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Why Health Insurance Matters: A Comprehensive Guide

Healthcare is a fundamental aspect of our lives, and as the demands on our healthcare system continue to rise, it's crucial to consider whether having health insurance is a wise decision. Surprisingly, only about 30% of New Zealanders have health insurance, according to the Health Funds Association of New Zealand. Now let us explore the significance of health insurance and provide valuable insights into what to look for when comparing policies.

 The Public Healthcare System

With New Zealand's publicly funded healthcare system in place, some individuals might feel that additional health insurance is unnecessary. While the public system does take care of acute medical needs, it's essential to recognize its limitations. Non-acute or diagnostic requirements often lead to waiting lists, leaving individuals in discomfort and uncertainty. In fact, a significant number of people in need of elective surgery, estimated at around 280,000, didn't qualify for public treatment back in 2015.

The Importance of Health Insurance

1.     Faster Access to Services: The private health sector now offers a growing number of services that were once exclusively performed in the public sector. Having health insurance ensures you can access these services promptly and avoid extended waiting times and you can get back to work sooner and start enjoying life again.

2.     Choice of Doctors and Specialists: Health insurance grants you the freedom to choose the doctors, specialists, and surgeons you prefer, providing you with a personalized approach to your healthcare.

3.     Control Over Treatment Options: Health insurance allows you to have more control over where and when you receive treatment. This flexibility enables you to explore different treatment options tailored to your specific needs.

4.     Covering Non-Subsidized Treatments: Some treatments are not subsidized by PHARMAC, making them expensive to obtain without insurance. Health insurance can help cover these treatments, reducing the financial burden.

5.     Access to Routine Health Screenings: Regular health screenings are essential for early detection and prevention of potential health issues. Some health insurance providers include coverage for routine health screenings, helping you stay proactive about your well-being.

Health Insurance: A Wise Investment in Wellbeing

Taking out health insurance does more than just provide financial security; it also contributes to your overall wellbeing. Several factors, including psychological, physical, and social aspects, determine our wellbeing. By securing health insurance, you alleviate stress and uncertainty, which positively impacts your mental and emotional health.

Affordability and Age Considerations

One common concern about health insurance is its cost, which can increase significantly with age and as new, costly treatments become available. To determine if health insurance is right for you, consider the following questions:

1.     Do You Have Savings for Medical Bills? If you have sufficient savings earmarked for medical expenses, health insurance might not be immediately necessary, provided you don't require major elective treatments in your younger years.

2.     Can You Afford Doctor's Appointments? For some, comprehensive coverage with higher premiums might not be essential if you can afford doctor's appointments and basic healthcare costs independently.

3.     Are You Prepared for Surgery Costs? If you need elective surgery but are not eligible for public treatment, consider the potential costs involved. Health insurance can be a financial safety net in such cases.

4.     Are You Open to Cost-Sharing Policies? Some insurers offer cost-sharing policies that involve paying a percentage of the claim. This approach encourages responsible healthcare decisions and may result in lower premiums.

5.     Assess Your Health Risks: Healthy lifestyle choices, including diet and exercise, play a vital role in reducing the likelihood of needing major medical treatment. Consider your health risks before deciding on health insurance.

Choosing the Right Health Insurance Policy

When searching for health insurance, ask the following questions to ensure you get the coverage you need:

·        Does the policy exclude common procedures or medical conditions?

·        Are there limits per procedure or year for treatments?

·        How generous is the policy regarding scans and investigative procedures?

·        Can you claim for procedures that don't result in hospital treatment?

·        What minor surgeries are covered by the policy?

·        Will non-Pharmac funded drugs be covered?

·        Does the policy provide home-based nursing for post-operative care?

·        Can you claim for post-operative physiotherapy?

·        Does the insurer allow treatment overseas?

·        Are children covered from birth and until what age?

·        Are pre-existing conditions covered after a stand-down period?

·        Can you opt for cost-sharing or a higher excess for a lower premium?


Tips for Making Claims

Making a claim can be a daunting process, so here are some helpful tips:

·        Always consult your regular doctor first for advice.

·        Check whether you must visit the insurer's affiliated health providers to ensure full coverage.

·        Apply for pre-approval before undergoing any significant procedures to avoid claim rejections.

·        Review the policy terms to know what is and isn't covered, including follow-up appointments.

In Conclusion

Health insurance is a valuable investment in your wellbeing and peace of mind. It provides faster access to essential services, choice over your healthcare providers, and financial security for potentially costly treatments. By carefully assessing your needs, financial capabilities, and health risks, you can make an informed decision about whether health insurance is right for you.

Remember, your health is your most significant asset, and taking care of it is paramount. Whether you choose health insurance or not, prioritize healthy lifestyle choices, and consider regular health screenings to stay proactive about your well-being.


·        Health Funds Association of New Zealand

·        Southern Cross

·        Nib

Stay healthy and make informed decisions for a brighter and healthier future!

Call us on 0800 230 235 for a free quote today