Choosing the right policy 

Having made the important decision to take out health insurance, the next step is choosing the right policy that will suit your needs and budget.

Depending on where you’re at in life, there are features you’ll want from your health insurance and ones you won’t. The policy that is right for a single person may not work for a family. And a policy that works for one family may not be right for another. The aim is to find a good balance between cost and cover, so it is affordable and meets your specific needs. Take a little time to find the right policy by following a few simple steps.

Check whether your employer provides subsidised health insurance

Many employers want to ensure the well-being of their staff by offering subsidised health insurance. This option will normally be the most cost effective, as your employer will either subsidise all or part of your premium.

Research which insurers provide health insurance

Some key things to look for:

• A trusted insurer with a proven history as a health insurance provider
• Look for an insurer that is a member of the Health Funds Association of New Zealand (HFANZ). The HFANZ requires its members to meet minimum solvency requirements which provides consumers with higher levels of confidence that claims are able to be met. You can view who is a member at www.healthfunds.org.nz

Consider what policy would best suit you

Key considerations:

• A basic or comprehensive policy:
  A basic policy only covers the costs related to hospitalisation in a private hospital for surgical or non-surgical procedures, whereas a comprehensive policy includes all the cover of a basic policy plus primary care costs, such as the cost of GP visits, prescription charges and specialist consultations
• Fully underwritten or auto-accepted at time of application:
  Some policies require that your medical history is disclosed at the time of applying. The insurer will then underwrite your application based on this information and clarify what is covered and if there are any exclusions. With auto-acceptance policies, you don’t need to declare your medical history at the time of applying. However, when you make a claim, your medical records would be assessed to determine if your problem is covered. With auto-acceptance, often pre-existing conditions are not covered for a set period of time (i.e. three years) and some are never covered. If choosing auto-acceptance, it is important you are clear on what is covered and what’s not, so you don’t have any surprises or disappointments should you make a claim.

Compare policies

Compare the policies of at least two insurers before selecting the one that best matches your needs, at a price that offers value for money. Key factors to look for in a policy include:

• Sufficient coverage limits on both surgical and non-surgical treatment
• The type of specialists and tests covered (before and after hospital treatment)
• Clarity of what is covered and what is not
• A range of excess options available to help you manage costs
• Whether loyalty benefits are offered after a set period of time

Experts to help you

You may already have a relationship with an adviser who can offer you advice. Alternatively, most health insurers – including TOWER – have experts available to assist over the phone or they can recommend an adviser in your area.