About 1.2 million of New Zealand’s estimated 5.2 million residents are covered by private health insurance, according to the Financial Services Council’s (FSC) latest industry snapshot, a figure that is equivalent to almost a quarter of the entire Kiwi population.
Overall, the country’s top health insurance providers have written $948.7 million worth of premiums and paid out $697.3 million in claims in the first half of 2022, a slight drop from the $950.2 million in premiums written and $741 in claims paid in the same period last year.
Despite the dip, these numbers still indicate a thriving private health insurance market in a nation where the public health system, along with the Crown entity Accident Compensation Corporation (ACC), already provides a good level of support for accident and acute care.
Although covered by the public healthcare system, a considerable number of Kiwis are taking out private health insurance because of “the reassurance in knowing they’re covered in the event of a medical incident,” according to LifeCovered, a Hamilton-based digital life and health insurance brokerage.
The insurtech firm added that despite the benefits offered by New Zealand’s public health system, especially for emergency medical treatments, “public hospitals cannot provide everything for everyone.”
“If a condition is non-emergency, you will usually need to go through an assessment process and qualify for ‘elective’ treatment in the public system,” the company noted.
Data gathered by LifeCovered has shown that unmet demand for elective surgery has reached an estimated 174,000 Kiwis in recent years. The firm also found that those with public health insurance can have their surgeries 100 days earlier on average compared to those relying on the public health system.
“Common elective treatments include hip or knee replacement, heart surgery, hysterectomy, cataract removal, cancerous tumour removal, and diagnostic services such as endoscopy, laparoscopy, MRI scans, tonsillectomy, and grommets,” the company explained.
“Private health insurance covers the cost of many non-urgent procedures and allows patients to receive treatment at private hospitals more quickly. When you don’t have to wait for treatment in the New Zealand health system, you can get back to work faster and live a better life.”
Medical care in New Zealand can be very expensive, especially for those who do not have sufficient coverage. Here’s how much Kiwis need to shell out for common medical procedures, according to Southern Cross, the nation’s largest private health insurance provider. The costs are based on the insurer’s claims data for the 2020-21 financial year.
|
Medical procedure |
Average cost range |
|
Skin cancer removal |
$200 to $2,400 |
|
Colonoscopy (with or without associated procedure) |
$1,500 to $3,200 |
|
Grommet surgery |
$2,100 to $2,500 |
|
Tonsil removal |
$4,400 to $6,400 |
|
Squint correction |
$5,100 to $7,800 |
|
Varicose veins |
$6,300 to $7,800 |
|
Endometriosis surgery |
$8,400 to $21,000 |
|
Prostate cancer surgery |
$18,600 to $25,800 |
|
Hip replacement |
$22,400 to $27,300 |
|
Knee replacement |
$23,100 to $27,700 |
|
Heart valve replacement surgery |
$63,100 to $80,400 |
Source: Southern Cross Heath Insurance
In general, there are three types of health coverage that New Zealanders can access. These are:
Read more: Revealed: Kiwis' most common health insurance claims
When looking for a health policy that best suits their needs, consumer website Top Reviews NZ advised Kiwis to consider the following policy benefits:
Health insurance coverage varies between policies, but some of the most common inclusions according to LifeCovered are:
On the other hand, private health insurance typically excludes:
To find out which private health insurance firms offer the best coverage, Top Reviews NZ analysed several policies from leading industry players. The consumer website then picked out the top providers in different categories based on a range of factors, including products, premiums, and reputation. Here are the insurers that made the list.
|
Top pick for |
Tailored Health Insurance Plans |
|
|
Health insurance policies |
HealthEssentials, Wellbeing Starter, Wellbeing One, Wellbeing Two, UltraCare, RegularCare, KiwiCare, Cancer Care, Cancer Assist, Critical Illness |
|
|
Featured benefits |
Surgery, specialists, cancer care, diagnostic imaging & testing, day-to-day healthcare, critical illness |
|
|
Annual premiums* |
||
|
No excess |
$500 excess |
$1,000 excess |
|
$1,789.38 |
$1,520.86 |
$1,341.94 |
|
Financial strength |
A + (Strong) – Standard & Poor’s |
|
Source: Top Reviews NZ
|
Top pick for |
Value |
|
|
Health insurance policies |
Hospital Plan, Everyday Plan |
|
|
Featured benefits |
Cancer surgery, diagnostics, obstetrics, home nursing, dental care, glasses & contacts, GP visits & prescriptions, physiotherapy, chiropractic, osteopathy, remedial massage, acupuncture vaccination |
|
|
Annual premiums* |
||
|
No excess |
$500 excess |
$1,000 excess |
|
$2,280.88 |
$1,693.41 |
$1,458.43 |
|
Financial strength |
A – (Strong) – Standard & Poor’s |
|
Source: Top Reviews NZ
|
Top pick for |
Value |
|
|
Health insurance policies |
Trauma Cover, Moderate Trauma Cover, Severe Trauma Cover, Private Medical Cover, Specific Condition Cover, Hospital Cash Cover |
|
|
Featured benefits |
Surgical treatment, non-surgical hospital treatment, serious illness treatment, non-subsidised drug treatment, hospitalisation costs, major diagnostic costs |
|
|
Annual premiums* |
||
|
No excess |
$500 excess |
$1,000 excess |
|
$2,784.98 |
$2,006.51 |
$1,747.02 |
|
Financial strength |
A – (Excellent) – AM Best |
|
Source: Top Reviews NZ
|
Top pick for |
Financial Strength Rating |
|
|
Health insurance policies |
Private Health, Private Health Plus, Cancer Care |
|
|
Featured benefits |
Unlimited surgery claims, cancer cover medical hospitalisation & testing, overseas treatment, enhancement passback specialist & tests, reproductive health, health screening, premium waiver |
|
|
Annual premiums* |
||
|
No excess |
$500 excess |
$1,000 excess |
|
$2,447.82 |
$1,878.69 |
$1,499.27 |
|
Financial strength |
AA (Very Strong) – Fitch Ratings |
|
Source: Top Reviews NZ
|
Top pick for |
Fast Applications |
|
|
Health insurance policies |
SmartCare, SmartCare+, SmartStay, KidSmart, StaffCare+, StaffCare |
|
|
Featured benefits |
Hospital & surgical base plan, general surgery, private hospital medical admission, non-Pharmac subsidised drugs, best doctors, optional plans, specialist plan, dental care, optical plan, GP plan, natural health plan |
|
|
Annual premiums* |
||
|
No excess |
$500 excess |
$1,000 excess |
|
$1,777.80 |
$1,417.00 |
$1,197.50 |
|
Financial strength |
B+ (Stable Outlook) – AM Best |
|
Source: Top Reviews NZ
*Annual premiums are based on a 40-year-old non-smoking couple’s joint policy, up to date as of November 2021
