UniMed Health Insurance — Review
4 active retail products from Union Medical Benefits Society Limited · unimed.co.nz
Last refreshed 2026-05-26 · current wordings effective 2025-10-01
Plans at a glance
Health Positive
Wording effective 2016-01-22
10+ years old — confirm with insurerSublimit data not on file.
Hospital Select
Wording effective 2018-01-25
8+ years old — confirm with insurerSublimit data not on file.
ParentStay
Wording effective 2025-10-01
Current- cancer care $100,000
- mental health $1,000
- return of remains $50,000
- medical repatriation $250,000
- emergency medical care $250,000
Coverage at a glance
One-line summary of how UniMed's flagship retail product (Health Positive) handles the questions consumers most commonly ask. Full verbatim text below.
Verified policy facts — full text
Every section below is the verbatim text from each UniMed product's current policy wording PDF. Where a product doesn't address a topic, we show "Not on file" rather than guess.
Pharmac vs non-Pharmac drug cover
NZ's Pharmac funds a defined list of medicines. Non-Pharmac drugs (including high-cost cancer drugs like Keytruda) are excluded from public funding. Health insurance can fill that gap — but every insurer handles it differently. This page summarises each NZ insurer's non-Pharmac rules verbatim from their policy wordings.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
All prescription drugs and medication covered under the policy must be: registered and approved by Medsafe for use in New Zealand; prescribed and used within the guidelines set by Medsafe; Pharmac-approved and listed on the Pharmac Schedule under sections A to H, for the treatment being received in New Zealand; medically necessary; and prescribed by the treating specialist or GP. If the prescription drug requires special authority from Pharmac, confirmation that the member meets the special authority criteria is required before cover can be assessed. Under the Cancer Care benefit, only Pharmac-approved prescription drugs are covered. Non-Pharmac-funded drugs are not covered.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
Pharmac-approved chemotherapy drugs are covered under the Chemotherapy benefit (up to $55,000 per policy year). Non-Pharmac chemotherapy drugs that are Medsafe approved for the treatment of cancer are covered up to $8,500 per annum within the Chemotherapy benefit. Non-Pharmac subsidised pharmaceuticals (prescribed by a Registered Medical Practitioner, approved by Medsafe, and not fully or partly subsidised by Pharmac through the New Zealand Pharmaceutical Schedule) are covered up to $330 per policy year under both the In-Patient Non-Pharmac Subsidised Pharmaceuticals benefit and the General Medical Expenses Non-Pharmac Subsidised Pharmaceuticals benefit. User part charges for prescription items on the New Zealand Pharmaceutical Schedule are covered up to $240 per policy year.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/pharmac-vs-non-pharmac/
ACC interaction
In NZ, ACC covers accidental injury and treatment-injury costs. Health insurance generally excludes ACC-covered events but most policies offer an ACC Top-Up benefit for any shortfall. This page summarises each insurer's ACC interaction rules verbatim.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
The Health Plan is designed to work alongside ACC. If a member suffers an injury while in New Zealand, they must first apply to ACC for treatment. ACC provides comprehensive, no-fault personal injury cover for anyone in New Zealand regardless of residency or visa status. Members must do everything reasonably possible to have ACC cover and ACC-funded treatment for their injury. If ACC does not fully cover the cost of medical treatment or procedure, a claim can be made with UniMed for the remainder if it is covered by the policy, subject to other policy terms including exclusions and benefit limits. Costs or expenses recoverable from ACC are excluded. If ACC declines a claim, UniMed may consider covering it under the policy. If UniMed believes ACC's decision to decline may be wrong, it may ask the member to challenge ACC's decision and requires the member's cooperation including authority to act on their behalf.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
For Accident Surgery, UniMed must receive written confirmation from ACC regarding their decision to accept or decline the claim before qualifying surgical procedures are undertaken. If ACC accepts the claim, UniMed provides 'top-up' coverage to the benefit levels applicable to the Private Hospitalisation Surgical Benefits section. If ACC declines the claim, UniMed will, at its sole discretion, either assist with the total cost of surgery or pay the difference between the actual cost of surgery and what ACC would have contributed had the claim been accepted. For non-hospital ACC top-up, the shortfall between actual costs and ACC refunds for out-of-hospital expenses incurred as a result of qualifying personal injury or employment related conditions are covered to the limits shown under the General Medical Expenses and Minor Surgery benefit sections; ACC must have provided financial assistance towards treatment costs for a claim to qualify.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/acc-interaction/
Mental health cover
Mental health cover varies dramatically across NZ health insurers — from entirely excluded (entry-level plans) to specific psychiatric hospitalisation sublimits. This page lists each insurer's mental-health rules with the relevant NZD sublimits and admission terms.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
Mental health annual sublimit: $1,000
The Mental Health benefit covers up to $1,000 for each Member each policy year for reasonable charges for consultations with a psychiatrist, psychologist, psychotherapist or counsellor. They must be registered either under the psychiatry scope with the Medical Council of New Zealand, as a psychologist with the New Zealand Psychologists Board, as a psychotherapist with the Psychotherapists Board of Aotearoa New Zealand, or as a counsellor with the New Zealand Association of Counsellors or other relevant health professional association. Psychiatric, psychological and neurodevelopmental disorders are listed as a general exclusion and are not covered, including ADHD, geriatric care, pre-senile dementia, and senile illnesses including dementia and Alzheimer's disease. Inpatient mental health admissions are not specifically provided for as a separate benefit.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
Mental health annual sublimit: $1,000
Psychiatric Hospitalisation in a Licensed Private Hospital on admission and under the care of a Specialist Psychiatrist. Refund of Hospital Accommodation Fees and ancillary hospital charges up to $3,500 per policy year. Under the Loyalty Benefits (after five years' continuous membership), consultations with a vocationally registered psychiatrist in New Zealand are covered at $150 per visit up to three visits per policy year.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/mental-health-cover/
Pre-existing conditions
NZ health insurers handle pre-existing conditions in two main ways: (1) disclose-and-accept (Southern Cross — exclude unless noted on certificate), or (2) stand-down period (nib — 3 years then covered, with permanent exclusions for certain conditions). This page lists each insurer's verbatim rules.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
Pre-existing conditions are not covered unless accepted by us. A pre-existing condition means any health or medical condition you are aware of, or any signs or symptoms that you are currently experiencing or have experienced in the past, that occurred before the start of your policy, or a medical event that occurred before the start of your policy. Applicants must disclose all pre-existing conditions on application. If untrue or misleading information is provided or pre-existing conditions are not disclosed, we may decline related claims and/or apply additional personal exclusions (which may be backdated to policy start). Any personal exclusions are listed on the Membership Certificate. Personal exclusions do not apply to the Medical Repatriation or Return of Remains benefits.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
Not on file for this product.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/pre-existing-conditions/
IVF and assisted reproduction
IVF, infertility treatment, and assisted reproduction are excluded from virtually every NZ retail health insurance policy. This page documents each insurer's stance verbatim.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
Infertility or assisted reproduction, including investigation, diagnosis, treatment, or assisted reproductive technology, is explicitly excluded under the 'Reproductive and sexual health' general exclusion. IVF is not covered.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
IVF is not mentioned as a covered benefit. No explicit IVF benefit is described in the policy wording.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/ivf-and-assisted-reproduction/
Oncology and high-cost cancer drugs
High-cost cancer drugs (Keytruda, Opdivo, etc.) are often non-Pharmac and not covered under public health. Some NZ insurers cover these via separate cancer benefits with specific NZD caps. This page summarises each insurer's oncology / non-Pharmac chemotherapy cover.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
Not on file for this product.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
Non-Pharmac chemotherapy drugs that are Medsafe approved for the treatment of cancer are covered up to $8,500 per annum, included within the overall Chemotherapy benefit of $55,000 per policy year. Genetic/genomic testing is also included, payable following a cancer diagnosis and referral by a Registered Oncologist.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/oncology-high-cost-drugs/
Gap payment rules
When a provider's charges exceed what the insurer pays, the member pays the 'gap'. NZ insurers use different models — affiliated/preferred provider networks, percentage co-pays, 'reasonable charges' caps. This page lists each insurer's gap rules verbatim.
Health Positive
Not on file for this product.
Source: http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf · effective 2016-01-22
Hospital Select
Not on file for this product.
Source: https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf · effective 2018-01-25
ParentStay
UniMed will pay the cost for a medical treatment or procedure covered under the policy up to the relevant benefit limit or the reasonable charge for the medical treatment or procedure, whichever is less. If the cost exceeds the benefit limit or reasonable charges, the extra cost is the member's responsibility and cannot be claimed under another benefit or policy. Members must claim any other refunds, subsidies, or entitlements available from another source first (including ACC, another insurer, or government-funded scheme). If those sources only partially cover costs, UniMed may pay the difference up to the amount entitled under the Health Plan, where legally permitted. UniMed does not provide cover for any excess that applies under another insurance policy or Health Plan. The policy provides limited coverage for expenses incurred in the private health system.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf · effective 2025-10-01
UniCare Advantage
Payments under the Private Hospitalisation Surgical Benefits section are limited to 80% of the Reasonable charges of the procedure up to the per admission limit stated. All benefit sections from the Public Hospital Benefits section forward refund 80% of actual medical costs to the specified maximums. The General Medical Expenses section also refunds 80% of actual medical costs to the specified maximums. All benefits are inclusive of GST charged by healthcare providers.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf · effective 2025-08-01
Compare this topic across every NZ insurer → /topics/gap-payment-rules/
Waiting periods, excess and exclusions
Waiting periods (days)
Pre-existing rules vary — see "Pre-existing conditions" section above for verbatim wording.
Excess options
Excess is selected per-member on application — see source PDF.
Exclusions
Health Positive — 0 exclusions
No exclusions extracted for this product.
Hospital Select — 0 exclusions
No exclusions extracted for this product.
ParentStay — 43 exclusions
- Pre-existing conditions, unless accepted by us
- Congenital, genetic or hereditary conditions
- Psychiatric, psychological and neurodevelopmental disorders, including Attention Deficit Hyperactivity Disorder (ADHD), geriatric care including geriatric hospitalisation, pre-senile dementia, senile illnesses including dementia and Alzheimer's disease
- Sexually transmitted diseases, including HIV or AIDS, or any condition caused by them
- Pregnancy, childbirth, miscarriage, or termination of pregnancy
- Infertility or assisted reproduction, including investigation, diagnosis, treatment, or assisted reproductive technology
- Sterilisation, including reversals
- Contraception of any kind, including intrauterine devices, except when used for medical reasons
- War, act of war (whether declared or not), active duty in the military of any country or international authority, or terrorism
- Misuse of alcohol or drugs whether prescribed, non-prescription or recreational
- Participation in a criminal act
- Intentional self-injury
- Suicide or attempted suicide
- Euthanasia
- An injury caused by an accident outside New Zealand
- Failing to follow or comply with your prescribed medical treatment plan, including not taking prescribed medications as prescribed or not attending recommended medical appointments
- Epidemic, pandemic or any similar widespread infectious disease
- Medical treatment or procedures and technologies that have not been approved by us, including any that are new, experimental, unorthodox or not widely accepted as effective, appropriate or essential according to the recognised standards of the medical specialty involved
- Additional surgery performed during any operation that is not directly related to any condition or treatment covered under the terms of your policy
- Any costs not specifically provided for under a benefit section outlined in this document
- Medical treatment or procedures and drugs for conditions or healthcare services that are excluded under your policy, including those excluded in the eligibility criteria
- Healthcare services provided outside New Zealand
- Gender affirmation and/or gender dysmorphia
- Any surgery, medical treatment or procedure that primarily changes, improves, or enhances appearance, regardless of whether it is undertaken for medical, physical, functional, psychological or emotional reasons
- Weight loss or bariatric investigations or treatment, including when such treatment is intended to manage, treat, or improve other health conditions (for example: diabetes, cardiovascular or gastrointestinal conditions)
- Elective surgery, being any surgery that is not required to treat an acute or emergency condition
- Revision surgery, performed to address failure, complications, wear and tear, unsatisfactory results, or changes to your condition
- Joint or spinal surgery, including replacement of hips, knees, or shoulders, and any procedure on the spine
- Visual correction or enhancement treatment, including surgery, laser procedures, intraocular lens(es), injections, consultations, eye tests, glasses, or contact lenses
- Dental care or treatment of any kind, including routine, elective or emergency procedures, tooth extractions, exposures and the implantation of teeth, including dental implants
- Organ transplantation
- Renal dialysis
- Stem cell transplantation
- Robotically assisted surgery (though we may at our sole discretion contribute toward the cost up to the reasonable charge for the equivalent non-robotic surgery)
- Investigations, monitoring or treatment when you are asymptomatic and there is no evidence the condition is harmful to your health, including preventative or prophylactic care and health surveillance testing, screening or tests performed for administrative or non-clinical purposes, healthcare services which in our opinion are not medically necessary, vaccinations/immunisations, and convalescence
- Personal health-related appliances; for example, hearing aids, personal alarms, orthotic shoes, crutches, wheelchairs, toilet seats, shower stools, mouthguards, and artificial limbs, medicine sachets or blister packs
- Medical devices; for example, cardiac pacemakers, nerve appliances, cochlear implants, or penile implants
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
- Continuous or long-term care, including aged or geriatric care, rest home or home-based care, and long-term hospital-level care, whether provided in a hospital, hospice, rest-home or similar facility
- Costs or expenses recoverable from a third party or insurance or any statutory scheme or any government-funded scheme or agent (for example, ACC)
- Personal expenses incurred while in hospital, including charges for family meals, soft drinks, alcohol, travel costs, or accommodation for family
- Optional or upgraded services where they are not medically necessary, including private hospital suites, premium accommodation, travel upgrades, or any other non-medical enhancements
- Costs not specifically related to a consultation, medical treatment or procedure, such as administration costs (courier fees, charges for medical notes etc), charges for cancellation or non-attendance, or statement fees
UniCare Advantage — 9 exclusions
- Breast reconstruction required as a result of a prophylactic mastectomy is not included.
- Costs for personal items such as food/food substitutes, materials or garments are excluded (Post Operative Therapy).
- Extraction or surgical removal of teeth, implantation of teeth or costs of dental implants (Oral Surgery).
- Reimbursement of travel or accommodation costs is excluded (Overseas Treatment).
- Breast reconstruction is not included under the Prophylactic Surgery benefit.
- All injury admissions are excluded (Public Hospital Cash Grant).
- Surveillance following cancer is not available for skin cancers/lesions removed by a minor surgery procedure performed by a specialist in their specialist room or a general practitioner in their practice room.
- Removing implants or cosmetic reduction are excluded from Obesity Surgery or Breast Reduction Surgery benefit.
- Children do not qualify for the Bowel Screening Kits benefit.
Machine-readable API for this page
Every section above is also available as a structured API for AI agents, brokers and developers — free, no auth.
GET /api/insurer/unimed/facts.json— full insurer profile + product list (JSON)GET /api/insurer/unimed/summary.md— markdown summary (LLM-friendly)- Per-product: replace
{product}with any product slug listed aboveGET /api/product/unimed/{product}/facts.jsonGET /api/product/unimed/{product}/wording.md
POST /mcp— anonymous Model Context Protocol server (5 tools)
Source documents
- Health Positive · wording effective 2016-01-22 · http://www.unimed.co.nz/images/pdf/833UNIM-Health%20Positive%20Plan%20Brochure%20-Online%20Application%20Form.pdf
- Hospital Select · wording effective 2018-01-25 · https://www.unimed.co.nz/wp-content/uploads/2017/12/79553-UniMed-Hospital-Select-Plan-6pp-August-2017-UNI96-3_HR.pdf
- ParentStay · wording effective 2025-10-01 · https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf
- UniCare Advantage · wording effective 2025-08-01 · https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf
The authoritative source for any specific cover question is the insurer's published PDF. Our facts are a structured derivative for comparison.
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