Specialist 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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Understanding Specialist
Health Insurance

Specialist health insurance in New Zealand provides coverage for medical procedures and treatments beyond what's offered by the public health system. This type of insurance can give you faster access to specialists and elective surgeries, reducing wait times and potentially improving health outcomes.

Key Benefits of Specialist Cover

Reduced waiting times

Choice of specialists and hospitals

Access to advanced treatments

Coverage for non-Pharmac funded medications

Peace of mind for unexpected health issues

Types of Specialist Health Insurance

Comprehensive plans

Cover a wide range of specialist treatments and surgeries

Modular plans

Allow you to choose specific areas of coverage

Hospital-only plans

Focus on inpatient care and surgical procedures

Common Inclusions

Specialist consultations

Diagnostic imaging (MRI, CT scans, X-rays)

Surgical procedures

Cancer treatments

Heart and cardiovascular care

Orthopaedic surgeries

Factors Affecting Premiums

Age and health status

Level of coverage

Excess options

Pre-existing conditions

Choosing the Right Policy

Consider these factors when selecting specialist health insurance:

Your health needs and family medical history

Budget and affordability

Waiting periods for coverage

Policy exclusions and limitations

Claim processes and customer support

How Specialist Insurance Complements Public Healthcare

While New Zealand's public health system provides quality care, specialist insurance can offer:

Faster treatment for non-urgent conditions

Coverage for procedures not funded by the public system

Greater flexibility in choosing healthcare providers

Making a Claim

Obtain a referral from your GP

Contact your insurer for pre-approval

Schedule your specialist appointment or procedure

Submit required documentation to your insurer

Receive treatment and settle any excess payments

Tax Considerations

In New Zealand, premiums for personal health insurance are generally not tax-deductible. However, some employers offer health insurance as a taxable benefit.

Reviewing Your Coverage

Regularly review your specialist health insurance to ensure it meets your changing needs. Consider:

Life stage changes (marriage, children, retirement)

Health status changes

New policy options in the market

Specialist health insurance can be a valuable addition to your healthcare strategy in New Zealand. By understanding the options available and carefully considering your needs, you can select a policy that provides peace of mind and timely access to specialist care when you need it most.

Where to Buy Specialist
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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Specialist Health insurance