The New Zealand health system

Living in New Zealand certainly has its health benefits – a public hospital system that will look after you in an emergency and the ACC insurance scheme that steps in when you injure yourself accidently.  Plus, for those who want extra choice and certainty there are many private healthcare providers, who you can seek treatment from directly or via your private health insurance. 

 

The public health system provides emergency healthcare for New Zealand citizens. If you’re ill with an acute, life-threatening illness or are seriously injured in an accident, you should call an ambulance, contact your doctor immediately or go to your nearest accident and emergency clinic.

 

If your medical condition isn’t acute, you should make an appointment with your usual doctor.  If you’re not registered with a regular doctor, you can visit any health service provider. They may be able to diagnose and treat your condition or they might refer you to a specialist health service provider.

 

Health insurance could help here: If your health insurance policy allows it, you might be able to claim for the cost of your doctor’s appointment.

 

If the doctor decides that your health condition or injury is the result of an accident, you will be processed by the Accident Compensation Corporation (ACC).  See www.acc.co.nz for more information.

 

Your doctor may decide that specialist help is needed to help diagnose and/or treat your condition.  Some doctors concentrate on specialty healthcare services.  Some examples are ophthalmologists (eyes), orthopaedics (muscles and skeleton) and oncologists (for cancer).

 

Health insurance could help here: If you have private health insurance you can choose which specialist health service provider you’d like to see and make an appointment for a time that’s convenient to you.  Once an appointment is booked, you can ask your doctor to forward the relevant case notes and test results to this specialist health service provider. 

If you don’t have private health insurance, depending on the demand in the public health system, you may have to wait for an appointment.  The priority assigned to your case and the length of the waiting list in your region will determine how long you have to wait.  You won’t normally be able to decide which specialist health service provider you see or the time and place of your appointment.

 

 

It’s common for you to have an initial consultation with your specialist health service provider, followed by some tests.  If surgery is required you will have a pre-surgical consultation, the surgery and a post-surgical consultation, as well as any follow-up rehabilitation appointments.

 

Health insurance could help here: If your health insurance policy allows it, you may be able to claim for the cost of these consultations, tests, surgery and hospital care.  You will need to apply for prior approval if the costs are likely to be exceed $1000 or if your treatment involves any form of surgery or hospitalisation (even day stays).

 

Before your first appointment, it’s a good idea to write down any questions you want to ask.  It can also be helpful to take someone with you, but check beforehand as it will not be appropriate in all cases.  Having a friend or relative with you will make it easier to remember the discussion you had. 

If surgey is recommended and your surgeon is a Southern Cross Affiliated Provider, they will contact Southern Cross for prior approval on your behalf.  If not, you will need to arrange prior approval with Southern Cross yourself.  Its important that you understand what Southern Cross has agreed it will pay for and what (if anything) you will need to pay for.

Many health service providers will organise payment directly with Southern Cross, so you’ll have one thing less to worry about.