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Avoid the wait with Medical and Health Insurance

Personal health insurance provides access to the very best medical care for non-acute conditions at a time that suits you, in the hospital of your choice...No public waiting lists.

What is Health Insurance?

This type of insurance provides quality care as and when required without the need
for waiting lists or unnecessary delays. A major medical policy, rather than
covering your day to day costs such as doctors' visits, dentists and optician
bills, is tailor made to specifically cover 100% of the costs associated with major
medical procedures as well as hospital visits and specialist consultations.

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Why do I need Health Insurance?

The public health system is overloaded and it is only going to get worse.  
Public waiting lists are getting longer and longer. No one plans to get sick but if you
did and you needed medical treatment, wouldn't you want to be able to access the
help you needed quickly?  The sooner you can get treatment, the sooner you can get
back to living your life.

You can also include cover for specialist visits, this means that you don't have to wait.  
You can see a private specialist quickly and get the help you need.

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When should I get Health Insurance?

Get it when you are young and healthy - in other words, before you need it - so the
chances of having exclusions on your policy will be minimised.

By adding your children to your policy when they're born, you can avoid any
exclusions.  Most insurance companies let you add your child to your policy
before they're three months old without any underwriting or an application form - they usually need a written request and copy of the birth certificate.  We can handle all of
this for you.

If you let us know when you have little people on the way; we can make a note to
remind you to add them to your policy.

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What about ACC?

Many people mistakenly assume that ACC will take care of them if they become ill.  ACC
only provides cover for medical issues that are a result of an accident, not if you need treatment for an illness.

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What is a pre-existing condition?

A pre-existing condition is a health issue that you knew about (or suspected) before taking out Medical Insurance. Most policies don't cover pre-existing conditions, but some companies allow them to be reviewed after a period of time.

Some insurers will cover a pre-existing condition and charge a higher premium. An example of this is if you are significantly overweight.  You may still be able to get cover, but will pay a little more.

There's a lot of variation in the offerings from different insurance companies, your adviser can take you through all the different options to find the one that's best for you.

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Do I have the right cover?

Some personal Medical Insurance plans may seem like good value for money as they are comparatively less expensive, but you get what you pay for.

Your Health Insurance could be costing you more than it should, if your policy covers you for GP visits and prescriptions.  The cost of premiums for this type of cover is approximately $500 per annum more than a major medical policy.  Unless you're visiting the doctor 8 to 10 times a year (at $40 per visit), it's simply not value for money.  The same applies to cover for dental and optical, unless you are claiming the full amount every year it's not a strategic decision.

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I did not have to concern myself with filling in copious forms or spending time on the phone with the insurance company.

Due to having medical cover I had several options. I was able to plan my surgery date to suit my family, select one of the best surgeons in the country and book into a private hospital. All too easy!

Mark Hobday

Can I choose to be treated by any doctor, specialist or private facility?

For the most part, yes. Unlike the public health system, you are not assigned to a doctor; you can choose your own. You also have greater control over where (and when) you are treated. However, all providers require your chosen specialist to be a registered medical professional.

Some providers, such as AIA, require policy takers to undergo treatment in one of their recognised private hospitals, while other providers such as Southern Cross require you to access treatment through an affiliated provider. To avoid any surprises, read the fine print of your preferred policy before you opt in.

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Will my medical insurance cover me while I’m overseas?

Australia and the UK have reciprocal health care agreements with New Zealand and some cancer patients may opt to seek treatment overseas. In these circumstances, several medical insurance providers include overseas treatment in their policies. Conditions do apply and they can vary depending on provider.

Important: An overseas treatment benefit should not be used in place of travel insurance.

Some providers also include a medical tourism benefit that allows the policyholder to seek medical treatment in a country of their choice. The key provisor is that the treatment must be recommended by a registered specialist in New Zealand. The treatment must also be of a type that could be performed in New Zealand within the next six months.

Most providers have additional clauses about the kind of cover their medical tourism benefit includes, so we recommend reading the fine print of your policy if you intend to seek treatment outside New Zealand.

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What about travel insurance for my pre-existing conditions?

Unfortunately, travel insurance policies will exclude any pre-existing condition. In the case of cancer, this also includes any cover for cancelled air fares and cancer-related costs while you travel.

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Can I get health insurance if I’ve had cancer?

Yes. However, most insurance providers will not cover serious pre-existing conditions such as cancer. If you have had cancer and want to take out a new health insurance policy, cancer cover will likely be excluded from your new policy.

To avoid exclusions relating to pre-existing conditions, we recommend getting medical insurance while you are young and healthy. This way, you are not only covered for any health issues that appear after you’ve taken out a policy, but you also reduce the risk of a claim being affected by a previous medical condition.

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Does medical insurance cover cancer treatment?

Yes. However, there are limits. Some insurance providers only cover Pharmac (publically funded) drugs, while others will extend their cover to non-Pharmac drugs that are on the Medsafe approved list.

The amount of cover also varies from provider to provider. For example, Southern Cross’s Wellbeing Two policy covers up to $10,000 worth of claims per year in chemotherapy treatment only, while Partners Life covers up to $300,000 per year.

All health insurance has some form of surgery cover and this can vary from $300,000 per person, per year to an unlimited value.

To make sure you get the right cover, we recommend you read the fine print of your preferred policy.

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Will my medical insurance cover cancer screening

No. However, you may be able to utilise a loyalty benefit (if you policy has this) towards the cost of elective screening.

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What are the excess options?

Most insurers offer the option of adding an excess - in other words you pay a set amount of the bill and your insurance pays the rest; the higher your excess, the lower your premium. Note: excess options vary between companies and you can increase your excess at any time.

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How do I claim?

To make a health insurance claim, you need to complete a form and send it to your insurer along with any referral letters or other supporting documentation. We can sort and send the paperwork for you, and act as your advocate.

We always recommend you get prior approval for treatments and investigations, so you know for certain that you will be covered, giving you one less thing to worry about.

It's really important to give the insurance company as much information as possible to allow them to process your claim quickly.

Protect your health. Get in touch.