[Debbie]

Or: What is already covered by the NZ health system?

We've taken out a health policy but since doing so I've begain to wonder what real benefit it has and wanted to check out some things with others on the forum.

According to our GP, If we become urgently sick, (for example my son has a bad allergic reaction) then that's covered by emergancy treatment and is free in hospital. Like most medical covers our insurance doesn't include A&E and emergancy treatment.

If we have an accident then the insurance doesn't cover as that's supposidly covered by ACC.

So am I right in thinking that our insurance is only needed if we are unfortunate enough to have a protracted illness. Even so I can't understand what is covered by the health system under treatment and what isn't.

For example, my son's epi-pens aren't covered and we have to buy them even though they could make the difference between life and death for him, but all other medication so far has been free. My daughter needed blood tests done and there was no charge for these but apparently I will have to pay for my Pap smear.

Is there some form of reasoning that can be applied to tell what is covered and what is not ? Our health insurance is one of our biggest expences and I like the security of having it but it does seem that most of what it covers is also covered by the standard level of health service.

Am I missing something?

Debbie

[Anita & Marco]

Hi,

My major reason to have private health insurance is to avoid waiting lists, because when you have to wait for treatment while you are not able to work, this will cost you a lot of money. And also because of some experiences from other people in both private and public health care, but this also boils down either 'wait and get the treatment for free' or 'get the treatment straight away but pay yourself'.

Yes, it is costing a lot of money and luckily only needed it once upto now and hopefully do not need it anymore, so that I can see it as a 'waste of money'.

Cheers,
Anita

[Debbie]

I don't mind paying for the cover especially with the children but I just don't understand what is covered by the health service here and what isn't.

Would you get treatment for all illness for free here if you where willing to wait for it? How can you tell which tests you pay for and which you don't?

Debbie

[Oregonkiwi]

In my personal opinion (and I know plenty of people would disagree), private health insurance is unnecessary in NZ. (Compared to the US where you really don't want to be uninsured.) As Anita says, most people who do have it want to avoid waiting lists for specialist treatment or surgery.

This might help explain what is covered;
http://www.moh.govt.nz/moh.nsf/indexmh/eligibility-healthservices-doctor

A lot of it boils down to how much the government subsidy is. For example, my son has an ear infection and got 2 prescription medicines yesterday; because he's under 5, the cost was fully subsidised, so we only paid a $1 'pharmacy charge'. Most medications are subsidised, but not all, which is why you have to pay for the epi-pens.

[gil]

Difficult to find easily accessible, clear information about what is provided by the health service here Debbie. I suspect the answer will be along the lines of "Depends on your region and practice".

We have found health insurance to be useful for dental and optician costs too. Am about to examine the benefit of paying to have GP visists included in our cover, as we seem to be using their services a fair bit more than anticipated.

Gil

[Timbo]

This very subject came up tonight, after watching Close up. In tonights prog, they did an article on (mainly)prostate cancer.
It certainly made me sit up and take notice, and I have got to wondering what the financial implications would be if either of us were ever put in a similar situation.
Time for some serious research I think.

[Debbie]

Timbo,
What was the conclusion of the program, I missed it. If anyone knows how to watch it on my computer I would be gratefull.
Debbie

[IanW99]

Try this link:-Close Up 30th August (http://tvnzondemand.co.nz/content/close_up_2007/ondemand_video_skin?tab=&sb=date-descending&e=close_up_2007_08_30#ep_close_up_2007_08_30)

Ian

[tigerlily]

I remember an article a while back about how different private insurance covered different costs for chemotherapy- I seem to recall Southern Cross as the worst- something like $20K of the cost was paid for. Others covered much more- into the $100K so closer to actually covering the entire cost of treatment. That is different from the health insurance that I am used to in the USA- here you generally get a percentage paid for often 80 -90% up to a maximum out of pocket expense. I'd be interested if anyone has details on how NZ private insurance works. Do you see different doctors? Or same guy, just get to see him faster?