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.

Medical insurance is a changing landscape, not only with policy terms and conditions but with the providers now. 

10 years ago, we had 10 different medical providers; we now have 6 and likely that there will be more mergers in the market.

Medical insurance is a product that typically is not reinsured, so the money for claims, operating the insurer, marketing & sales all come out of the same pot.

 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.

Mental Health - Not so much the resources but the funding

Since Covid hit we have seen a marked incraes in people's awareness of mental health and the distinct lack of support we have in the general community.

As an adviser, mental health comes up in discussion on a regular basis. Be it working through an existing application, discussing the terms of cover an insurance company has offered or dealing with a claim.

This prompted me to have a closer look at what services are available and what funding and financial support for mental health exists for you, if you need it.

Melanoma is the most serious form of skin cancer and with over 4,000 people diagnosed with melanoma in New Zealand each year, we have one of the world’s highest rates. Sun exposure is the number one cause of melanoma, with genetics also playing a part. Melanoma is the uncontrolled growth of melanocytes, which are the cells which produce the pigment which colours our hair, skin and eyes. If caught early enough, it is treatable, but once it has spread, the prognosis is not so great.

It’s all about Pharmac when it comes to melanoma treatment. Pharmac either fund it or they don’t. If they do and if it is the right treatment for you, then you get it. If they don’t, even though your doctor recommends it, you get a big fat no. A no is not something you want to hear when you’re battling a diagnosis of melanoma, regardless which stage it is at. So, how do you turn that no into a yes and get the right treatment for you?

Do You Need to Fight for Your Melanoma Treatment?

Breast cancer is a game changer. With over 3000 women and 20 men diagnosed each year, breast cancer wrecks lives. It’s not all doom and gloom however. If identified while it is in the early stages, a complete recovery is possible. The problem being, access to free breast cancer screening is restricted here in New Zealand.

Truth About Breast Cancer

It sucks. What more can I say?

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.

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.

Insurance and shades of grey, no not 50 shades but certainly something most people don't like to hear when it comes to insurance. Most people want to hear black and white. My experience is every claim has shades of grey and they are rarely cut and dried. There is always something that pops up; most are foreseeable, some not so much.

Where I am going with this is the differing effects different policy wordings have at claim time.

For example there are a few insurance company trauma policies where a good angina attack could almost qualify for a trauma claim and then there are others where you have to be half dead and not working, probably not working in a manual job ever again, before you could claim.

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.

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.

This is where as an adviser, I’ve sat down across the table and the eye’s have rolled, saying here we go again.

You know what, it probably is a good idea, she has been thinking what if?

Especially 'what if you're not here?'