NZMedical.

Online Insurance for Kiwis

Frequently Asked Questions

Q: How are my premiums calculated?

A: We consider your age, gender, excess selected and current health status when we calculate the premium you are required to pay in relation to the benefits you have selected. Try changing the age, gender or excess in the Quote Calculator.

Q: What is an excess?

A: Sovereign has several excess options available on the policy, which may help to reduce the total amount of premium you pay. An excess is the amount paid directly to Health Care providers before the policy begins to reimburse. Choosing a higher excess means that the premium you pay will be reduced. It all depends on you and the amount you want to pay out of pocket at the time you receive a medical treatment, which is covered under the policy. An excess does not apply to the Optional Specialists and Diagnostic Testing claims.

Q: What is Rate for Age?

A: Rate for Age is applied to all benefits. The premium will be recalculated at each anniversary date based on the age of the life assured, the amount of cover and Sovereign's underlying premium rates at that time. Claims tend to rise as you get older, and medical costs continue to increase each year. Your annual review will reflect these costs in premium increases.

Q: What are Diagnostics?

A: Typically, someone with abnormal medical symptoms will consult a doctor, who will then obtain a history of their present condition and examine them for signs of disease.

Diagnostics is the process of identifying a disease by its signs, symptoms and results of various medical Diagnostic Testing or procedures. The conclusion reached through that process is called a diagnosis.

The list of most likely and possible diagnoses based on available information is called a differential diagnosis; the final diagnosis is only arrived at after other diseases on this list have been eliminated through further investigations or consultations.

Q: Where do you go for diagnostics?

A: Diagnostic testing can be conducted in a variety of medical establishments, including hospitals, depending on the type of testing required. Your doctor or specialist will be able to advise the appropriate establishment to visit.

Q: How does Sovereign Private Health cover diagnostics?

A: Private Health's base policy provides cover for surgical or non-surgical private hospital admission. These are subject to the benefit maximums and any excess as defined in the policy wording.

Surgical benefits:

  • General Surgery
  • Cardiac Surgery
  • Oral Surgery

Non surgical benefits:

  • Medical Hospitalisation

Diagnostic fees and/or procedures are also covered under the optional "Plus" (Specialists and Diagnostic Test) benefit and are subject to the benefit maximum. Optionally, no excess applies under this optional benefit, or you can select a $250 excess to save on the Plus premium.

Q: Are visitors and new immigrants eligible for public health or to apply

A: Residents and people holding work permits for a stay of two years or more (and their dependent children) are eligible for publicly funded health and disability services.

They may also apply for Medical Insurance. Other work permit holders, students, and visitor permit holders generally are not eligible.

Q: We are visitors. Are we covered by the public health system?

A: People covered by New Zealand's Reciprocal Health Agreements with Australia and the United Kingdom are entitled to publicly funded health care for immediately necessary medical treatment only. Other overseas residents visiting are not and must pay for health care.

Q: How long does it take to pay claims?

A: Our clients have advised that they have had an excellent claims service from Sovereign. They will pay claims within 48 hrs of receipt of documents. We recommend that you seek pre-approval for certainty.

Q: What sort of savings can I get by changing from a Comprehensive to a Hospital and Specialists plan?

A: This is dependent on age and options selected but savings of up to 50% can be expected. Use our Quote calculator.

Q: Does the Medical Insurance cover you overseas?

A: Normally no, although we have had clients where emergency operations have been covered. These costs should be covered by Travel Insurance. You normally need to return to New Zealand to receive the benefits of the Private Health policy. (Note–whilst overseas premiums can be placed "on hold" on your request.)

Q: Are pre-existing conditions covered?

A: Pre-existing conditions are covered, if the symptom or condition was disclosed at the time of your application and accepted in writing by Sovereign. The best way to find this out for your circumstances, is to submit an application, and include all details of any conditions, (there is no cost in applying). Any "conditions, exclusions, or loadings" will be clearly identified in an offer to you.