Private Medical Insurance – Do I really need it?

New Zealand has a very good acute health system, so if you were to be run over by a bus or had a heart attack then you would be treated immediately, however if you develop a chronic condition needing treatment this isn’t always the case.

For example, if you needed a knee replacement or surgery, the waiting lists on the public system can be longer than you think, even if you were given an approximate waiting time, events such as Covid-19 can push the waiting time out longer and by the time your surgery arrives, you could have been suffering and in pain for some time, your condition can have got worse and your quality of life has been affected. Imagine waiting 6 months for a Colonoscopy – then finding out you have Bowel Cancer.

This is why about 1.4 million Kiwi’s pay for Private medical cover. There are many different types of Private Medical policies available, and it is best to seek professional advice as to which one would be suitable for you and your family.

Regardless of this all private medical policies will help you jump the queue and get you in to hospital quicker. Some policies have add-ons that reimburse you for a portion of or all or for GP visits, opticians and dental visits. Others have add on for Specialist’s and Tests so if you need to see a specialist for a condition or need an MRI for example, these could be also paid for by the insurer.

It is our opinion that a Private Medical Insurance policy should cover non-Pharmac drugs. That is not just those drugs that are Govt. funded, but also the best available drugs available for use in NZ. These are on the Medsafe list, and many private health insurers do not fund these, or their funding is inadequate.

If you have children or grandchildren it is worth getting them Private Medical cover as early as possible as not only are the premiums cheaper up to the age of 21 but it also ‘locks in’ their good health, so as they age and if they then start to be diagnosed with an illness or condition, it would not have been excluded from the policy and still be covered for private treatment.

Some polices come with “guaranteed policy wording” and “guaranteed policy upgrade” meaning that your policy does not get locked in a ‘time warp’ if the insurer makes improvements to the policy. If they do, then they are passed on to you too, so your policy is always the latest and greatest on offer. 

Still not convinced, well if you don’t want to wait on the public system and don’t want private medical insurance here are some costs you could expect to pay if you ‘went private’.

• Cataract Surgery $2,800 - $4,800                                                   
• Tonsils removed $3,400 - $4,500
• Heart bypass   $42,000 - $65,000
• Spine Surgery $65,000 - $73,000
• Hysterectomy $8,700 - $21,700
• Hip Replacement $20,600 - $29,300
• Knee Replacement $21,600 - $30,600
• Chemotherapy $15,000 - $170,000 per round
• Radiotherapy $17,000 to $30,000 per round

Most people will claim on their medical policy during their lifetime, and, as the saying goes “if you don’t have your health, you don’t have anything” Isn’t that worth protecting?