Those that have been reading my blog and social posts on a regular basis will have seen I’ve got a particular bee in my bonnet about unfunded medicines. Partly driven from my view insurance advice needs to improve but also ensuring you have access to the best treatment possible when you really need it the most.

This blog article was updated and reposted here on the 3rd of October 2016. I have left this here for comparison purposes to show the impact of Sovereign's announcement on the 30th of September.

As I wrote in this article, unfunded medicines the real risk to you, if you’re a Southern Cross policy holder you have about a 6.3% risk that if you develop cancer you’ll have to find money to pay for your cancer treatment. If you’re with another provider who doesn’t have any contribution to your unfunded treatments, you’ll have a 15% chance you’ll have to contribute to your treatment.

I wrote recently about a new approach Asteron was taking to income protection.

In the right client situation quite appropriate, in others it would potentially be a disaster. As the options in insurance advice expand and hybrid or niche products develop, the need to have an adviser involved is even more apparent. One that really understands the application of insurance benefits to your risks.

One of the things that is often said, reported in the news, and generally complained about are the increasing costs of medical insurance.

We've heard about Southern Cross policyholders up in arms because of the premium increases they have seen. To be fair, all providers' premiums increase; Southern Cross has the biggest pool of clients and the oldest pool of clients, so increases do hit hard in that particular group.

This article has been updated here, and this one has been maintained for historical reference.

Mobile phones, those funny devices that used to be the domain of yuppies and annoyed those looking for a quiet dinner out, now we can’t get by in life with out one.

The expectation is you’re now available 24/7 and your smart phone will substitute all manner of thinking requirements.

We’ve heard plenty about mobile phones and driving, yet people still hold their phone while driving. No, holding it in your hand on speaker phone is not hands free ;) ahh, it’s still in your hand!

Though, they are causing all manner of distractions, and my couple of weeks driving an electric vehicle highlighted this, as I nearly mowed down at least 6 or 7 ambling pedestrians.

There's an undercurrent philosophical debate going on just behind the screen. At present, you're unaware of it, unless you're already in the health system as a patient or a doctor. This undercurrent defines what treatment is available to you and how much the government is prepared to spend their budget on you.

It might sound crass to put a number on the value of a life, unfortunately, in the world we live in, money talks, you know the rest.

The New Zealand Herald kicked off their five-part series on cancer today. Martin Johnson investigates the controversies in cancer testing and treatment and the moving stories of people diagnosed with cancer.

I've mentioned many times, here in my blog and many times to clients and frankly anyone who will listen, that our public health system, while good in many areas, often falls short in many others.

Managing medical expenses is a large area of risk management. It is also an area where people often don't spend a lot of time. Public health is an area where the government spends the most ($15 billion for 2015), which should be an indicator that you need to consider your options here as well. 

Medical Insurance Treatment Myths and Realities

My share of my blog post on Movember got a really good reply with some well thought out points that I come across with clients every day. Some are well founded and understood, others things have changed as has the approach. I felt it was worth a blog post by itself.

Susan’s original post:

Good on you Jon-Paul, admirable cause, but it is my view that Health insurance company don't do Health prevention, you have to pay for this type of health service even if you have a mastectomy your health insurance won't pay for a re-build for want a better word, apparently its plastic surgery and its not covered to have you looking normal after going through harrowing surgery and treatment...

When the subject of medical insurance or cancer treatment comes up, the discussion on non-Pharmac medicines usually follows.

What are non-Pharmac medicines?

Non-Pharmac medicines are where the government does not fund the drug or treatment being prescribed or recommended for a treatment and you will have to find the money to pay for it.

It does not matter what the stats are, if you are someone who needs a treatment and the government does not fund it, you want to be able to access it. Which is why, dollar for dollar you take the medical policy with coverage over the one that does not, even if it is a bit more expensive you probably still should.

ACC have published the new motor vehicle levies and they make interesting reading.

ACC have gone through and assigned a rating system from L1 to L4 for most vehicles, L1 being the most expensive and L4 being the least. If yours is not defined then the levy works on a year of manufacture basis. L1 for older vehicles and graduating though to the cheapest L4 for newer vehicles.

The reason I’m writing this is I disagree with some of the assertions in the NZ Herald article. ACC have done this review based on claims risk from actual injury data not vehicle safety. Injury’s drive ACC’s costs, not vehicle safety. Yes safer vehicles generally means less injuries and less ACC cost, but that doesn’t always translate directly from vehicle safety testing.

Ok, I have raved about this in other blog posts. I have had an idea, a general concept, that access to medicine was becoming a problem—a real problem—with one of the four pillars of New Zealand society: Health, Education, Justice, and Social Support.

Now with this latest report, there is a clear indication we’re well behind with Health funding. Education, Justice and Social support all have their challenges, I am sure, but Health is an area I spend a lot of my time working with on behalf of my clients.

Something that often pops up in the insurance industry and media, but what does it really mean for you.

Over insurance is where you are carrying more protection than you need and under insurance is when you have less than you need.

This is not about you having insurance or not, it is about you having the right type of insurance, at the right level for your situation.

Looking at the numbers, most households will have some form of insurance. It might be House, Contents or Car cover, it may also be Life or Medical Insurance.

What the numbers do tell us though, about 80% of households, possibly higher, will have exposure if someone was to be disabled and 75% of you would have to use the public system for medical treatment, or pay your own way for private medical treatment.

Breast cancer, or for that matter any form of cancer, with women gets a reaction in the media. Breast cancer has certainly been the one that has had the majority of attention over the years.

In 2003, there were large headlines about access to Herceptin and its costs, especially as the Aussies had access to it from an early stage.

• Here in NZ, the budget at the time just didn't have the capacity to handle the cost.
• On the insurance side, there were only two medical insurers at the time able to offer cover, one that stopped not long after Herceptin hit the market, leaving 1 insurer providing non-Pharmac cover for new policies for nearly 10 years.

Now that we've got over most of the funding discussion on herceptin, it's partially funded rather than fully funded; other areas around cancer treatment are getting attention.

The health system is a bit like public transport. Something you take if you have to, but something you'd rather avoid. And just like the bus, it can be a pain to catch, sometimes it's right on time, most of the time it's full or you just plain old miss it.

Today's health system is markedly different from what it was even 5 years ago. It's starting to look like it's being rationed rather than provided as a free public service.

These articles highlight the plight of those subject to waiting for the public health system:

If you are pregnant or looking to have children, this is a great question to be asking.

To start with, you will be focused quickly on how baby is doing and finding the right baby things for you to be using, then after baby arrives, you will be too busy with baby to think about insurance.

One insurance thing you do need to put on the to-do list, is adding baby to your medical insurance cover within three months of arriving, this article talks more about baby. This post is about you as mum.

In general, if you have income protection you will have some disability coverage for the first 12 months after finishing work, if you are on maternity leave for longer than this, then things get a little more interesting.

Roy Morgan Research has published updated information on insurance coverage in New Zealand and it is not a particularly pretty picture.

What does it really look like out there in New Zealand?

Almost 1 in 7 Kiwi’s do not have any insurance cover at all. I don’t know about you, but 1 in 7 people I know are not financially independent enough not to need insurance cover at some level. This suggests Kiwi’s are taking the risk that ‘she’ll be right’. This may be knowingly but most likely unknowingly.