High income — tax-efficient cover and employer-funded
Employer-funded vs personal, FBT considerations, and benefit-tier choice for high-income earners.
You're in the top tax bracket and either choosing how to structure private health cover (employer-funded vs personal) or evaluating an employer scheme. The tax treatment varies and the right tier is usually the comprehensive one (your time + foregone earnings make speed-to-treatment worth more).
Top policies for this scenario
Ranked by aggregate semantic match across 5 scenario-specific queries. Score reflects clause-level fit, not premium. We don't know what you'd pay — get a quote for the shortlist.
- score 1.74
#1 · Southern Cross
RegularCare
Watch out for
- For top-tier policies, overseas-treatment cover for serious illness is one of the differentiators. Check the country list + per-treatment cap.
Show matched clauses (4)
Query: "non-Pharmac drugs high annual limit cover" · similarity 55% · weight 1
Section D: How to make a claim > Some conditions apply to cover for prescription drugs
Your policy provides cover for drugs under various benefits depending on what type of healthcare service they relate to. - Chemotherapy drugs taken as part of chemotherapy treatment for cancer are covered under the 'Chemotherapy for cancer (base)' benefit (page 21), or 'Cancer Cover Plus' (page 21) if you have this upgrade. - Drugs prescribed and administered when associated with chemotherapy tre…
Source PDF →Query: "comprehensive tier specialist consult cover" · similarity 49% · weight 0.9
Section B: What the KiwiCare and the RegularCare plans cover > Consultations > Specialist consultations
**$4,000 each claims year** This benefit provides cover for consultations performed by a specialist who is an Affiliated Provider contracted for consultations. Consultations with a health services provider who is working under the supervision of a specialist are also covered if this type of consultation is: - included in the Affiliated Provider's contract with us, and - approved by us. This be…
Source PDF →Query: "private hospital rate private room cover" · similarity 55% · weight 0.7
Section C: What the KiwiCare and the RegularCare plans don't cover > Other costs that we don't cover > Personal costs related to a stay in hospital
We don't cover any hospital charges incurred for your personal convenience that are related to, or a result of, your stay in hospital, such as newspapers, meals for your family, alcohol, and TV rental.
Source PDF →Query: "overseas treatment cover for serious illness" · similarity 58% · weight 0.6
Section B: What the KiwiCare and the RegularCare plans cover > Overseas treatment allowance
**$5,000 each claims year** This benefit provides a reimbursement towards medical expenses for treatment that you receive overseas if that treatment is not available in New Zealand. All the following must apply to the overseas treatment: - it's not available in public or private health facilities anywhere within New Zealand - it's recommended as necessary by a specialist for your health conditi…
Source PDF → - score 1.73
#2 · Accuro
StaffCare
Show matched clauses (4)
Query: "non-Pharmac drugs high annual limit cover" · similarity 57% · weight 1
Additional modules > GP module > Prescription drugs
This benefit covers the costs of prescription drugs ordered by a New Zealand-registered medical practitioner or registered medical specialist. Up to $20 for each item, to a maximum of $300 for each person in a policy year. ---
Source PDF →Query: "comprehensive tier specialist consult cover" · similarity 57% · weight 0.9
StaffCare at a glance > Start with the base plan and add additional modules > Specialist module
Cover for specialist consultations and diagnostic tests.
Source PDF →Query: "private hospital rate private room cover" · similarity 55% · weight 0.7
Hospital and Surgical base plan > Standard benefits: > Private hospital medical admission
**$65,000 for each person in a policy year** **An excess applies to this benefit** This benefit covers the costs of Reasonable charges for admission to a private hospital for reasons other than surgery. The non-surgical hospital treatment must be recommended by an appropriate registered medical practitioner as being necessary to improve the health of the Member. This benefit covers the followin…
Source PDF →Query: "employer group scheme cover and benefits" · similarity 53% · weight 0.5
Making changes to your policy > Leaving employment
After you leave your current job, you may qualify to transfer to your own individual policy without further underwriting (such as additional medical questions). This depends on how long you have participated in your current employer's Group insurance scheme. If you do qualify, we will send you an offer to continue your cover once we've had confirmation you have left your job. You will have 30 days…
Source PDF → - score 1.70
#3 · Accuro
KidSmart
Show matched clauses (4)
Query: "non-Pharmac drugs high annual limit cover" · similarity 56% · weight 1
Hospital and Surgical base plan > Standard benefits: > Non-Pharmac subsidised drugs
**An excess applies to this benefit** This benefit covers the costs of Reasonable charges associated with accessing the most effective treatment available. This is regardless of whether or not the drug qualifies for a government or other subsidy, such as Pharmac funding. With this benefit, we'll reimburse the costs of all drugs registered by Medsafe for use in New Zealand where: - the treatment…
Source PDF →Query: "comprehensive tier specialist consult cover" · similarity 57% · weight 0.9
KidSmart at a glance > Start with the base plan and add additional modules > Specialist module
Cover for specialist consultations and diagnostic tests.
Source PDF →Query: "private hospital rate private room cover" · similarity 56% · weight 0.7
Hospital and Surgical base plan > Other benefits > Transport and accommodation > Road transport
- Return bus fares and return taxi fare from the station to the private hospital - Return private car journey, calculated on the mileage travelled at $0.30 a kilometre These costs must directly relate to an overnight admission in a private hospital under this policy. You must send receipts for reimbursement with the claim. Pre-operative and post-operative consultations or treatments do not qualif…
Source PDF →Query: "employer group scheme cover and benefits" · similarity 48% · weight 0.5
Hospital and Surgical base plan
The following benefits apply to the Hospital and Surgical base plan. Please take the time to read over these and ensure you understand them. Contact us if you have any queries about any of our benefits.
Source PDF → - score 1.64
#4 · Southern Cross
UltraCare
Watch out for
- For top-tier policies, overseas-treatment cover for serious illness is one of the differentiators. Check the country list + per-treatment cap.
Show matched clauses (4)
Query: "non-Pharmac drugs high annual limit cover" · similarity 63% · weight 1
B – What the UltraCare plans cover > Day-to-day treatment > Prescriptions
Drugs prescribed by a health services provider. This excludes cover for drugs that are not Pharmac approved. **We'll cover the actual charges incurred up to: $600 each claims year.**
Source PDF →Query: "private hospital rate private room cover" · similarity 55% · weight 0.7
C – What the UltraCare plans don't cover > Other costs that we don't cover > Personal costs related to a stay in hospital
We don't cover any hospital charges incurred for your personal convenience that are related to, or a result of, your stay in hospital, such as newspapers, meals for your family, alcohol, and TV rental.
Source PDF →Query: "overseas treatment cover for serious illness" · similarity 58% · weight 0.6
B – What the UltraCare plans cover > Overseas treatment allowance
**$30,000 each claims year** This benefit provides a reimbursement towards medical expenses for treatment that you receive overseas if that treatment is not available in New Zealand. All the following must apply to the overseas treatment: - it's not available in public or private health facilities anywhere within New Zealand - it's recommended as necessary by a specialist for your health condit…
Source PDF →Query: "employer group scheme cover and benefits" · similarity 54% · weight 0.5
B – What the UltraCare plans cover > Day-to-day treatment
This benefit provides cover for general practitioner services, annual health checks, flu vaccinations, and more.
Source PDF → - score 1.52
#5 · nib
Ultimate Health Max
Watch out for
- For top-tier policies, overseas-treatment cover for serious illness is one of the differentiators. Check the country list + per-treatment cap.
Show matched clauses (4)
Query: "comprehensive tier specialist consult cover" · similarity 53% · weight 0.9
02. Your Base Cover > I've been referred for tests, or to see a health professional for consultation or treatment > OPTIONS
You may also have cover available under the following Option if you have added this to your policy: **Specialist Option** - Specialist Consultations Benefit - Specialist Second Opinion Benefit - Sports Physician Benefit - Diagnostic Tests Benefit - Cardiac Investigations Benefit ---
Source PDF →Query: "private hospital rate private room cover" · similarity 61% · weight 0.7
02. Your Base Cover > I need to stay in hospital for surgery or treatment > Non-Surgical Benefit > What am I covered for?
If you're admitted to a **private hospital** for treatment that doesn't involve **surgery**, we'll pay for your: - hospital accommodation (e.g. a bed or private room, but not including suites); - in-hospital x-ray examination and ECG; - intensive post-treatment care and special in-hospital nursing; - in-hospital post-treatment **physiotherapy**; - ancillary hospital charges (e.g. dressings, banda…
Source PDF →Query: "overseas treatment cover for serious illness" · similarity 62% · weight 0.6
02. Your Base Cover > I need to stay in hospital for surgery or treatment > Overseas Treatment Benefit > How much am I covered for?
Up to $30,000 per **insured person** for each overseas **surgery** or treatment.
Source PDF →Query: "employer group scheme cover and benefits" · similarity 50% · weight 0.5
01. How this document works > Cover Overview
To make it easy to find what you're covered for, we've grouped the benefits under the different situations where you may need to use them. Under each of these categories, you'll find the related benefits that you can claim for. Some benefits can be used in multiple categories. Some benefits are only available to you if you've added the Option with those benefits to your policy. *This benefit may …
Source PDF →
What to watch out for
- annual limit: High-income earners should look at top-tier policies with $500k+ surgical limits and $250k+ non-Pharmac drug limits. Sub-limits below those are economically suboptimal at your income.
- overseas: For top-tier policies, overseas-treatment cover for serious illness is one of the differentiators. Check the country list + per-treatment cap.
Ready to shortlist a policy for high income — tax-efficient cover and employer-funded?
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How this ranking works
This scenario translates to 5 semantic queries (weighted). Each query runs against every NZ health insurance policy clause we've ingested (3,000+ clauses across 5 insurers). The best clause-per-product per query contributes its similarity × weight to the product's aggregate score.
Try the underlying semantic clause search to run your own queries.
This is mechanical retrieval + ranking — not personalised financial advice. The actual policy you should buy depends on factors only an FSPR-registered adviser can assess (your medical history, budget, family composition, risk tolerance). Use this to shortlist, then talk to an adviser.