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Thread: Private Medical Insurance

  1. #1
    Join Date
    Mar 2011
    Location
    South Africa
    Posts
    35

    Default Private Medical Insurance

    I have read quite a few posts on the forum regarding long waiting lists to see specialists etc
    Coming from SA, we all have what we call Medical Aid - more than an insurance it is a hospital cover with some medical savings for day to day things as in medicines and consults - as our public healthcare is really not an option.
    If you need to see a specialist for an appt before it gets as far as a hospital visit you generally pay cash. If you have any medical savings then you are refunded by the medical aid.
    However we dont experience these types of waiting periods so if we need to see a specialist you just book an appointment and within a few weeks you go.
    eg My son (9mths) was referred to an ENT (had an appt within 3days of phoning) due to fluid not draining from his ears and causing ear infections. The ENT monitored him and assessed him and after the 3rd ear infection (not to mention the previous ones before we were referred) said he needed grommets on the Friday. On the Tuesday the procedure was done.

    What does having private medical insurance in NZ mean? I know you dont have to have it for hospital stays as that does not seem to be the issue. But if you or your children need to see a specialist or get referred for an MRI, a scope or any other procedure do you then not wait in a queue?

  2. #2
    Join Date
    Dec 2007
    Location
    Stanley Bay, Auckland, NZ
    Posts
    1,480

    Default

    Quote Originally Posted by Siouxzee View Post
    What does having private medical insurance in NZ mean? I know you dont have to have it for hospital stays as that does not seem to be the issue. But if you or your children need to see a specialist or get referred for an MRI, a scope or any other procedure do you then not wait in a queue?
    Pretty much just that - it allows you to book an appointment with a specialist and queue jump as you see them privately rather than be limited to the times they are working in the state system.

    It also means that surgeries can be done in private hospitals / clinics and can be done quicker.

    There are many different types of cover though; the one that I have only covers surgery so that, if I needed surgery but my life wasn't at risk, I could get it done quickly using my health insurance. The reason that I went for this is that, through work, I'm a member of a trust that pays a percentage of other medical bills so will cover me for around 60% of the cost of diagnostics. You can, however, get medical cover that covers surgery, diagnostics, general health-care or a mixture of the above!

    It should be noted though that there are still queues with private medical as most consultants are reasonably busy all the time! To give you a demonstration of how it works in practice:

    My OH went to GP with a suspicious mole a couple of weeks ago
    GP removed the mole and sent it away for testing (cost $200 - covered by health insurance as surgical)
    Test came back to say it was Melanoma-in-situ
    GP performed wide excision a week ago to remove more skin and flesh to make sure all melanoma gone (cost $200 - covered by health insurance as surgical)
    GP advises OH to see a specialist dermatologist about some other suspicious moles.
    OH phones dermatologist and gets earliest appointment - 31 March.
    Cost of visit will be around $350 if no surgery needed ... and health insurance won't cover that but the trust will so actual cost to us will be $140. If surgery needed then will cost around $1,500 but will be covered by health insurance (including original $350).

    We could also see the dermatologist on public system but that would involve lots of waiting and worry for OH so isn't something we looked at.

  3. #3
    Join Date
    Mar 2011
    Location
    South Africa
    Posts
    35

    Default

    Thanks James Thankfully at this point none of us need it but I would rather be prepared and have the right cover in place

  4. #4

    Default

    Make an informed choice about your insurer if you are going to purchase health insurance, they are not all the same. Seek advise from an adviser who can provide all the major players, Onepath, Sovereign, AXA, Tower and .... Southern Cross.

    As an adviser my first choice is always Onepath, but seek advise and make an informed decision.

  5. #5
    Join Date
    Aug 2010
    Location
    Earth
    Posts
    139

    Default

    Please, from personal experience, get private health insurance! I always had it in Australia, when I moved to NZ I listened to family and friends, and didn't take it out..

    We found out my husband had a very serious health condition, we would still be in NZ and not back in Oz if we had health cover...

    Some companies that teamplayer2003 has mentioned are highly recommended..

    Good luck with your move..

  6. #6
    Join Date
    Mar 2011
    Location
    South Africa
    Posts
    35

    Default

    @teamplayer2003 - where do I find a list of recommended advisors in the Wellington area. How does it work to use an advisor do you pay a fee? Here in SA the company that you take out medical aid with or say life insurance pays a commission to the broker. So would like to know how it works there.

  7. #7
    Join Date
    Dec 2010
    Location
    Auckland-Spain
    Posts
    43

    Default

    Quote Originally Posted by Siouxzee View Post
    I have read quite a few posts on the forum regarding long waiting lists to see specialists etc
    Coming from SA, we all have what we call Medical Aid - more than an insurance it is a hospital cover with some medical savings for day to day things as in medicines and consults - as our public healthcare is really not an option.
    If you need to see a specialist for an appt before it gets as far as a hospital visit you generally pay cash. If you have any medical savings then you are refunded by the medical aid.
    However we dont experience these types of waiting periods so if we need to see a specialist you just book an appointment and within a few weeks you go.
    eg My son (9mths) was referred to an ENT (had an appt within 3days of phoning) due to fluid not draining from his ears and causing ear infections. The ENT monitored him and assessed him and after the 3rd ear infection (not to mention the previous ones before we were referred) said he needed grommets on the Friday. On the Tuesday the procedure was done.

    What does having private medical insurance in NZ mean? I know you dont have to have it for hospital stays as that does not seem to be the issue. But if you or your children need to see a specialist or get referred for an MRI, a scope or any other procedure do you then not wait in a queue?
    I am also ex SA many years ago though.

    I can personally recommend http://www.southerncross.co.nz/ I had Hospital & Specialist care cover for both of us. They paid out 2 surgical claims for OH (cardiac surgery) $60,000 paying claims in full.

    Being able to be admitted immediately to private hospital & immediate surgery was such a relief, could have had operations in public hospital but only if OH had heart attack first which fortunately was not the case, as you end up with damage to heart muscle & not the best. This was because public has`waiting lists.
    So I encourage you to take our private health insurance, not all companies are the same after much research I joined Southern Cross.

  8. #8

    Default

    Please Please Please ensure you see a broker or an adviser about your choice. Southern Cross have many limitations including medical limits and I know of a client who was recently refused the new prostate rod treatment and had to borrow from the bank to fund it. Southern Cross also have medical limits for certain treatments. One of my new clients had southern cross, went in for a hip operation, the consultant charged $20,000 however southern corsses limits on the type of operation was only $15,000 at the time, hence they had to find $5000 to top up the cover. Dont get me wrong southern cross will do a good basic job. I sell southern cross cover, but rarely do I advise for clients to buy it over other products. To further emphasize my point, I get souther cross cover for free, but I also pay for OnePaths product as I want my heathcare to look after me in the event of a serious illness or accident, provide the newest latest treatments and drug and ensure that both me and my family are protected.

  9. #9
    Join Date
    Dec 2010
    Location
    Auckland-Spain
    Posts
    43

    Default

    Quote Originally Posted by teamplayer2003 View Post
    Please Please Please ensure you see a broker or an adviser about your choice. Southern Cross have many limitations including medical limits and I know of a client who was recently refused the new prostate rod treatment and had to borrow from the bank to fund it. Southern Cross also have medical limits for certain treatments. One of my new clients had southern cross, went in for a hip operation, the consultant charged $20,000 however southern corsses limits on the type of operation was only $15,000 at the time, hence they had to find $5000 to top up the cover. Dont get me wrong southern cross will do a good basic job. I sell southern cross cover, but rarely do I advise for clients to buy it over other products. To further emphasize my point, I get souther cross cover for free, but I also pay for OnePaths product as I want my heathcare to look after me in the event of a serious illness or accident, provide the newest latest treatments and drug and ensure that both me and my family are protected.
    Can you give me information where I can find out about Onepath. We are returning to NZ soon & will be looking at best option for private health insurance.

  10. #10

    Default

    Gypsy I have Pm'd you.

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