Private Medical Insurance for Expats Living in New Zealand

New Zealand is a country that likes to get value for money and with them spending less on healthcare than the 14 other developed countries in the world, they appear to be succeeding. During 2013, New Zealand spent the equivalent of 3328 US dollars per person on health, compared to the OECD average of 3453 US dollars (OECD, 2015) and health care expenditure, per person, is known to be less than in the US. This good performance is due to the mix of public and private health care facilities within their system. Strong action has been taken on private health insurance, in a similar to Australia, which helps to avoid long waits for state hospital treatments.

Public hospitals are well spread across the country and all have high standards. Citizens and permanent residents, are treated free of charge and are managed at a district level. However, having good standards has not reduced the waiting time for treatment which has encouraged the market in private medical insurance. Southern Cross Health Insurance has a non-profit scheme and is the biggest operator, claiming it has half the market and covers over a quarter of all New Zealanders.

Cost for Accident victims

A good approach has been taken with financing the public health system, which ensures that treatment that is required because of an accident will not be centrally financed but funded by tax on employers, employees and other sources such as car insurance.

Treatment is open to everyone and legally includes tourists. One advantage of this is that it limits the spread of the compensation culture. Within New Zealand, it is not easy to bring an action for compensation for injury, under their law. Unfortunately, the system is often abused as once certain citizens understand the workings of the law, they can easily call everything an accident to avoid responsibility.

Family Doctor

It is a requirement that New Zealand’s patients pay to see their GP and pay for their medication, but these payments are subsided for people holding community health service cards or high-user health cards.

Entry control into New Zealand

Good health is required for those seeking permanent residence in New Zealand, if they are to be accepted into the system. Buying medical insurance is not enough and the reason, given by the authorities for this, is that they would not be able to prevent any new arrivals with a pre-existing medical condition from using their public system, even if they had good private cover. On immigration, New Zealand has previously stated that it is not able to limit any resident’s access to the health system and therefore, if you do not meet their health policy, they are unable to accept offers to pay for private health insurance.

How to join the health system

Expats will not need to join New Zealand’s health system unless they have a work permit exceeding two years. If they are staying less than two years, new arrivals are told to get private health insurance.

Official advice is: “Government funding of health and disability services means that eligible people may receive free in-patient and out-patient public hospital services, subsidies on prescription items and a range of support services for people with disabilities in the community. If not eligible for publicly funded health and disability services, the services are still available; however expats must pay for them and should get health insurance to cover this.

UK- New Zealand reciprocal health cover

In an emergency, New Zealanders in Britain are entitled to free NHS treatment and the same applies to Britons in New Zealand. However, the health ministry states that this provision is likely to be insufficient and those who are not entitled to full state care and those relying on UK-New Zealand reciprocal arrangements, should buy private insurance as the agreement only covers immediate and essential treatments. Visits to a general practitioner, non-urgent or discretionary, rehabilitation, and repatriation are not funded within the agreement and the reciprocal agreement does not include follow up care, medicines for existing conditions and ongoing treatment.

Medical Health test

In addition to the two year permit requirement, the authorities assess applicants to determine whether they are likely to be a drain on the public system.

What they don’t want

The conditions that are likely to stop people registering in the state system are:

• Hepatitis B
• Hepatitis C
• HIV infection
• Transplants
• Most cancers, even if under treatment, or in the past
• Cardiac disease
• Chronic renal failure or progressive renal disorders
• Motor neurone disease
• Osteoarthritis, likely to need joint replacement in a few years
• Genetic and congenital disorders
• Severe autoimmune disease, physical disability
• Chronic obstructive respiratory disease
• Severe vision or hearing impairment.

The process

The medical examination that is needed for each individual consists of a questionnaire, where the applicant must truthfully record their medical history. A warning from the immigration service is that if any false information or deliberate omissions are made, it may result in the application being declined.  The process also requires routine tests and chest X-rays to be taken, to detect for tuberculosis, a key reason for the X-ray.

People, who are planning to settle in New Zealand, will be required to have medical tests before their departure, if there is a designated doctor or panel doctor available to carry out the procedure. The Panel doctor’s report, plus the X-ray, cannot be more than three months old when submitted as part of the visa application and any application will be rejected if it exceeds this time limit. Blood tests may have to be re-taken if the individual’s test results fall outside the normal range and furthermore, the applicant may also be asked to provide additional information to a health professional.

The immigration service employs medical assessors to resolve borderline cases and their job is to weigh up any health condition or combination of factors, whether chronic or acute.

Occasionally they can make a time allowance for treatable conditions, so that an application can be approved once an illness is resolved. Six months is the maximum deferral period and this only applies for cases of RB, for other conditions the deferral limit is three months.

What happens If you fail the medical examination

Individuals who fail the assessment may apply for a medical waiver, which according to the immigration services are granted occasionally. If a waiver applies “the balance of factors must indicate that the applicant may make a good contribution to New Zealand which outweighs any potential costs or burden on New Zealand’s health system”.

Health insurance for qualifying expats

Those who meet the correct criteria can decide for themselves how much cover they want, over and above the publicly funded services. Benefits tend to vary across the plans as for example, some plans cover for dentistry, which is not state provided by New Zealand for those aged over 18.

Many residents buy private insurance to overcome the long waits for treatment, which exists in the state care system. These residents benefit from choosing the time, date and location of any surgeries.