Basic health insurance

This type of insurance is designed to cover everyday health needs, providing Kiwis with additional support for primary healthcare services.

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Comprehensive Guide to Basic Health Insurance in New Zealand

Introduction to Basic Health Insurance

What is Basic Health Insurance?

In New Zealand's healthcare landscape, basic health insurance plays a crucial role in complementing the public health system. This type of insurance is designed to cover everyday health needs, providing Kiwis with additional support for primary healthcare services. Understanding basic health insurance can help you make informed decisions about your healthcare coverage and potentially save on medical expenses.

Basic health insurance, also known as everyday or primary care insurance, is a policy that covers routine healthcare needs. It's typically more affordable than comprehensive plans and focuses on services you're likely to use regularly.

Key Coverage Areas

1. GP Visits Most basic health insurance plans in New Zealand subsidise visits to General Practitioners (GPs). This coverage can significantly reduce the cost of regular check-ups, vaccinations, and treatments for minor illnesses. Some policies may cover a set number of visits per year, while others offer a percentage discount on each visit.

2. Prescription Medications Basic plans often contribute towards the cost of prescription medications. This usually includes a wide range of commonly prescribed drugs. Some policies may cover the entire cost after the standard $5 prescription fee, while others might offer a percentage subsidy.

3. Diagnostic Tests Coverage typically includes routine diagnostic tests such as:

Blood tests

X-rays

Ultrasounds This can speed up diagnosis and treatment for various conditions, reducing wait times you might experience in the public system.

4. Specialist Consultations Some basic plans offer limited coverage for specialist consultations. This might be capped at a certain number of visits per year or up to a specific dollar amount. It's important to check if your plan requires a GP referral for specialist visits to be covered.

5. Minor Surgical Procedures Certain minor surgical procedures, often performed in a GP's office or outpatient clinic, may be covered. These could include:

Skin lesion removals

Minor biopsies

Ingrown toenail surgeries

6. Preventive Care Many basic health insurance plans emphasise preventive care, which may include:

Annual health check-ups

Flu vaccinations

Screening tests (e.g., cholesterol checks, diabetes screening)

Benefits of Basic Health Insurance

Affordability

Lower premiums compared to comprehensive health plans make basic insurance accessible to a wider range of Kiwis.

Reduced out-of-pocket expenses

By covering routine healthcare costs, basic insurance can significantly lower your day-to-day medical expenses.

Faster access to services

With private insurance, you may be able to access certain services more quickly than through the public system.

Complement to public health

Basic insurance works alongside the public health system, filling gaps in coverage and potentially reducing strain on public resources.

Predictable healthcare costs

By covering routine needs, basic insurance can make your healthcare expenses more predictable and easier to budget for.

Who Should Consider Basic Health Insurance?

Individuals in good overall health who want coverage for routine care

Young adults starting their healthcare journey

Families looking for affordable coverage for day-to-day health needs

Those who primarily use public health services for major medical needs but want additional support for routine care

People looking to reduce costs for primary healthcare services

Choosing the Right Basic Health Insurance

When selecting a basic health insurance plan in New Zealand, consider the following factors:

Coverage Limits

Check the annual limits for different types of care. Some plans may have:

Overall annual limits

Specific limits for different services (e.g., a cap on specialist consultations)

Per-visit limits

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Excess Options

Many insurers offer different excess levels. A higher excess usually means lower premiums but more out-of-pocket expenses when you claim. Consider your budget and how often you're likely to use your insurance when choosing an excess.

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Network Providers

Some insurers have preferred provider networks. Using these providers may result in:

Lower costs

Easier claim processes

Faster approvals

Check if your preferred healthcare providers are in-network for the plans you're considering.

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Claim Process

Understand how to make claims. Some insurers offer:

Easy online claim systems

Mobile apps for quick claim submissions

Easy online claim systems Mobile apps for quick claim submissions Automatic payments to healthcare providers

Others may require more paperwork. Choose a system that fits your preferences and technological comfort level.

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Waiting Periods

Be aware of any waiting periods before you can claim for certain services. Common waiting periods might apply to:

Pre-existing conditions

Pregnancy and birth-related services

Certain specialist services

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Pre-existing Conditions

Most basic plans exclude pre-existing conditions. Understand how your insurer defines and treats these. Some may offer:

Gradual inclusion of pre-existing conditions after a set period

Coverage for pre-existing conditions with a loading on premiums

Exclusion of specific conditions while covering others

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Where to Buy Basic
Health Insurance

Southern Cross

Southern Cross is a well-established name in the New Zealand health insurance market. As a not-for-profit organisation, it focuses on returning value to its members.

Offers a range of plans, including basic options like their "Wellbeing Starter" plan

Known for efficient claim processing, with many claims settled within 5-7 working days

Provides a mobile app for easy claims submission and policy management

Offers a network of affiliated healthcare providers for potential cost savings

Regularly scores high in customer satisfaction surveys

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Nib

nib entered the New Zealand market in 2012 when it acquired Tower Medical Insurance. Since then, it has grown to become one of the major players in health insurance.

Offers flexible coverage with their "Basic" plan as an entry-level option

Provides digital tools including a mobile app for policy management and claims

Focuses on preventive care with programmes like health screenings

Offers coverage for some pre-existing conditions after a waiting period

Provides options for adding extras like dental and optical cover to basic plans

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AIA

AIA is a global insurance provider that entered the New Zealand health insurance market by acquiring Sovereign in 2018.

Offers integrated life and health insurance options

Provides a vitality programme that rewards healthy lifestyle choices

Offers loyalty benefits for long-term customers, such as increasing cover over time

Provides options for both individual and business health insurance

Offers a "Private Health" plan as their basic health insurance option

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UniMed

UniMed is another member-owned, not-for-profit health insurer with a history dating back to 1979.

Offers both comprehensive and basic plans, with their "UniCare" plan as a basic option

Provides options for both individuals and employer groups

Known for its strong focus on customer satisfaction

Offers some unique benefits like cover for obstetrics and infertility treatment on certain plans

Provides loyalty benefits, increasing certain benefit limits over time

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