Health insurance in New Zealand

2020, Responses from: Chris Boon

I have private health insurance but it doesn’t cover me for pre-existing conditions. What should I do?

Contact Andrea, General Manager, at Adelphi Insurance Brokers at aphillips@ains.nz She will look at your personal circumstances and help you put in place a health insurance policy that will cover many (but not all) pre-existing medical conditions. Endometriosis, pelvic pain and most gynaecological conditions are covered after 3 years. If these conditions are not pre-existing, then they are covered from day one.

Why is health insurance important to have for endo in NZ?

The New Zealand Public Health System is one the finest in the world when it comes to acute situations like heart attacks, car crashes, broken legs etc. but struggles to cope with the volume of ‘elective procedures’, hence the long waiting lists. An ‘elective procedure’ is a procedure you have decided to have, in consultation with your specialist. Endometriosis and other gynaecological procedures are classified as ‘elective’ not ‘acute’. These conditions have a profound effect on someone’s quality of life but because they aren’t considered life threatening aren’t given the priority they deserve. You could wait months or years to have surgery which can seriously affect your quality of life. Health insurance gives you immediate access to treatment when and where you want it and covers, the often expensive, costs involved. In effect you book a hospital bed when and where you want it.  One further point I believe it is very important to insure your children, full stop, but doubly important to insure your daughters, before any symptoms appear, that way they don’t need to deal with pre-existing conditions.

What can health insurance cover for the treatment of endometriosis in NZ?

The short answer is everything. Depending upon your health insurance policy you can have all cost including treatment and/or surgery covered. My recommendation is to have a policy that:

  • Focuses on Hospitalisation only (don’t include GP visits and pharmacy scripts as these can blow out the premiums)
  • Has excess options available so you can control the premiums throughout the life of the policy
  • Has a high level of Surgical Cover to cope with the high cost of new and improved procedures and the high costs of technology involved
  • Has a high level of non-Surgical cover (where treatment is required without surgery) to cope with new and improved ways of treating people
  • If possible, having access to non-Pharmac approved drugs
  • If possible have ‘Guaranteed Wordings’ so the wording of your policy can’t be altered to remove procedures that become expensive to the insurance company
  • All the above points allow you to ‘Future Proof’ your policy

I would recommend you contact Andrea, General Manager, at Adelphi Insurance Brokers at aphillips@ains.nz She will look at your personal circumstances and help you put in place a health insurance policy that fits your circumstances and needs. If you are already on the ideal health insurance policy for you she will let you know that too, giving you peace of mind.

ENZ Response

Health Insurance Brokers do not represent a particular insurance company they work in the interest of the buyer to ensure you have the correct insurance policies for your individual circumstances and needs.

Endometriosis New Zealand are not in the business of insurance so we would like to thank Chris Boon, Managing Director of Adelphi Insurance Brokers for taking the time to answer our members questions about health insurance in New Zealand.

To learn more about Adelphi Insurance Brokers

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