In New Zealand, many people assume that the Accident Compensation Corporation (ACC) covers all their healthcare needs. While ACC provides extensive support for injuries, it does not cover everything. Private health insurance complements ACC by covering areas that ACC does not. So, do you need both? Let’s explore what each covers and how they can work together to provide comprehensive protection.
What Does ACC Cover?
ACC is a government-funded scheme that offers cover for injuries, regardless of who caused the accident. It can cover:
Medical treatment costs related to an injury, including doctor's visits, surgery, and rehabilitation.
Weekly compensation for lost wages if you cannot work due to the injury (usually covering 80% of your income).
Home and vehicle modifications if your injury results in a permanent disability.
ACC's focus is solely on injuries. It does not cover illnesses or medical conditions that develop over time, such as cancer, heart disease, or mental health issues unrelated to an injury. If you need treatment for these conditions, ACC will not help – that's where private health insurance steps in.
What Does Private Health Insurance Cover?
Private health insurance in New Zealand provides access to a wider range of medical treatments than ACC. This includes:
Non-accident-related medical conditions, such as surgeries, specialist consultations, and diagnostic tests.
Elective surgeries that are not covered by the public health system or have long waiting times.
Cover for ongoing treatment of chronic conditions, which are typically excluded by ACC.
Private health insurance can ensure quicker access to services, allowing you to avoid the public system’s waiting lists. It can also offer treatments not available through the public health system, ensuring a higher standard of care.
The Benefits of Having Both ACC and Private Health Insurance
Having both ACC and private health insurance provides more comprehensive protection. Here’s how they complement each other:
Comprehensive Medical Coverage - While ACC covers injuries, private health insurance fills in the gaps for illnesses and conditions unrelated to accidents. Having both ensures you're covered for a broad spectrum of health issues.
Faster Access to Medical Care - With private health insurance, you can skip public health waiting lists for elective procedures and specialist consultations. If you're injured, ACC will cover the immediate costs, and private insurance can handle follow-up care if needed.
Financial Security - Private health insurance can provide coverage for treatments that ACC does not fund, reducing the financial burden on your household. It can also cover additional treatments such as physiotherapy, dental work, or alternative therapies if not related to an injury.
Choice of Providers - Private health insurance gives you more control over who provides your care, allowing you to choose specialists and facilities. With ACC, you may be limited to certain providers approved by them.
How to Decide If You Need Both
To determine whether you need both ACC and private health insurance, assess your lifestyle, health history, and financial situation. Ask yourself:
Do you engage in activities that increase the risk of injury? If yes, private insurance can offer extra peace of mind beyond ACC.
Do you have a family history of serious illnesses? Consider the likelihood of needing treatments that ACC won’t cover.
Would you want quick access to specialists or elective surgeries? Private health insurance can ensure shorter waiting times.
Having the right balance of coverage is crucial for protecting your health and financial future. For those who want more security and flexibility, combining ACC with private health insurance is a prudent approach.
Final Thoughts
ACC and private health insurance serve different but complementary roles in New Zealand's healthcare landscape. While ACC covers accidents and injuries, private health insurance fills in the gaps for illnesses and non-accident-related treatments. Combining the two provides comprehensive coverage and faster access to healthcare, ensuring you have the protection you need no matter what life throws your way.
If you're unsure about your insurance needs, explore your personal insurance options or get started with Seek Cover to find a plan that fits your lifestyle.
The information in this article is general information only and is not intended as financial, medical, health, nutritional, tax, or other advice. It does not take into account any individual’s personal situation or needs. You should consider obtaining professional advice from a financial adviser and/or tax specialist, or medical or health practitioner, in relation to your own circumstances and before acting on this information.
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