BRAVEday Blog

What cancer screenings does medical insurance cover?

Written by BRAVEday team | Aug 20, 2018 8:58:00 PM

Early detection is critical when it comes to fighting cancer, and regular cancer screenings play a crucial role. However, not all screenings are publicly funded and often subsidised screenings don’t kick in until a certain age, leaving everyone else wondering where they stand.

Screenings do not diagnose cancer. They are designed for people who are at risk of developing cancer but show no outward signs that it is present. Screening programmes may be aimed at men or women, or certain age groups. However, it’s important to realise that outliers exist beyond the most at-risk groups that these programmes target. People can develop bowel cancer before they reach 50, for example, and men can develop breast cancer.

If you have a family history of cancer or notice symptoms, you may choose to undergo screening where you’d otherwise not, and in the case of publicly funded screenings, you may not be covered.

 

 

Funded cancer screenings

New Zealand’s national screening programme funds screenings for bowel, breast and cervical cancer.

 

Bowel

Currently the National Bowel Screening Programme is being rolled out across the country. Hutt Valley, Wairarapa, Waitemata and Southern District Health Boards (DHBs) have made a full transition to the programme. Come 2021, all DHBs will have this service in place and are expected to detect 500-700 cancers per year.

This screening is funded for:

  • Men and women.
  • People between 60 to 74 years old.
  • One screening every two years.

If you fall outside these criteria, you may find you have to pay for the full screening out of your own pocket. Most health insurance policies won’t cover this cost. However, if symptoms such as polyps are found via a colonoscopy, medical insurance will kick in since you show outward signs of having cancer.

 

Breast

BreastScreen Aotearoa is New Zealand’s breast cancer screening programme. It offers a free mammogram to women aged 45 to 69 every two years. While breast cancer is uncommon in women under 50, it does happen—approximately 30 per cent of women diagnosed are under 50.

 

Cervical

The New Zealand Cervical Screening Programme offers a reduced cost cervical screening every three years for women ages 20 to 70. Moreover, because it is publically funded, it doesn’t cost any more than it would to see a doctor.

 

Non-funded cancer screenings

Unfortunately, not all cancer screenings are publically funded, but that doesn’t mean you shouldn’t undergo them—especially if you fall into an at-risk group. While these screenings can cost, a loyalty benefit from your medical insurance company can help take away some of the sting. You’ll need to check your specific policy to see what, if any, loyalty benefits you can access.

However, if symptoms are found during a screening, the following diagnostic testing, surgery and some treatments (depending on whether your provider includes the use of non-Pharmac drugs) are covered.

Recommended reading: Common health insurance FAQs

 

Loyalty could pay off

Many medical insurance providers include loyalty benefits in their policies, which may help cover the cost of screening and cancer treatment. Accuro, for example, provides $150 to cover the cost of a health check by a medical professional after three years of continuous cover, and every three years after. Meanwhile at Sovereign, the allowance goes up to $500.

Loyalty benefits vary depending on your provider. If you have medical insurance and want to get cancer screening—particularly one that is not funded—it’s worth checking what is available. If you’re yet to choose a provider, take a look at the loyalty benefits on offer. They could help you save money and your life if they help you screen for cancer.


Every health insurance provider has different rules and benefits that cover surgery, cancer treatment, tests and specialist appointments. To help you see what the major differences are, we’ve created this handy medical insurance comparison chart, so you can make an informed decision about protecting your health.