Here we are heading into 2026, and with medical insurance, the one constant over the last 10 years has been said, reported in the news, and generally complained about: the increasing costs of medical insurance. The last 12 to 18 months have seen the largest premium increases in 30 years!

As an advice business, we need to adapt to a significantly more challenging market. Here's how we are responding.

With this update, this will be the last one of these in this series with this structure. The combination of premium increases and subtle changes in the product structure choices being made as a result means future comparisons need to be tweaked enough to be different.

I have been discussing managing medical premiums for quite some time. This article I wrote in 2016 is the start where I discuss the life cycle of medical insurance for the typical household. This discussion and approach is still quite valid.

However, with Covid, challenges with the public medical system and cost-of-living pressures, medical insurance remains an essential tool to ensure you have access to the medical care you need, but it's a whole lot more expensive than it used to be.

For a long time, I have discussed the need for unfunded medicine coverage. Ideally, this coverage is baked into your medical policy, but that's not always the case.

In the middle of last year, I wrote this piece for GoodReturns highlighting a significant issue in the way unfunded medicines claims are handled by most insurers.

As I said in the article, this isn't about demanding a change to policy wordings. While it would be nice, we are also talking about an area of claims that is very expensive for insurers.

This is an update to a similar article I wrote in 2016, and this shows in the seven years since, medical insurance premiums have mostly doubled and what has changed since then. Added to that is access to public health services is at an all-time low, with around 2/3 of people not being seen in required Ministry of Health time frames.

Don't take my word for it; you can check out Public Health services delivery response that is linked, though this hasn't been updated since before the 2023 election. Click time series view, and it will show you how well current public health delivery is achieving to expectations.

Have you had an injury or medical event, and you have found you haven't been treated as quickly as you expected, with the result you are now living with some level of permanent impairment?

Over the years, this situation has arisen regularly, prompting some interesting responses from our medical and health systems.

With increased awareness and understanding of scams and data breaches, people are increasingly concerned about protecting their data. 

We've seen an increasing number of people, some well-educated and working in financial services, being taken for large amounts of cash through unwitting scams or just plain fraud.

If the people who should know better are getting taken in on these things, what chance do you have?

Often said in business 'You need to get out there and network!' The problem with this statement is it is not that helpful for those who haven't done it before. 

In a recessionary market, the way forward is to get out there and market, not retrench and pull back. "When in Hell, don't stop! Keep going." often attributed to Winston Churchill 

Yes, you may have been to a conference or two, but if you haven't been in a sales or relationship role previously, networking can be daunting, especially when you're trying to get your new venture off the ground. 

Great idea, product or service. You're busy getting going, so adding more to the load isn't easy to contemplate. Even if you've been in business for a while, you need new or more contacts, but you're not sure how or where to spend your time.

Breast cancer is a consistent news story we all see, in more recent times we've seen the challenges people face with their insurance company's getting breast reconstructions done.

This 2016 article in the New Zealand Herald, 11th Hour Shock, for Anna Jobsz who is having a preventative mastectomy and breast reconstruction is pretty typical of what we see.

This follows on from the high profile treatment Angelina Jolie had when she found out she was exposed to a high chance of developing breast cancer.

 We hear regularly about the challenges of Dunedin student flats, expecially for those students about to start the year and are flat hunting.

If you're renting, you need to have some level of contents cover. Ideally, it is enough to replace your possessions but, more importantly, cover damage you may be liable for.

Where do I start with this? There are so many things wrong that it's not easy to pick on one thing.

Having been involved with life, disability, and medical insurance for over two decades I've seen a thing or two.

Just to quantify what I'm talking about before I launch into a ranting tirade about our medical system from some middle aged stale pale male, let's have a look at what I have seen more recently.

It's been ten years since insurers started adding breast reconstruction after cancer surgery to medical insurance. At the time, insurers had a hard time with the subject, but over the last ten years, all insurers, with the exception of some older employer plans, now have the benefit.

The article, which you can read here, only mentioned four of the 10 providers of medical insurance benefits in the New Zealand market at the time, which does the market a disservice as it does provide valuable benefits to policyholders in need with 8 out of 10 at the time having some response to breast reconstruction after surgery.

I’ve said for many years that Kiwi's love being self-employed, and we seem to switch between employed and self-employed a lot. Some succeed, some have a change of direction, and some are about a change of situation. The point is that change is inevitable.

What will surprise you; typically, there are over 45,000 start-up businesses each year in New Zealand. Anecdotal evidence also suggests that a large number of these businesses are registered with the Companies Office early in the new year. Unfortunately, a lot of these businesses will simply fail due to cash-flow constraints. Some will be because the business isn’t sustainable, but the more likely reason is someone got injured or was prevented from working due to a disability.

I work but don't get paid; the insurance company won't insure me.

This is probably right for disability-related benefits. Not to diminish what you do, but lots of valuable people in our community do essential things but don't get paid for it; mothers and volunteers tend to top that list.

One of the factors with this is that insurance companies insure for financial loss; with unpaid occupations, this is hard to quantify.

Janine Starks has recently highlighted issues with the way banks are operating mobile payment services, and it's a bit scary.

Back in Feb 2023, Janine published this article outlining the problem; overseas and not here, most won't have taken any notice

However, more recently, there have been cases where New Zealand account holders have been ripped off using the same approach.

So you have existing medical insurance coverage, but you are concerned about unfunded and non-Pharmac subsidised medicines, especially for cancer.

You are concerned because your present cover is either limited or non-existent for this area of your medical treatment. 

If you are fit and healthy, then this is not quite the issue it could be, and moving to a plan that does cover this is relatively straightforward. 

But that’s not the reason you are reading this either.