NZ Health Insurance — Topic Comparisons
Side-by-side breakdowns of how every NZ health insurer handles the coverage questions consumers actually ask — sourced verbatim from each insurer's published policy wording.
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.
Compare across insurers →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.
Compare across insurers →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.
Compare across insurers →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.
Compare across insurers →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.
Compare across insurers →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.
Compare across insurers →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.
Compare across insurers →Data sources
Every fact on these pages is extracted from the current published policy
wording PDF for each insurer, with the source PDF URL cited inline. We
also publish the structured data as machine-readable JSON + Markdown
at /api/topic/{slug}/summary.md and
/api/product/{insurer}/{product}/facts.json.
See our llms.txt for the full endpoint list.