Health insurance: What to review and why?

Health insurance can make a big difference when you need to access medical treatment.

Depending on what is required, having cover can mean you can avoid hospital waiting lists and have major costs covered.

But, as with most insurance solutions, it’s not something you can set and forget.

It’s important to review your health insurance regularly to make sure it’s still a good fit for you.

Here are a few things to chat to us about when it’s time to check in.

What’s covered?

Health insurance policies are not all the same: some cover you only for surgical and hospital treatments, others cover specialists or diagnostics, while some help cover the cost of run-of-the-mill healthcare needs such as optometrists or GP visits. We can guide you through what you are covered for, and the situations in which you could make a claim.

For example, there may be common procedures that are excluded from your policy, or limits on how many times you can claim for a certain treatment. You might also want to know how generous the policy is about scans and investigations, or whether it covers non-Pharmac drugs.

Do you have enough cover?

A review is a good chance to talk to us about your biggest concerns, so we can make sure your insurance is addressing them. What are the things you really want cover for, and what are you happy to self-insure? As your insurance adviser, we can help you work out whether you’re happy that your cover is providing enough protection – and how it might apply to the things that matter most to you.

What pre-existing conditions are excluded?

Depending on when you took your health insurance out, you may have pre-existing conditions specified in your policy. This means that you may not be covered for health issues that you had before you took the cover out. Sometimes insurers will cover these after you’ve been with them for a set period of time – we can help you work out whether this is the case for you.

What would happen at claim time?

Health insurance is one of the more frequently claimed-upon types of insurance. We can tell you what your claims experience is likely to be like. In some cases, you may be expected to pick up part of the bill on the day of your treatment, if you have an excess on your policy. Plus, most insurers usually require you to get pre-approval for large claims (e.g., surgeries).

Is it still the right policy for you?

We can help you work out whether the cover you have is still fit for purpose – whether it is designed to cater for the things that are most important to you, and whether it provides the level of support that you would like to have available to you.