiac, orthopaedic, general)
- Hospital accommodation (private room)
- Specialist follow-up visits
- Cancer treatment, including some non-Pharmac funded drugs (depends on policy)
- Physiotherapy and rehabilitation after surgery
- Mental health support after eligible hospital treatment
- Major diagnostic tests with pre-approval
Not Usually Covered:
- GP visits (unless you add GP cover)
- Prescription medications (unless you add prescription cover)
- Pre-existing conditions (initial stand-down periods apply)
- Cosmetic procedures
- Elective fertility treatment
- Routine dental care (unless add-on purchased)
- Anything already covered under ACC
Optional Add-Ons (available with some insurers):
How Health Insurance Works in New Zealand
Health insurance covers private hospital care, surgery, diagnostics, and specialist treatment for illnesses not covered by ACC. You pay a monthly premium, choose an excess ($250–$10,000), and your insurer covers the remaining approved treatment costs.
Most NZ health insurance policies include:
- Hospital & surgical cover
- Cancer treatment benefits
- Diagnostic imaging
- Specialist consultations
- Specialist follow-up care
You can optionally add:
- GP & doctor visits
- Prescriptions
- Dental & optical
- Day-to-day healthcare cover
- And more depending on the insurer
When you need treatment, you:
- Get a referral from your GP (or go directly to a specialist if your policy allows)
- Book with a private specialist or hospital
- Your insurer pre-approves the treatment
- You pay your excess once per policy year and this covers all treatment in that year
- Your insurer covers the remaining approved costs
Your adviser will help you select a plan that matches your health needs and budget.
Is Health Insurance Worth It?
Health insurance in NZ is often considered a lower priority than life, trauma, income protection, and TPD—mainly because we have ACC and a strong public health system. But when you need treatment urgently or want access to non-Pharmac cancer medication, private health insurance becomes extremely valuable.
Consider health insurance if:
- You want faster access to treatment
- You have ongoing health conditions
- You value choice (specialists, hospitals)
- Public waitlists stress you out
- You have a family with kids
- You're approaching 40+ (when health issues increase)
You might skip it if:
- You're young, healthy, and low-risk
- Budget is very tight
- You're comfortable with public system wait times
Our take: Health insurance is peace of mind. You might not need it now, but when you do, you'll be glad you have it.
Who Needs Health Insurance?
Health insurance is valuable for most New Zealanders, especially:
Families with young children
Kids get sick and injured often. Private health insurance means faster access to specialists and treatment without long public wait times.
People with ongoing health conditions
Chronic conditions often need specialist care. Health insurance gives you faster access and more treatment options.
Anyone wanting faster surgery
Hip replacements, cataract surgery, and other procedures can take 12-18 months publicly. Private insurance = weeks, not months.
People aged 40+
As you age, health issues become more common. Locking in health insurance while you're healthy means better rates and coverage.
Those concerned about cancer
Access to non-Pharmac cancer drugs and faster diagnostics can be lifesaving. Health insurance provides peace of mind. Consider pairing with trauma insurance for lump-sum cancer diagnosis payments. trauma insurance
High earners or business owners
You can't afford months off work waiting for public surgery. Health insurance keeps you healthy and productive.
Frequently Asked Questions
Do pre existing conditions affect health insurance?
Are pre existing conditions ever covered later on?
Can I claim on more than one health insurance policy?
Do I still need health insurance if I am covered by ACC?
Does health insurance cover non Pharmac funded cancer drugs?
Can I upgrade my health insurance policy later?
What happens if I miss a premium payment?
What is the difference between hospital cover and comprehensive cover?
Have more questions?
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