Endurance athlete — orthopaedic surgery + rehab
Knee, hip, achilles surgery cover + physio + sports-injury rehab compared.
You're a runner, cyclist, or endurance athlete and most likely to claim for orthopaedic injuries — meniscus tears, ACL reconstructions, achilles ruptures, hip labrum repairs — plus extended physio rehab. ACC interaction is critical: some injuries are ACC-funded but the gap (specialist fees, faster pathway, robotic surgery) is where private insurance matters.
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 2.09
#1 · nib
Easy Health
Watch out for
- If ACC accepts the claim, your policy usually only covers the gap — not the full procedure. Look for explicit ACC top-up clauses.
Show matched clauses (5)
Query: "orthopaedic surgery knee hip cover" · similarity 58% · weight 1
05. Using your cover > Pre-existing Conditions > What pre-existing conditions are never covered? > Hip or knee condition:
We don't pay for any health services relating to any pre-existing hip or knee conditions, including any degenerative condition, disease of, or injury to hip(s) and/or knee(s). The following are also not covered: - the cost of any prostheses due a pre-existing condition of either hip or knee - any corrective or revision surgery, including surgery to replace earlier joint replacements
Source PDF →Query: "ACC top-up specialist surgical gap" · similarity 53% · weight 0.9
02. Your Base Cover > I need financial support > ACC Top-Up Benefit > What am I covered for?
If your ACC claim payments don't fully cover the cost of the surgery or medical treatment you're having for a physical injury, we'll pay the difference.
Source PDF →Query: "sports injury rehabilitation physiotherapy" · similarity 47% · weight 0.9
02. Your Base Cover > I'm recovering from a stay in hospital > Physiotherapy Benefit > What am I covered for?
We'll pay for your physiotherapy treatment for up to six months after being discharged from a private hospital.
Source PDF →Query: "physio session annual limit" · similarity 53% · weight 0.6
02. Your Base Cover > I'm recovering from a stay in hospital > Physiotherapy Benefit > What am I covered for?
We'll pay for your physiotherapy treatment for up to six months after being discharged from a private hospital.
Source PDF →Query: "arthroscopy meniscus ACL reconstruction" · similarity 37% · weight 0.8
04. What we don't cover > WHAT WE DON'T COVER > Vision
- myopia, hypermetropia, presbyopia, radial keratotomy, and photo-refractive keratectomy
Source PDF → - score 2.02
#2 · AA Health
AA Private Hospital + Specialist Cover
Watch out for
- If ACC accepts the claim, your policy usually only covers the gap — not the full procedure. Look for explicit ACC top-up clauses.
Show matched clauses (5)
Query: "orthopaedic surgery knee hip cover" · similarity 54% · weight 1
5. Using your cover > Pre-existing Conditions > What pre-existing conditions are never covered? > Hip or knee condition
We don't pay for any **health services** relating to any **pre-existing** hip or knee **conditions**, including any degenerative **condition**, disease of, or injury to hip(s) and/or knee(s). The following are also not covered: - the cost of any prostheses due a **pre-existing** **condition** of either hip or knee - any corrective or revision **surgery**, including **surgery** to replace earlier …
Source PDF →Query: "ACC top-up specialist surgical gap" · similarity 52% · weight 0.9
2. Your Base Cover > I need financial support > ACC Top-Up Benefit > What am I covered for?
If your ACC claim payments don't fully cover the cost of the **surgery** or medical treatment you're having for a physical injury, we'll pay the difference.
Source PDF →Query: "sports injury rehabilitation physiotherapy" · similarity 50% · weight 0.9
9. Important Words > Important words > Physiotherapy
Treatment by a physiotherapist who: - is a member of the Physiotherapy Board of New Zealand (or its replacement) - is in private practice; and - holds a current annual practising certificate
Source PDF →Query: "physio session annual limit" · similarity 52% · weight 0.6
9. Important Words > Important words > Physiotherapy
Treatment by a physiotherapist who: - is a member of the Physiotherapy Board of New Zealand (or its replacement) - is in private practice; and - holds a current annual practising certificate
Source PDF →Query: "arthroscopy meniscus ACL reconstruction" · similarity 31% · weight 0.8
5. Using your cover > Pre-existing Conditions > What pre-existing conditions are never covered? > Hip or knee condition
We don't pay for any **health services** relating to any **pre-existing** hip or knee **conditions**, including any degenerative **condition**, disease of, or injury to hip(s) and/or knee(s). The following are also not covered: - the cost of any prostheses due a **pre-existing** **condition** of either hip or knee - any corrective or revision **surgery**, including **surgery** to replace earlier …
Source PDF → - score 1.65
#3 · nib
Ultimate Health
Watch out for
- If ACC accepts the claim, your policy usually only covers the gap — not the full procedure. Look for explicit ACC top-up clauses.
Show matched clauses (4)
Query: "sports injury rehabilitation physiotherapy" · similarity 55% · weight 0.9
03. Options > GP Option > Physiotherapy Benefit > What am I covered for?
We'll pay for physiotherapy treatment that you need.
Source PDF →Query: "ACC top-up specialist surgical gap" · similarity 53% · weight 0.9
02. Your Base Cover > I need financial support > ACC Top-Up Benefit > What am I covered for?
If your ACC claim payments don't fully cover the cost of the surgery or medical treatment you're having for a physical injury, we'll pay the difference.
Source PDF →Query: "physio session annual limit" · similarity 69% · weight 0.6
02. Your Base Cover > I'm recovering from a stay in hospital > Physiotherapy Benefit > How much am I covered for?
You can have unlimited physiotherapy treatments during this time, up to your overall benefit limit*.
Source PDF →Query: "arthroscopy meniscus ACL reconstruction" · similarity 32% · weight 0.8
03. Options > Serious Condition Financial Support Option > Serious Condition Definitions > Heart valve surgery
The undergoing of surgery to replace or repair cardiac valves as a consequence of heart valve defects or abnormalities. Repair via angioplasty, intra-arterial procedures, or other non-surgical techniques is specifically excluded.
Source PDF → - score 1.56
#4 · AA Health
AA Private Hospital Cover
Show matched clauses (4)
Query: "orthopaedic surgery knee hip cover" · similarity 54% · weight 1
5. Using your cover > Pre-existing Conditions > What pre-existing conditions are never covered? > Hip or knee condition
We don't pay for any **health services** relating to any **pre-existing** hip or knee **conditions**, including any degenerative **condition**, disease of, or injury to hip(s) and/or knee(s). The following are also not covered: - the cost of any prostheses due a **pre-existing** **condition** of either hip or knee - any corrective or revision **surgery**, including **surgery** to replace earlier …
Source PDF →Query: "sports injury rehabilitation physiotherapy" · similarity 49% · weight 0.9
9. Important Words > Important words > Physiotherapy
Treatment by a physiotherapist who: - is a member of the Physiotherapy Board of New Zealand (or its replacement) - is in private practice; and - holds a current annual practising certificate ---
Source PDF →Query: "physio session annual limit" · similarity 53% · weight 0.6
9. Important Words > Important words > Physiotherapy
Treatment by a physiotherapist who: - is a member of the Physiotherapy Board of New Zealand (or its replacement) - is in private practice; and - holds a current annual practising certificate ---
Source PDF →Query: "arthroscopy meniscus ACL reconstruction" · similarity 32% · weight 0.8
5. Using your cover > Pre-existing Conditions > What pre-existing conditions are never covered? > Hip or knee condition
We don't pay for any **health services** relating to any **pre-existing** hip or knee **conditions**, including any degenerative **condition**, disease of, or injury to hip(s) and/or knee(s). The following are also not covered: - the cost of any prostheses due a **pre-existing** **condition** of either hip or knee - any corrective or revision **surgery**, including **surgery** to replace earlier …
Source PDF → - score 1.34
#5 · nib
Ultimate Health Max
Watch out for
- If ACC accepts the claim, your policy usually only covers the gap — not the full procedure. Look for explicit ACC top-up clauses.
Show matched clauses (3)
Query: "sports injury rehabilitation physiotherapy" · similarity 52% · weight 0.9
03. Options > GP Option > Physiotherapy Benefit > What am I covered for?
We'll pay for **physiotherapy** treatment that you need.
Source PDF →Query: "ACC top-up specialist surgical gap" · similarity 52% · weight 0.9
02. Your Base Cover > I need financial support > ACC Top-Up Benefit > What am I covered for?
If your ACC claim payments don't fully cover the cost of the **surgery** or medical treatment you're having for a physical injury, we'll pay the difference.
Source PDF →Query: "physio session annual limit" · similarity 67% · weight 0.6
02. Your Base Cover > I'm recovering from a stay in hospital > Physiotherapy Benefit > How much am I covered for?
You can have unlimited **physiotherapy** treatments during this time, up to your overall **benefit limit***.
Source PDF →
What to watch out for
- ACC: If ACC accepts the claim, your policy usually only covers the gap — not the full procedure. Look for explicit ACC top-up clauses.
- session limit: Physio annual limits of 6–12 sessions are common and tight for serious rehab. Higher tiers offer 20+.
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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.