Health Insurance in New Zealand: How to choose your plan

New Zealand has one of the world's most unusual healthcare systems. The government covers all accident-related healthcare for everyone in the country (tourists and foreigners included). This is done through the accident compensation corporation (ACC).

But there’s an important caveat: ACC doesn’t cover most illnesses. This means tourists and short-term expats are covered if you break your leg skiing, but not if you get pneumonia. That’s why health insurance in New Zealand is key for most.

It’s important to understand the difference between these treatments. In fact, it’s one of the most important elements of healthcare in New Zealand.

In this article, we explain the system in detail, so you can understand what health insurance you do (and don’t) need.

Basics: How does healthcare work in New Zealand?

New Zealand has a generous public healthcare system, offering wide coverage for both citizens and long-term residents. Mostly, healthcare is either free or heavily subsidized and is largely funded by taxes on employers and employees.

In fact, New Zealand was one of the first countries in the world to create a universal healthcare system – in 1938. But the system has evolved a lot since then. Most importantly, private healthcare now plays a bigger role.

This is because the public healthcare system in New Zealand doesn’t cover all treatments and costs. For instance, treatments like eye and dental care (for over 18s) aren’t included. At the same time, certain expats don’t get medical coverage automatically either. And for local citizens, private healthcare can offer wider coverage and shorter waiting times. That’s why many still choose to buy health insurance in New Zealand.

Public healthcare in New Zealand

Public healthcare in New Zealand involves two major systems:

Accident Compensation Corporation (ACC)

The ACC provides healthcare treatment for accidents. This is a fairly unique feature of healthcare in New Zealand. Not many countries have separate systems for accidents and other medical treatments. Here are some examples of treatments that ACC covers:

• Broken leg from a fall
• Sports or exercise-related injuries
• Burns from an accident at home or work
• Concussions or other accident-related trauma

Here’s the most important thing to know about ACC: It is available to everybody in the country for free. That includes citizens, expats, visitors, tourists, and even undocumented migrants. This is also quite rare in other countries. It is also not the case for the standard public healthcare system (see next section).

It can initially be a bit tricky to work out what treatments are and aren’t covered under ACC. For instance, a leg injury caused by a fall is probably covered by ACC. But if it’s caused by arthritis or osteoporosis – it probably isn’t.

Standard public healthcare

The standard public healthcare system covers most other healthcare treatments, including:

• Inpatient and outpatient care
• Maternity
• Mental health support
• Prescription medication
• Rehabilitative and palliative care
• Preventative care

In practice, this is the default option for most healthcare treatments in New Zealand. But unlike ACC, it’s not available to everybody. Visitors, tourists, and short-term expats aren’t covered under this system. This can be confusing, as visitors get accident coverage – but not most other healthcare treatments.

There’s also another important difference. This system involves co-payment costs for some treatments. This is mostly restricted to GP visits and prescriptions. But these costs are still subsidized and capped by the Government. In general, you can expect to pay around NZ$15-50 for GP visits. Prescription medicines are also capped at NZ$5 per item.

But there are also several subsidies for these costs:

• Community Services Card: Offers reduced costs for people on low or moderate incomes.
• High Use Health Card: Another subsidy for anybody who visits the GP more than 12 times a year.
• Prescription Subsidy: Prescription charges are capped at 20 items a year. Everything thereafter is free.

Private health insurance in New Zealand

Private health insurance also plays an important role in New Zealand. In fact, around 37% of people have a separate private policy. Many people buy this themselves, but others get plans through their employers. Here are some reasons why private healthcare is popular:

• Waiting lists: Public healthcare in New Zealand struggles with long waiting times. Partly, this is due to staff shortages and limited capacity. In fact, the country has around 251 hospital beds per 100,000 people, less than half the OECD average of 537. Private health insurance in New Zealand offers high-quality treatment without the waiting times.
• Coverage: Public healthcare doesn’t cover certain treatments, including physiotherapy, eye care, and most adult dental procedures. Private insurance extends your coverage to avoid out-of-pocket costs.
• Co-payments: Private insurance can also cover the co-payments for GP visits and prescriptions.
• Expats: Most importantly, certain expats don’t qualify for public health coverage. This mainly applies to students and anybody on a work visa that lasts for less than two years. Here, private insurance is the only way to avoid out-of-pocket costs.

If you’re looking to get health insurance in New Zealand, there are two main options:

New Zealand private healthcare

This is the default option for long-term residents and citizens. It offers widespread access to private health providers in New Zealand. It also includes additional treatment like dental and eye care, while also covering co-payment costs.

This works for long-term residents who spend most of their time in New Zealand. But for expats, there's a catch. This option is designed to top up the public system, so if you're not eligible for public healthcare, most local insurers won't accept you either. That means it’s usually only feasible for citizens and long-term residents who already have public healthcare.

There are several private insurance providers in New Zealand. However, Southern Cross is overwhelmingly the largest, with a market share of around 65%. Other well-known options include nib NZ, AIA, and Chubb.

International health insurance in New Zealand

The other main private insurance option is best for expats and anybody who regularly travels abroad. That’s because it offers global health insurance outside the country. This is on top of the same coverage as standard health insurance in New Zealand.

But this is also the best option for expats who aren’t covered by the public healthcare system. It's also the only realistic option for expats who can't get public healthcare; local insurers usually won't accept you either. This applies directly to students and anybody on short-term work visas. In this case, international health insurance will cover everything except accidents. That includes GP visits, prescriptions, and hospitalizations, alongside dental and eye care.

Read more: International health insurance: a guide for expats

Public vs private vs international: Comparing the main healthcare options

Looking to choose the best health insurance in New Zealand for your situation? Here’s a comparison of the four main types of healthcare options we’ve discussed in this piece:

So, which is the right option for your situation? Here are some examples to help you decide what’s best for you:

• Tourist/visitor: ACC covers accidents, but you don’t qualify for public healthcare coverage. The best choice is generally international or travel health insurance in New Zealand.
• Work visa, more than two years: If you’re on a work visa of more than two years, you qualify for public healthcare. You may also choose private health insurance to boost your coverage and avoid long waiting times. If you regularly travel abroad or plan to return to your home country, international health insurance is a good choice.
• Work visa, less than two years: In this case, you don’t qualify for public healthcare. You will likely also struggle to be accepted by standard private insurers. Therefore, international health insurance is likely the best option to avoid out-of-pocket costs.
• Student visa: Students aren’t covered by public healthcare. You also have to have private insurance as a requirement of your student visa. International health insurance is generally the best choice here.
• Permanent resident/citizen: ACC and public healthcare will cover most healthcare needs. Consider additional private or international health insurance to reduce co-pays and waiting times.
• Retiree: Assuming you’re a permanent resident, you’ll qualify for ACC and public healthcare. But if you want private coverage, international health insurance can be a better option. That’s because standard private insurers often have age limits, meaning you might struggle to get coverage. Even if you do, premiums will likely be higher.

Feather: International health insurance in New Zealand

At Feather, our goal is to make healthcare coverage as easy as possible for expats right around the world. And when we say that, we really mean it – because we were founded by expats like you. We know that getting decent health insurance as an expat is harder than it should be. And that’s why we’re on a mission to make it as straightforward as possible.

To do that, we offer international health insurance in New Zealand and around the world. Here’s what that includes:

• Worldwide coverage, including New Zealand, portable when you leave
• Covers illness, repatriation, and healthcare in your home country
• Meets student visa insurance requirements
• Continuous coverage, regardless of visa status changes

If you want to chat through your situation, get in touch with our friendly team to see how we can help.