Why do You need Medical Insurance in New Zealand?

How is the New Zealand medical system different to South Africa?

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    How does Public Healthcare work in NZ?
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    Do I qualify?
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    So how does Medical Insurance cover the gaps?

Hi, here at Network Financial Services we have been helping new immigrants to help settle in New Zealand since 2011. We believe in giving you impartial advice so that you are able to make the best decisions for you and your family!

How does Medical Insurance work?

The New Zealand health system is very different to what you will be accustomed to in South Africa. To understand how medical insurance works, you first need to come to grips with the fundamentals in the New Zealand healthcare in general as there is a mix of public and private funding throughout the system. By understanding the system as a whole, it is easier to make an informed decision whether or not you should look at getting medical insurance for you and your family. 

The New Zealand Public Health System

The healthcare system is a mixed model system where there are a number of components with different funding models. Generally, these components are broken out as below:

Accident Compensation Corporation (ACC): is a crown entity responsible for administering the nationwide no-fault accidental injury scheme. The scheme covers the cost of treatment for accidents to citizens, residents and temporary visitors. ACC is funded through numerous levies and government contributions. 

Primary Care: is the care provided by family doctors or GPs to patients and includes medicine that is subsidised by the government agency PHARMAC. Generally, visiting a GP and getting a script for medication will require some co-pay from the patient as these services and medications are not fully funded. If you require specialist treatment your family doctor will have to refer you to a specialist. 

Secondary Care: is the network of public hospitals and specialists that is run by the local District Health Board (DHB). Under a local DHB you will be able to access relatively extensive and high quality treatments. However, for many operations, procedures or tests that are not seen as urgent often require the patient to go on a waiting list. The waiting times vary but overall times are  currently around 304 days.  Because of these wait times, there is a secondary market of health insurance organisations to privately fund operations and treatment for its members. 

Who is eligible for public healthcare?

The Ministry of Health determines who may be eligible for public healthcare in New Zealand. Below is the wording from Ministry of Health website regarding work visa holders: 

A person who holds a work visa that either:

  • entitles them to remain in New Zealand for two years or more (work visas start on the person’s first day in New Zealand) OR
  • entitles them to remain in New Zealand for a period of time which, together with the time that person has already been lawfully in New Zealand immediately prior to obtaining the visa, equals or exceeds two years

    is eligible for publicly funded health and disability services.

You will also be required to prove your eligibility to your health service provider by showing them a valid passport with your work visa or permit. 

If you qualify for public healthcare, you will also qualify for medical insurance. 

I don't qualify for public healthcare! What now? You may still be able to use public healthcare  services but you will be responsible for the total cost of any care provided. However, there are options available to get health insurance that fits within this gap and can give you peace of mind while making New Zealand your new home. 

Elective Services and waiting times- what is the big deal?

Elective services are medical or surgical services for people that do not need to be treated right away. The general process for these services are that you first need to see your Family Doctor (primary care) and get them to refer you to either a specialist or a test to determine what the next steps are. If your referral is accepted by the DHB, then you will go on the waitlist to see a specialist or have your test.  There can be significant wait times dependent on the test, specialist or surgery required. You could opt to pay for some of these services yourself to have treatment earlier but they can be quite costly. For example a specialist appointment could easily cost a few hundred dollars or an MRI is between $1,500 and $2,500.

Waitlist times are a major issue in New Zealand, it only takes a quick Google search to see how many articles have popped up with this issue in recent years. There are cases where people have had to live in pain for months before they could receive any treatment. The question that all Kiwis (or soon to be Kiwis) should ask: "How long am I willing to wait before my condition potentially affects my health and my ability to provide for my family?

Here are a couple of examples of how medical insurance works

A story about John:


John has shortness of breath and pain around his chest. An ambulance is called and John is taken to the emergency unit at the nearest public hospital. In providing a diagnosis, various tests are done to find out the cause and eventually they decide to do an angiogram. This provides the outcome that a heart bypass is required. John is in a public hospital and it will take 6-8 weeks till he can have the procedure. Fortunately, John has medical insurance and decided to put in a claim. Once approved John had his surgery within 2 weeks. 

A story about Paul:


Paul was busy on his paddle board in the ocean, when he felt tremendous pain in his shoulder.  Once back on shore, he went to his A & E, which referred him to have an MRI. The Doctor advised him that should he want to go through the public health system he would need to wait around 4 months for this to be done.  

After deciding to use his medical insurance, Paul was able to have the MRI quickly, see a specialist and have surgery all within a few weeks. Had he not had this done, Paul would not only have had limited movement and possible loss of use, but it could have affected his quality of life. 

We are here to help!

In our opinion it is of the utmost importance that you make the right choice the first time round when it comes to medical insurance. Your success in a new country will depend on your ability to perform at work. Your inability to be at work due to illness will severely impact this. It is important to remember that being an immigrant in a new country you have no safety net and may only get limited support from family and friends. 

We have assisted 100's of South African immigrant families with advice on medical insurance. Please do not hesitate to contact us for a free information session. During this session we can answer any questions that you may have regarding medical insurance, what should you do with you South African medical insurance and whether you will be eligible for cover in NZ.

Our advice is free and there is absolutely no obligation to purchase anything. 

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About us

Network Financial Services was founded by Eugene in 2012 initially working by himself. Over the years the business has grown to a point where he was able to involve both his wife and his son, to create a truly family business. This sense of family is what we bring to our clients, we are there to help our clients choose the right insurance products and really be there for them when they need it most.Eugene has over 25 years experience in the insurance industry both here in New Zealand and in South Africa.

Out of his need to help others, Eugene also started the New Immigrants Network. Having gone through the process of immigrating to New Zealand, he knew how hard it was for new people to settle in their new adopted home. This network has grown across the country where like-minded people work together to help new immigrants settle into New Zealand.    

Disclosure statements are available on request. All information on this site is general in nature and no substitute for personalised financial advice.

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