Medical / Health Insurance
What is Medical / Health Insurance?
Health and Medical insurance are same, only two different names for the same type of cover. Holder of Health/ Medical insurance policies can claim as per their health/ medical insurance policy terms and conditions, their medical bills such as non-surgical and surgical expenses, diagnostic test expenses including MRI and CAT scan, Xray, Ultrasound and other tests cost as recommended by your doctor including specialist doctor visit expenses which can be otherwise very costly. Health/ Medical policies also cover cost of purchasing medicines/ drugs as recommended by your doctor. Most of the health/ medical insurance policies can claim for preventive care services such as vaccinations, screenings, and wellness check-ups. These preventive measures help detect health issues early on and can lead to better medical outcomes and lower medical care and treatment costs in the long run. Some of the health/ medical insurance companies do allow you to get treatment in overseas hospitals as per the insurance policy terms and conditions if either in New Zealand hospitals that treatment is not available or there is long waiting list for a particular treatment. Some of the health/ medical insurance providers after 2 to 3 years can cover your treatment cost of your pre existing diseases also as per insurance policy terms and conditions.
Overall, having health/ medical policies will give you peace of mind and freedom for your medical treatment because your insurance provider will take care all diagnostic & treatment cost as per health/ medical insurance policy terms and conditions.
How much you can claim?
It depends upon your health/ medical policy terms and conditions. If your insurance policy has any excess, you can claim all your expenses over and above your excess chosen by you while taking health insurance cover within the limit set by insurance company for each treatment. In some cases, Excess amount it can be NIL also. Generally, higher the access amount, lower the premium. Medical/ Health insurance policies come in various types and can be tailored to meet specific needs. Whether you need coverage for an individual, a family, or want to add additional benefits like dental, eye treatment or maternity coverage, there are flexible options available to suit personalised and specific requirements. There are policies where you can insure only hospitalisation treatment cost because generally treatment in hospitals is more expensive. Such medical/ health insurance policies are cost effective. The maximum amount of cover for treatment cost for certain diseases such as cancer as high as $500K.
Why people take Health / Medical cover when treatment in Govt/ public hospitals is free?
New Zealand’s public health system is generally good in acute emergency care. Non-emergency medical issues often result in waiting lists for specialist appointments or surgeries. Timely treatment can prevent a condition from worsening. As per your health/ medical insurance policy, you can chose treatment of your medical/ health problems privately and quickly and the cost of privately treated medical cost is covered by your insurance company as per medical/ health insurance policy terms and conditions. Further, although the government subsidizes numerous medicines in New Zealand, many remain non-subsidized. Health/ medical Insurance policies can cover both subsidized and non-subsidized medications, ensuring you are protected regardless of treatment costs but within insurance policy terms and conditions.
In nutshell, health/ medical insurance policies help individuals manage medical costs effectively, reducing the burden on their finances. Not only this, having health insurance encourages individuals to prioritize their health and well-being. Regular medical check-ups and early intervention can lead to healthier lifestyles and better management of chronic conditions.
How much it cost?
Health/ Medical insurance premium depends upon your age. Lower the age lesser the premium. Further, insurance premium also depends upon excess chosen by you. Higher the excess lowers the cost. Moreover, health/ medical insurance premium also depends upon the number of risks which you want to insure. Higher the number of risks which you want to insure, greater the insurance premium. Only Cancer care Insurance premium for a 30-year-old person can be around $8 per week and for 40 years old about $9 per week and for 50 years old about $13 per week, 60 years old $20 per week. Further, information can be obtained either from your life and health insurance adviser/ broker or from insurance providers.
How the claim can be made?
Whenever, you want to claim cost of your medical treatment, you must take a recommendation letter from your family doctor/ GP and then contact to the specialist/ diagnostic test centre or private hospital to whom you have chosen to treat you and obtain their quote or an estimate of treatment cost. It may be sent/ informed to the insurance company either online or by sending it physically through your insurance adviser. Insurance company approves your estimate or pay directly to treating doctor/ specialist / diagnostic centre or private hospital after deducting your access amount if any. If you are treated in a public/ Govt hospital for more than 3 days, you can be paid certain amount per day to the maximum amount as per your medical/ health insurance policy terms and conditions even you have not incurred any medical/ health care cost.
While diseases such as cancer, heart attacks, pandemic like Covid 19 are increasing, health/ medical insurance is necessary in safeguarding one’s health and financial security. It ensures that individuals and families can access timely medical care, maintain their well-being, and protect themselves from sudden burden of medical treatment cost which sometime can be in hundreds of thousands.
Before choosing any medical/ health insurance policy, it’s essential to carefully review the coverage, benefits, premium and terms and conditions to find an insurance policy that best suits individual needs and circumstances. Time to time health/ medical insurance premium and coverage must be compared with other similar providers, provided you have not developed any new ailments after taking your existing medical/ health insurance cover to ensure you have got the best insurance cover and at the right insurance premium.