shockedfaceOne of the more confusing, and slightly scary, insurance areas is health insurance, or medical insurance.

Policies are highly technical in terms of the definitions that are used, the medical jargon, and what will or won't be covered. It is one of the toughest areas to get right – even for trained professionals. But here are 5 quick tips to help make it a little easier to consider health insurance:

  1. If your employer offers cover, or a subsidised scheme, look into it. It can be a really valuable addition to your employment package, and help with your personal financial planning.
  2. Comparing coverage types is tough, but start by deciding whether you need as many expenses covered as possible, or just the really big bills like operations and hospital admissions.
  3. The lowest premium is not a good indication of a good policy. This is an area where you really do get what you pay for – and cheap is often a false economy that leads to disappoikntment.
  4. Work out what you are NOT covered for in any plan – there is usually quite a bit.
  5. If in doubt, get advice. It is one of the most challenging and complex areas of personal insurance. It is also one of the toughest to deal with in the event of a claim, and it is an area where a good adviser can make a huge difference to the performance of the plan at a time of crisis.

For a limited time you can get Health Insurance Cover for Pre-Existing Conditions!

southerncrosslogoSouthern Cross Health Society are the largest providers of health insurance in New Zealand.

They have a range of healthcare plans to suit different needs, budgets and to accommodate life stages.

We are pleased to be able to offer their products and to assist you deciding which may be suitable for your needs.

Southern Cross are currently making a very special offer.

Special joining discount 300x250Get cover for qualifying pre-existing conditions and save up to 20%*

Take out a new VIP policy before 30 September 2015 and get **:

  • cover for qualifying pre-existing conditions after 3 years continuous membership, and
  • a 10% special joining discount off your first year’s premium
  • PLUS a possible 10% healthy lifestyle reward for the first two years.

Of course as always terms and conditions apply. Please contact us on 07 578 3863 for details.

  • If you've investigated health insurance in the past and found they wouldn't cover you because of a pre-existing condition, or
  • If you've just assumed that pre-existing medical conditions would prevent you from getting health insurance

Now is the time to get in touch with us. Ring Jonathan on 07 578 3863.

*Total premium discount based on standard publicly advertised rates for individuals (without healthy lifestyle reward applied to those rates) available through Southern Cross contracted Advisers as at 31 May 2015.

** This offer is subject to standard policy terms and is open only to new individual sales (transfers, ex-group members or upgrades to existing policies will not be eligible for this offer). Promotion terms and conditions apply - www.southerncross.co.nz/society/buying-health-insurance/discount-offer-terms-and-conditions. Full details of the policy benefits, maximums and any exclusions or other conditions that may apply can be found in the Terms and Conditions and relevant Schedule of Benefits

At one time, health insurance was only for those who preferred to use the private health system. But times have changed.

With the cost of medical treatments and the availability of new procedures and drugs increasing, more and more New Zealanders are going private.

While urgent treatment is always available through the public system, people can find themselves in a slow-moving queue for those ailments that aren't immediately life threatening.

The solution

Health insurance eliminates waiting on public waiting lists, getting you treated and on the way to living normally again as soon as possible. That is its primary benefit for most people, and why it is worth considering.

Sovereign Insurance recently shared this rather sobering article with us.

Written by Thomas Patterson it will be published in M2 magazine, www.m2magazine.co.nz.

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The medical insurance company nib, have released figures on claims they paid out on in 2015. They say:

"Do you remember being 20 years old? Catching a frisbee down at the beach, dancing in clubs until the wee hours of the morning. We all may like to believe this is the norm, however the 2015 claim rates released this month continue to illustrate the requirement for nib health cover for everyone, including those as young as teenagers.

In 2015 nib met claims by both males and females under 20 years of age for hip and spine procedures. With the top claim over $55k, it raises the question, had nib health cover not been in place, what would they have done? (Did you have a spare $55k when you were that age?).

The nib value continues as we move up the demographic. Looking at those aged between 21- 30 years, the top 3 spine related paid claims came in at an average of $45k. Higher in value still is the top claim for this age bracket of general surgery for the pancreas, which amounted to $58k. These are real cases where real people felt the benefit of their nib health cover.

Chemotherapy continues to be a top claim point for those 31 years and above, with this being the top claim type for each age segment between 31 and 61 years. With the peak cost being $214k (within the 31-40 age bracket), nib policies continue to illustrate their fundamental value and why it’s never too soon to be prepared.

In the 41- 50 age bracket, radiation for bowel cancer is one of the top met claims, with an associated cost of $115k. Claims relating to general surgery for stomach cancer have also been met at the value of $85k.

Bowel and breast cancer continue to be key causes of claims in the 61-70 age bracket, with claims of $115k and $113k respectively being submitted and subsequently approved by nib.

Moving into the 71- 80 year old bracket, top claims are for heart procedures (bypass and valve replacement) and chemotherapy for bowel cancer, with nib continuing to provide value to our Health Cover policy holders by approving $95k claims in both cases.

So while you may be thinking ‘I’m still too young’ or ‘I’m in good health’ these real claims for real individuals act as a reminder of just how valuable heath cover can be."

We say that in New Zealand we have a very good tax payer funded public health system. If you are in critical condition - about to die - you will almost certainly get world class medical care. But if you aren't about to die those who are, are always going to be higher on the priority list for treatment.

Sovereign LogoSovereign have revamped their Health Insurance Policies

Private Health Cover and Private Health Plus policies offer access to timely private treatments and choice of medical provider. Whether you need diagnostic scans, surgery or ongoing help with recovery, you can be sure that your health is their priority.

Key reasons to consider Soverereign Private Health

  • Generous cover up to $300,000 per year for conditions requiring surgical treatment.
  • Cancer care at every stage, including diagnostic imaging and tests, non-Pharmac approved MedSafe indicated chemotherapy drugs, prostate brachytherapy and breast reconstruction.
  • Treatment in Australia (subject to policy maximums and reasonable charges).
  • Treatment overseas if the wait for private practice in New Zealand is longer than six months.
  • Credit on next year's premium if public system is chosen for treatment that Sovereign would otherwise have covered (minimum two-night stay required).
  • Private Health Plus provides all the benefits of Private Health Cover plus up to $10,000 per year for consultations and up to $100,000 per year for diagnostic imaging and tests.
  • With Private Health Plus, you enjoy extra loyalty benefits such as $750 per year contribution to pregnancy, maternity or infertility care after three years, and $500 for health screening after three years.

If you don't have Health Insurance or would like us to compare what you do have with Sovereign's Private Health or the other Insurance companies new policies available give Jonathan a call on 07 578 3836.

In its simplest terms, insurance premiums go up when the cost of paying out claims increases.

When it comes to medical, or health insurance, the claims increase as clients get older and therefore premiums have to rise to fund the claims.

There are several other significant factors that contribute to the increase in premiums:

  1. Access to the public heath system often takes longer, so private health insurance pays a higher price for quicker access.
  2. New medical technology is very expensive; so new treatments and new drugs push up medical expenses much faster than many other costs
  3. New Zealand’s population is getting older on average, and increasing in its reliance on the health system.

The chart below shows quite clearly that the average claims costs increases the older clients get, which is the key driver of the increasing premiums.

Insurance Claims by Age

If you are concerned about your the existing health insurance coverage or its costs then you should review it. Please don't just cancel health insurance without considering your options, for example you can probably reduce your premiums by increasing your excess.


The information on this site is intended as a guide only. The information is of a general nature and does not and cannot ever constitute personal advice.
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