Compare & Save On Health Insurance

What private treatment costs in NZ, and what health insurance costs

$28,300–$33,200is what a hip replacement costs in a private hospital, according to Southern Cross Health Society claims data³

That is the bill health insurance exists to pay. Without cover, going private means paying it yourself; with cover, you pay your excess and the insurer pays the rest, up to the policy’s limits. These are typical private costs for common procedures:

Southern Cross Health Society, 2025–2026 claims data, GST inclusive. Ranges cover the surgeon, anaesthetist and hospital; your own cost depends on the hospital and the specialist.

What health insurance itself costs

Premiums are set per person: by your age, the level of cover, your excess and any add-ons. That is why there is no honest single figure for “the cost of health insurance”, and why this page does not publish one.

What is clear is the direction. Premiums follow claims, and claims have climbed: the average health insurance claim paid per member was $1,921 in 2025, up from $1,097 in 2021¹. Southern Cross Health Society reported its claims cost growth easing from 12.2% to 7.1% a year in its latest annual result, and said it expects premium increases to moderate⁴.

The only way to know your own price is to compare plans on your own details. A free adviser can do that with you, across insurers, including what each plan leaves out.

Do you need health insurance in NZ?

35%of New Zealand adults, about 1.5 million people, held private health insurance in 2024/25¹

No law requires it, and public healthcare is free for eligible residents. Emergencies and acute illness are treated in the public system whether or not you are insured. What health insurance changes is the non-urgent part: the specialist appointment, the scan, the operation that is needed but not urgent.

That is where the public system prioritises by clinical need, and where waits happen. In April–June 2026, 66.1% of patients were seen for a first specialist assessment within four months, and 72.6% of those waiting for treatment received it within four months. The government’s target is 95% by 2030².

Public vs private healthcare in NZ

Quashed does not tell you whether to hold health insurance. The point of this page is that the decision gets made on real numbers: what treatment costs, how long the wait is, and what a policy would and would not pay for.

What health insurance covers

A health policy is built in layers. Every plan starts with hospital and surgical cover; the rest is added on. 67% of policies held in New Zealand are hospital-only, with no day-to-day cover¹.

1. The core

   Hospital and surgical

   Surgery and hospital stays in a private hospital, including the surgeon, anaesthetist and theatre. This is what most policies are built around, and the part that pays the large bills.

2. Often included or added

   Specialists and tests

   Specialist consultations and diagnostic tests, such as scans and colonoscopies, before and after surgery, and sometimes when no surgery follows. Some plans include it; on others it is an option.

3. Usually an add-on

   Non-Pharmac medicines

   Medicines Medsafe has approved but Pharmac does not fund, most often for cancer. Limits vary widely between plans, from about $10,000 a year on some base plans to several hundred thousand dollars with an add-on.

4. Day-to-day

   GP, dental, optical, physio

   Smaller, regular costs, usually paid back at a set percentage up to an annual limit. Sold as a separate plan or an add-on. It is priced on top of the hospital cover.

Health insurance vs medical insurance

They are the same thing. “Health insurance”, “medical insurance” and “private medical insurance” are all used in New Zealand for cover that pays for private treatment. Insurers use different names for their plans, which is part of why comparing them side by side is harder than it should be. It is different from trauma insurance, which pays a lump sum on diagnosis of a serious illness rather than paying treatment bills, and from life insurance.

How a health insurance excess works

An excess is the part of a claim you pay before the insurer pays the rest. Choosing a higher one lowers your premium, because the insurer pays less on every claim.

Raising the excess is one of the main ways people keep their cover when premiums rise. Southern Cross Health Society reported that 17,772 of its members added or raised an excess to keep their cover in FY25⁴. The trade-off is what you would pay yourself if you claimed. Some policies apply the excess per claim, others once a year, so check which when you compare.

What drives the price of health insurance

• Your age

  The biggest driver. Older members claim far more, so premiums rise as you get older, typically stepping up at each birthday.

• The level of cover

  A surgical-only plan costs much less than one that adds specialists, tests and day-to-day care. Most policies held in NZ are hospital-only.

• Your excess

  A higher excess lowers the premium, because you pay the first part of each claim yourself. See how it works below.

• Add-ons

  Non-Pharmac medicines, specialists and tests, and day-to-day benefits are each priced on top of the core plan.

• Who is on the policy

  Adding a partner or children adds to the premium. Children are generally priced well below adults.

• Individual or workplace

  Group schemes through an employer are often subsidised or discounted, and some accept pre-existing conditions at the start.

Six ways people pay less for health insurance

1. 1

   Compare plans across insurers

   Similar cover can be priced quite differently by different insurers, and the plans are structured differently enough that the cheapest-looking one is not always like for like.

2. 2

   Look at a higher excess

   Paying more of each claim yourself is a common way people bring a premium down without dropping the cover itself.

3. 3

   Check for a workplace scheme

   Many employers offer subsidised health insurance. A new employee is sometimes offered cover for pre-existing conditions, which individual policies rarely give.

4. 4

   Review the add-ons you pay for

   Day-to-day benefits cost more to hold than many people claim back. Some keep the hospital cover and drop the add-ons they do not use.

5. 5

   Pay annually if you can

   Some insurers charge less for an annual payment than for monthly or fortnightly instalments.

6. 6

   Check before you switch

   A cheaper policy that excludes a condition your current one covers can cost far more than it saves. See switching, below.

Pre-existing conditions and waiting periods

A pre-existing condition is one you had signs or symptoms of, or advice or treatment for, before your policy started. It is the single most important thing to understand before you buy or switch.

Health insurers commonly exclude pre-existing conditions. Some policies start covering certain pre-existing conditions after a period of continuous cover, often three years, while conditions such as heart disease, cancer or joint problems may stay excluded permanently. Others ask health questions at the start and write specific exclusions onto your policy.

Many policies also have stand-down periods for particular benefits, such as a few months before dental or optical claims. Illnesses that first appear after the policy starts are generally covered from day one.

This is why the best time to take out health insurance is before you need it, and why switching needs care: a condition that arose while you were insured with one insurer will usually count as pre-existing with the next.

Health insurance for families, children and workplaces

29% of New Zealand children were covered by health insurance in 2024/25¹. Most insurers let you add children to your own policy, and at least one sells a plan for children on their own. Covering children young means a condition that develops later is a new claim, not a pre-existing exclusion.

Workplace schemes matter more than many people realise: 43% of insured New Zealanders are covered through a group scheme, usually subsidised by an employer¹. Some accept pre-existing conditions for new staff. If you leave the job, ask the insurer whether you can carry on with an individual policy without new health questions.

How to compare health insurance with Quashed

Health insurance plans are hard to compare on your own: different names, different limits, different rules on pre-existing conditions. So Quashed connects you with an adviser who compares them with you, for free.

1. 1

   Choose health insurance

   Start on Quashed and pick Health. It takes a few seconds and costs nothing.

2. 2

   Tell us what you are after

   New cover, or a second look at the policy you already have. Reviewing an existing policy is just as common.

3. 3

   Book a time that suits you

   Pick a time for a free chat with a health insurance adviser. No phone calls you did not ask for.

4. 4

   Compare plans on your own details

   The adviser compares plans and what each one covers for you and your family. There is no obligation to buy.

What to have to hand

• Who you want covered: just you, a partner, children
• Your date of birth, and theirs
• Whether anyone smokes
• Any health conditions, and recent treatment or tests
• Your current policy and plan name, if you have one
• Whether your employer offers a health scheme

Financial advisers in New Zealand must put your interests first and tell you how they are paid, including any commission from the insurer⁵. Ask if it is not clear.

Compare health insurance

Health insurance providers in NZ

The main health insurers selling to individuals in New Zealand, in alphabetical order. This is not a ranking: there is no single best health insurer, because the right plan depends on your age, health and what you want covered.

Plan names as published on each insurer’s website, 12 October 2026. Insurers change and rename plans; check current details before you compare.

What health insurance does not cover

• Pre-existing conditions

  Conditions you had symptoms of, or advice about, before the policy started are commonly excluded, either permanently or for a stand-down period.

• Treatment in a public hospital

  Health insurance pays for private treatment. Treatment you receive free in the public system is not claimed.

• Injuries ACC covers

  ACC is the first payer for accidents. Policies generally pay only for the costs ACC does not.

• Cosmetic procedures

  Surgery that is not medically necessary is not covered.

• Pregnancy and fertility

  Commonly excluded, or covered only for specific complications and only after a waiting period. Terms vary a lot.

• Unapproved treatment

  Treatment that is experimental, or not approved for use in New Zealand, is generally excluded.

Exclusions vary between insurers and this is a general guide, not a policy summary. Always read the policy wording before you buy.

How to switch health insurers

Switching can save money, and it can also cost you cover you have built up. The order you do things in matters.

1. 1

   Find out what your current policy covers

   Especially any condition you have claimed for or been treated for since it started. Your current insurer may cover it; a new one may not.

2. 2

   Compare, including the exclusions

   A new policy is assessed afresh. A condition that arose while you were insured is likely to count as pre-existing with a new insurer.

3. 3

   Get the new policy in force first

   The Financial Markets Authority’s advice is to keep your old policy running until the new one is in force, so there is never a gap.

4. 4

   Then cancel the old policy

   Check what resets on the new policy, such as stand-down periods for some benefits, before you cancel.

Review my health insurance

Making a health insurance claim

Most claims start with a GP referral to a specialist. For surgery or larger tests, insurers usually ask for prior approval before treatment: your specialist sends the details, the insurer confirms what it will pay, and you know your share, usually the excess, before you go ahead.

Many insurers have networks of affiliated providers who bill the insurer directly, so you do not pay up front. With other providers you pay and claim the cost back. Day-to-day benefits are usually claimed online or in an app with a receipt.

Updated October 2026 by Quashed. This page is a general guide to how health insurance works in New Zealand. It is not financial advice and not a policy summary. Figures are from the sources below and are refreshed when those sources publish new data.

Sources

1. Coverage, claims per member, group schemes and policy types: MartinJenkins, “Insurance and the New Zealand healthcare system”, prepared for the Financial Services Council, May 2026. Coverage figures are from the New Zealand Health Survey 2024/25 (1,519,000 adults); claims, scheme and policy-type figures from the FSC health insurance member dataset, years ending 31 December.
2. Waiting times: Health New Zealand, health targets fact sheet, Q4 2025/26, April–June 2026. Shorter waits for first specialist assessment and for treatment, national results.
3. Procedure costs: Southern Cross Health Society, 2025–2026 claims data, GST inclusive, retrieved 12 October 2026. Children’s procedures: Southern Cross 2025 Annual Report Summary, 2024–2025 claims data.
4. Claims cost growth, premium outlook and members who raised an excess: Southern Cross Health Society, 2025 Annual Report Summary and FY26 annual report release, 29 September 2026.
5. Adviser duties and commission disclosure: Financial Markets Authority, getting insurance advice. Switching guidance: FMA, insurance.