Health Insurance

Compare health insurers in New Zealand at Canstar. Southern Cross Health Society, AA Health Insurance, nib, Sovereign and UniMed were compared on value for money, communication, claims lodgement, claims process, claims outcome, quality of service, clarity of policy, and overall satisfaction.

Rated brands

Overall satisfaction*

Value for money

Communication

Claims lodgement

Claims process

Quality of service

Clarity of policy

Claims outcome

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*Overall satisfaction is an individual rating and not a combined total of all ratings. Brands with equal overall satisfaction ratings are sorted by the mean overall satisfaction score as rated by consumers.

Canstar research finalised in April, 2019, published in May, 2019.

See our Ratings Methodology.

Most Satisfied Customers Award | Southern Cross Health Society

Southern Cross Health Society rated number one for customer satisfaction

 

Southern Cross Health Society is rated 5-stars for customer satisfaction

Southern Cross Health Society takes out Canstar’s  2019 Most Satisfied Customers Award, as the only  health insurance provider rated 5-stars for overall satisfaction.

With this award, Southern Cross has won the Most Satisfied Customers Award for  four consecutive years. Southern Cross Health Society is a not-for-profit health insurance provider and is the  largest health insurer in New Zealand, with more than 800,000 members. In this year’s ratings, Southern Cross Health Society is the only provider to receive 5-stars for communication, claims lodgement, claims process, claims outcome, quality of service and overall satisfaction. Canstar’s Most Satisfied Customers Award winner is calculated from the results of a  national survey. Canstar asked New Zealanders to rate their health insurance  provider on various factors, such as value for money, quality of service and claims process. Respondents only qualified on the basis they made a claim from their health insurance provider in the past 12 months.

With the public health system and ACC, New Zealanders enjoy a fairly high level of  health support. However, it may not be the best option in all circumstances,  especially for elective or non-emergency treatments. With health insurance, you can  avoid lengthy wait times and are covered for some, or all, of the cost of surgeries and health services. Health insurance provides you with some assurance, should you  suddenly fall ill. It also offers you protection from ever increasing costs of complex  and/or new procedures. The Health Funds Association of New Zealand reveals the  number of New Zealanders with health insurance is more than 1.4 million, for the first time in decades. This shows just how many New Zealanders view health insurance  as an essential purchase!

Canstar surveyed 5,000 New Zealand consumers across a range of categories to measure and track customer satisfaction, via ISO 26362 accredited research panels managed by Qualtrics. The outcomes reported are the results from customers who have a health insurance policy (which they pay for) and have made a claim within the last 12 months. In this case, 849 New Zealanders. Brands must have received at least 30 responses to be included. Results are comparative and it should be noted that brands receiving three stars have still achieved a satisfaction measure of at least six out of 10. Not all brands available in the market have been compared in this survey. The ratings table is first sorted by star ratings and then by mean overall satisfaction. A rated brand may receive a ‘N/A’ (Not Applicable) rating if it does not receive the minimum number of responses for that criteria.

About Private Health Insurance

What is Private Health Insurance?

New Zealand’s  health and disability system is mainly funded from general taxation. The Ministry of Health allocates more than three quarters of the public funds it manages via Vote Health to DHBs, who then use this to purchase and provide public health services.

Other funding sources include the Accident Compensation Corporation (ACC) and other government agencies. But the public health system does not cover all healthcare and private health insurance covers a wider variety of healthcare options.

More than 1.4 million New Zealanders have private health insurance, according to the Health Funds Association of New Zealand. Having private health insurance means New Zealanders can access treatment without the often-lengthy wait of the public health system. It also gives the policy holder some more control over their healthcare, such as the option of getting cover for extra treatments, such as dental, optical, chiropractic or physiotherapy.

These are a general explanation of the meaning of terms used in relation to health insurance.

Policy wording may use different terms and you should read the terms and conditions of the relevant policy to understand the inclusions and exclusions of that policy.

Annual limit: The maximum benefit payable for a particular service within a 12-month period.

Benefit: The dollar amount paid to you by your health fund when you make a claim with your hospital cover or extras cover.

Benefit limitation period: Benefit limitation periods are a period of time after taking out your health insurance policy where you will only be able to claim a restricted amount of benefit for nominated conditions. This time period usually commences after standard waiting periods have been served.

Claim: When you request that your health funds contributes to the cost of health services provided by a hospital, doctor, or other healthcare provider. If you have already paid the invoice in full, you can make a claim with your health fund afterwards and they will reimburse you with some or all of the cost via a direct payment such as electronic funds transfer or cheque. If the invoice has not yet been paid, the health fund will pay this invoice in full, and then request that you pay them the balance owing (the difference between the actual bill and the amount the health fund will cover).

Compensation or Damages: Fund benefits are not payable when compensation and/or damages may be claimed from another source, such as Workers’ Compensation, Compulsory Third Party (CTP) car insurance, Common Law, Sports Insurance, Travel Insurance, Litigation, or Crimes Compensation.

Default Benefits: The minimum level of benefits private health insurers must pay, as set down by the Government. These cover claims for treatment provided in public hospitals, non-contracted private hospitals and day surgeries.

Elective surgery: Surgical treatment of a condition that, according to your doctor, does not require immediate attention. Elective surgery waiting lists are one reason why it’s great having health insurance.

Excess: Much like with a car insurance policy, your health insurance policy charges an excess when you make a claim. It is an amount of money you agree to pay for hospital admission or medical services before you can claim anything back from your health fund. An excess does not apply to extras cover. Learn more about the health insurance excess.

Exclusions: Any medical procedure, treatment, or health service that is not covered by your policy. You cannot make a claim for these items with your health insurance.

Pre-existing condition: An ailment, illness, or health condition is considered to be pre-existing if, in the opinion of a doctor appointed by the health fund, it existed at any time during the 6 months prior to the member joining a hospital cover or upgrading to a higher level of cover. Health funds can impose a maximum 12-month waiting period for hospital treatment for ailments, illnesses, or conditions that are considered to be pre-existing. Learn more about health insurance pre-existing conditions.

Premium: The annual payment or monthly payment (or other regular periodic payment) that a policyholder makes to a health insurance company to pay for having health cover.

Restriction: Some hospital cover policies have procedures that are restricted, meaning they will only pay the Public Hospital Benefit for that procedure. Policyholders would pay a considerable gap fee if they chose to be treated for a restricted procedure.

Waiting periods: The time you need to wait after buying health insurance, before you can start claiming benefits on the policy. Learn more about health insurance waiting periods.