Congratulations on your choice to move to New Zealand!

We may just about be the farthest country from just about anywhere on the planet, but it is the best country in the world.

If you have just stepped off the boat or you have been here for a while, you are probably in for a bit of culture shock. While things here often look the same as home, they are just a bit different.

Our legal system is similar to Australia's, and like them, it is based on the British system, but it is different. First, you cannot sue people for punitive damages, which is a popular pastime in the US. We have a very unique system here called ACC, or the Accident Compensation Corporation, that covers that aspect automatically. 

ACC, what's this?

There is more on ACC in our FAQs. In summary, ACC pays for your medical treatment in an accident situation and replaces your income if you were working and that accidental injury prevents you from working.

The ACC system was established in 1974, primarily to address the issues caused by accidents connected to the Kiwi “She'll be right attitude”. 

New Zealand's personal insurance coverage for income protection and health insurance is some of the lowest in the developed world. ACC, which is paid for and funded by levies on the population, is an accident-only version of these insurance products. In some ways, it has contributed to the underinsurance by providing some security. However, it is often misunderstood that it does not cover non-accident medical conditions.

Some of the other things we have created a false sense of security, too. One is free medical care for children under 13. While this is great for families with children, it masks the need to have insurance for the conditions children typically get that will result in a wait for surgery.

We have two types of medical treatment provided, publicly and privately:

Emergency or immediate need, which our public hospitals and emergency departments do an excellent job. They are the only place to go for emergencies, there are no private emergency options in New Zealand.

It sounds strange to have your necessary treatment labelled elective, but that is the label here in New Zealand. Elective surgery is surgery that is not directly life-threatening, so it can wait, but it is necessary to relieve significant medical conditions or improve the quality of life.

There is a third surgery type, Cosmetic surgery, you are on your own with that, as neither the Public or Private Insurance systems will pay for your treatment here.

What's it really like?

We've seen our public health system struggle over the last couple of years with Covid, and it's not getting any better. Wait times for public health referrals are missing the maximum 4-month window for first specialist appointments. On the private side, things have slowed down; we're still miles ahead of the public system, with specialists, testing, and surgery typically done within 4-6 months. 

What the private numbers are hiding is one of the great things about private, you can schedule your surgery when you want it. I often see options presented to clients in private that can address their needs in a week or two, but for the convenience of life, it gets pushed out further. 

We regularly have clients who can have surgery done now push dates out to holidays or quieter periods; this means private averages look longer than they usually are. Sometimes, it takes time to try things and seek second opinions, this can be accommodated where the public system won't play here.

I have seen referrals, specialist consults, and surgery within the same week privately.

Public system reality

The Public system works a bit differently and you don't get a lot of choice about your surgery when your number is up, it's up. They do not like rescheduling it, and if you do, it can mean you are back at the end of the queue again.

While we have substantial wait times for public hospital surgery, it doesn't show the wait of those who haven't qualified for the waiting list, nor does it show how long they waited to get to the referral point. This could be years!

It was identified in 2015 that some 170,000 people who need surgery don't qualify for a waiting list; this is quite a significant unmet need for the public health system and it has only got worse since then. This is part of what the numbers above are hiding, and the government is being less than transparent with it.

Pharmac

That was about surgery, on the funding side, we have a Government drug-buying agency called Pharmac. Pharmac manages the negotiation and supply of publicly funded medicines to the New Zealand public through both the public and private systems. They hold the purse strings on which medicines get funded and which don't in New Zealand.

Here in New Zealand, presently, it can cost up to $200,000 to access some medical treatments you may have considered normal under your health system in your home country. We call these unfunded medicines. Presently, they are predominantly in the area of cancer treatment, but other conditions do have limited funded medicines, too.

Breast cancer, melanoma, and leukemia are the three big ones where unfunded medicines tend to hit the news headlines. Current testing for some of these existing treatments for bowel cancer will also fall into this category.

Ok entitlements

1. If you are here on a work visa for more than two years, you will qualify for the public health system. The same applies if you have a residency or permanent residency visa. PR and Citizen are generally interchangeable when talking about public health; they have the same access and support.
2. If you are here on a work visa that is shorter or a working holiday or visitor visa, then you need to have travel insurance for your medical treatment costs. Either from your home country or arrange inbound travel insurance for your medical needs here with a local provider. We know a good one.

What's the best answer?

If you're in situation one above, get some good health insurance. The sort that pays for the large unfunded medicines bill. Because this problem is not going away in the next 10-15 years. The budget from the government isn't increasing fast enough, and the terms of the patents on these medicines still have a long way to go before they hit the generic medicines market.

Our largest and most common medical provider, Southern Cross, does not offer a plan that covers unfunded medicines to the level you need. Most people look at the unlimited policy cover and don't read much past that. They do have a provision for unfunded medicine, but it is limited to $10,000.

The second thing is to get some form of income protection. If you're on a work visa, this is likely to be indemnity (prove the loss at claim time) only, though we do have some options around this with specialty products if they are suitable.

Something else to consider.

If you have immigrated but the rest of your extended family is back in your home country, a medical policy that covers medical tourism is worth considering. This will allow you to return to your home country for your surgery and have your family around while you work through your recovery.

That would be of course if the reason for you moving halfway around the world were not to get away from them ;)

Get advice

As you can see, there is a need to get some advice. This is where we come in with Willowgrove Consulting. We're specialist advisers in the area of personal risk. 

We take the time to ensure our clients understand the issues so that they can make the best-informed decision for them. In the area of immigrants, it's ensuring you understand the differences here that you may not be aware of when compared to home. It's surprising how many around us here at Willowgrove are also immigrants, so we know what you are facing.

Give us a call or if you're reading this and are looking at moving to NZ, drop us an enquiry, and we can chat about some of the things specific to you that you need to consider.