Private health insurance plans range from basic, ‘everyday’ covers to more comprehensive, far-reaching policies. The primary differences come down to cost and the reflected scope of benefits.
- Everyday plans offer cheaper premiums and no cover for surgery or high-impact/high-cost medical events.
- Comprehensive plans are more expensive but provide wider cover, in-depth policy tailoring, and higher benefits. Most base covers include cover for cancer care, surgical treatment and specialist consultations, diagnostic imaging, tests and recovery. Some offer optional add-ons for those who wish to include cover for regular healthcare expenses.
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Comprehensive Health Plans |
Everyday Health Plans |
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Premium cost |
More expensive |
Cheaper |
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What’s covered |
Major/high-cost medical events Broader protection - most cover cancer care, surgery, diagnostics, specialist consults, hospital stays, recovery, non-Pharmac medication, home care, overseas treatment, and more |
Day-to-day health costs, such as GP visits, dental and optical care, physiotherapy, alternative treatments, prescriptions, and more |
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What’s not covered |
Everyday medical costs such as GP visits, prescriptions, dental and eye care *optional add-ons may be available |
Major procedures/surgery & treatment for serious illnesses, non-Pharmac drugs, hospital accommodation, recovery-related expenses |
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Sample comparisons |
Jump to section |
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The benefits of comprehensive plans also translate into high levels of customer satisfaction, and insurance advisers - such as Policywise - will often refer to comprehensive policies, like nib Ultimate Health Max, Accuro SmartCare+, and Southern Cross Wellbeing One, for your consideration.
This article compares the key differences between comprehensive and everyday policies to help you decide which type of plan may suit your needs and budget.
Disclaimer: Policywise also works with Partners Life and AIA, as well as nib, Accuro, and Southern Cross products. In this review, we’ll look at those insurers who offer standalone comprehensive and everyday plans. If you have any questions or would like some help finding the right policy, book a callback with a Policywise adviser; it's fast and free.
Learn more about different types of insurance from a licenced financial adviser and see what's best for your circumstances.
Health | Life | Trauma | Total and Permanent Disability | Income Protection
Do you need comprehensive health insurance in New Zealand?
When faced with a serious health condition, comprehensive health insurance can help you access the tests and treatments you need faster while protecting your finances.
- Wait times for essential health services and elective surgery are increasing each year. In January 2024, 74,456 patients were waiting over four months for their first specialist assessment, while 33,077 were waiting longer than four months for treatment. These delays can lead to much poorer health outcomes, lost income, and increased levels of stress and frustration for those affected.
Source: Health New Zealand | Te Whatu Ora
- Accessing private medical care and paying for life-saving and life-extending non-Pharmac drugs can cost you from a few hundred to thousands of dollars.
How much can you expect to pay privately for some common treatments in New Zealand if you don’t have comprehensive health insurance?
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Private treatment costs in New Zealand |
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Treatment Type |
Cost (NZD) |
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Chemotherapy |
$18,000 - $180,000 |
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Radiotherapy |
$20,000 - $60,000 |
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Coronary artery bypass |
$50,000 - $75,000 |
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Coronary artery bypass and valve replacement |
$83,000 - $110,000 |
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Total hip joint replacement |
$22,000 - $28,000 |
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Total knee joint replacement |
$25,000 - $28,000 |
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Hysterectomy |
$14,000 - $20,000 |
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$2,000 - $3,300 |
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Ultrasound |
$300 - $600 |
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MRI scan |
$1,500 - $2,800 |
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CT scan |
$1,000 - $2,100 |
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PET scan |
$2,500 - $3,500 |
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Wisdom teeth removal |
$3,600 - $5,000 |
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Cataract surgery (unilateral) |
$3,600 - $5,000 each |
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Removal of skin lesions |
$2,300 - $4,100 |
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Skin biopsy |
$500 - $800 |
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Prostate biopsy |
$5,500 - $8,000 |
Source: nib claim statistics December 2022 and August 2023.
Fully comprehensive plans, such as nib's Ultimate Health Max, Accuro's SmartCare+, and Southern Cross’s Wellbeing One, cover major medical events, specialist and diagnostic services, and elective surgeries. They give broader protection and higher limits and are ideal for those wanting certainty, prompt treatment, access to non-Pharmac-funded drugs, and peace of mind across a wide range of health services.
In contrast, basic, everyday plans have lower caps and restrictions but do not offer protection against the huge costs of more complex healthcare needs.
nib NZ health insurance: An overview
“Help Kiwis and their families live healthier, happier lives.”
nib NZ is part of nib Australia, one of Australasia’s largest and fastest-growing travel and health insurance providers. nib currently supports more than 1.6 million Australian and New Zealand residents with a wide range of affordable and accessible health insurance policies.
Originating in 1952 as a hospital fund for steelworkers in NSW, nib’s continual improvement strategies and alliances resulted in their expansion to the New Zealand market in 2012. Procuring Tower Medical Insurance Limited and OnePath’s medical business around this time helped create nib NZ; the start of a Kiwi connection that consolidated in 2022 when nib acquired Kiwi Insurance Limited.
nib NZ is particularly proud of its Ultimate Health and Ultimate Health Max policies - top-tier comprehensive health insurance plans, providing generous cover across hospitals, specialists, tests, surgery, dental, optical, and more.
nib NZ also offers Everyday cover for policyholders’ day-to-day health costs, such as dental treatments, GP visits, physiotherapy, and prescriptions.
Comparison between nib Ultimate Health Max and nib Everyday
Comprehensive plans - such as nib’s Ultimate Health Max - cover major health costs, like surgeries, cancer therapies, specialist consultations, diagnostic tests, access to non-Pharmac-funded medicines, and treatments overseas, providing quick access to excellent private healthcare.
Ultimate Health Max pays up to 100% of costs for many services, with excess options to reduce premiums. It offers the highest limits and benefits compared to nib’s other plans.
nib’s Everyday plans, on the other hand, cover day-to-day healthcare costs, like GP and nurse visits, dental, eye care, chiropractic, and acupuncture treatments, and mental health consultations, but may not provide sufficient cover for serious illnesses or surgeries.
The choice between these policies depends on your healthcare needs and financial situation. It’s advisable to consider the pros and cons of each before committing. Policywise can help you through this process.
The table below shows a more detailed comparison of the benefits and cover of nib’s Ultimate Health Max and Everyday plans.
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nib Ultimate Health Max |
nib Everyday |
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STANDARD claim back 60% of costs |
PREMIUM claim back 80% of costs |
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Surgery-related benefits
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Up to $600,000 |
X |
X |
Non-surgical-related benefits
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Up to $300,000 |
X |
X |
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Follow-up investigations for cancer |
1 specialist consultation and relevant diagnostic investigations, up to $3,000/year for up to 5 consecutive years |
X |
X |
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Non-Pharmac cancer drugs in hospital |
Up to the benefit limit balance of the cost of non-Pharmac medicines (not limited to cancer) |
X |
X |
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Non-Pharmac drugs at home |
Non-Pharmac-funded drugs for use at home up to 6 months after hospitalisation |
X |
X |
| Diagnostic investigations - covers diagnostic tests such as colonoscopy, CT scan, CT angiogram, MRI scan, PET scan, and more |
Up to the overall benefit limit |
X |
X |
| Hospital diagnostic tests - covers diagnostic investigations up to 6 months before and after admission to a private hospital |
Up to the overall benefit limit |
X |
X |
| Hospital specialist consultations - covers specialist and vocational GP consultations up to 6 months before and after admission to a private hospital |
Up to the overall benefit limit |
X |
X |
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GP and nurse practitioner visits and prescriptions |
Optional add-on
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$350 |
$500 |
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Dental treatments |
Optional add-on Up to $500 |
$750 |
$1000 |
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Eye care |
Optional add-on
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$350 |
$500 |
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Ear care |
Optional add-on
|
X |
X |
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Physiotherapy, chiropractic, and osteopathic treatment |
Optional add-on
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$350 |
$500 |
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Acupuncture, traditional Chinese medicine, remedial massage and vaccinations |
Optional add-on
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$150 |
$300 |
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Speech therapy |
Optional add-on
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$200 |
$400 |
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Other benefits |
Loyalty benefits:
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Mental health consultations (up to $350) |
Mental health consultations (up to $500) |
Please note: Terms and conditions, as well as exclusions, apply to all nib NZ products. It's important to review your policy carefully to understand the specific terms of cover, benefits, and any limitations. This ensures that you have a clear understanding of the protection provided by each product. If you have any questions or would like some help finding the right policy, book a callback with a Policywise adviser; it's fast and free.
Accuro Health Insurance: An overview
“New Zealand’s best little health insurer.”
Accuro Health Insurance, a New Zealand-based, not-for-profit organisation, has provided comprehensive medical insurance for Kiwis since 1971. As a 100% New Zealand-owned entity, Accuro prioritises the needs of its 30,000 members over financial gain.
Accuro prides itself on innovation and can boast some notable firsts, including:
- First New Zealand insurer to introduce non-smoker and healthy weight discounts (2007).
- First New Zealand insurer to offer online quotes and applications.
- First health insurer in the world to offer instant online cover (2017).
The organisation offers a variety of comprehensive insurance plans, including SmartCare+, SmartCare, and a customisable Hospital and Surgical base plan. Additional policies for specialist and diagnostic testing, dental and optical care, GP and prescription cover, and natural health treatments are also available.
Accuro also offers Day to Day, a lighter-weight plan, to help policyholders cover the regular costs of staying healthy.
Comparison between Accuro SmartCare+ and Accuro Day to Day
SmartCare+ is one of Accuro’s more comprehensive plans that provides extensive cover for various health services, contributing to Accuro’s high customer satisfaction. It provides cover across surgery, private hospital admission, specialists, diagnostic tests, overseas treatment, dental, optical, and more. The Accuro SmartCare range has been recommended by consumer experts for “best product and price” since its launch in 2008.
Accuro’s Day to Day refund plan is designed to cover the costs of regular health needs, such as doctor visits, dental and optical care, and natural therapy treatments. There is a 30-day stand-down period and the plan is less comprehensive than SmartCare+. Day to Day benefits those who want to manage their everyday health expenses.
The choice between the two plans depends on your health needs and financial situation. It’s always best to consult a health insurance adviser to make an informed decision that suits you and your family.
The table below shows a more detailed comparison of the benefits and cover of Accuro’s SmartCare+ and Day to Day plans.
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Accuro SmartCare+ |
Accuro Day to Day Maximum refund per person per year: $600 |
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General surgery (including consultations, diagnostics, tests, essential prostheses, breast reconstruction, breast symmetry, and more) |
$500,000 |
X |
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Prophylactic (preventive) surgery |
Up to $80,000 for the lifetime of the policy |
X |
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Oral surgery |
$300,000 |
X |
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Private hospital medical admission (including chemotherapy and radiation treatments, diagnostics, cancer treatment, and more) |
$300,000 |
X |
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Non-Pharmac-subsidised drugs |
Maximum limit of either surgical or non-surgical benefit, whichever applies |
X |
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Minor surgery |
$3,000 per claim |
X |
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GP and nurse visits |
Optional add-on
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$150 per policy year |
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Specialist consultations |
Optional add-on
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$100 first visit $40 follow up |
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Prescription drugs |
Optional add-on
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$100 per policy year |
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Imaging (X-ray, ultrasound, image intensifiers, CAT and MRI scans, ultrasound, scintigraphies) and private hospital fees (surgical, medical, and other fees) |
See General Surgery Benefit and Physical Hospital Medical Admissions Benefit above Optional add-on
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$600 per policy year |
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Health practitioner treatment (physiotherapists, chiropractors, dietitians, nutritionists, acupuncturists, and more) |
Optional add-on
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$150 per policy year |
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Optical (consultations, prescription glasses, contact lenses) and dental (checks, cleaning, fillings, teeth removal, and more) |
Optional add-on
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$150 per policy year |
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Other benefits |
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Please note: Terms and conditions, as well as exclusions, apply to all Accuro products. It's important to review your policy carefully to understand the specific terms of cover, benefits, and any limitations. This ensures that you have a clear understanding of the protection provided by each product. If you have any questions or would like some help finding the right policy, book a callback with a Policywise adviser; it's fast and free.
Southern Cross Health Insurance: An overview
“Whatever your needs, we’ve got you covered.”
Southern Cross Health Insurance sits at the heart of a range of not-for-profit healthcare organisations that promise to have all your health and wellness needs covered. Southern Cross operates New Zealand’s largest network of private hospitals and independent healthcare facilities, combining these services with highly comprehensive insurance products.
As 2024 winner of the Reader's Digest Quality Service Award, and voted New Zealand’s Most Trusted Health Insurance Provider 2017-2023, Southern Cross is very well placed in the Kiwi health insurance market.
Southern Cross offers a variety of plans tailored to different needs, budgets, and stages of life. Southern Cross’ Wellbeing plans (One and Two) are comprehensive policies, which include cover for surgery, diagnostic imaging, tests, and specialist consultations.
Southern Cross also offers HealthEssentials, a day-to-day plan designed to help policyholders actively manage their everyday health needs without paying too much on premiums.
Comparison between Southern Cross Wellbeing One and Southern Cross HealthEssentials
Wellbeing One is a broad, in-depth surgical plan that covers cancer care, surgical treatments, specialist consultations, diagnostic imaging, tests, and recovery within six months of related eligible surgical treatment, chemotherapy, or radiotherapy. This plan provides comprehensive insurance for major health events and procedures, making it suitable for individuals who want the peace of mind of knowing they’re covered for a wide range of surgical and specialist services.
HealthEssentials is a day-to-day plan that covers 75% of regular healthcare expenses, such as the GP, dentist, or optometrist. This plan caters to individuals who are primarily concerned with managing the cost of their basic healthcare needs.
A Policywise adviser will work with you on how different health insurance covers compare across the market to find the best policy for your specific situation.
The table below shows a more detailed comparison of the benefits and cover of Southern Cross’s Wellbeing One and HealthEssentials plans.
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Southern Cross Wellbeing One (Caps are per claims year) |
Southern Cross HealthEssentials (Caps are per claims year) |
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Chemotherapy for cancer |
$60,000: Pharmac-approved chemotherapy drugs (includes $10,000 for non-Pharmac-approved Medsafe-indicated chemotherapy drugs) (With optional chemotherapy for cancer upgrades of up to $300,000 for Pharmac and non-Pharmac-approved chemotherapy drugs) |
X |
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Radiotherapy |
Unlimited |
X |
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Surgical procedures |
Unlimited (prostheses maximums apply) |
X |
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Specialist consultations |
$5,000 |
X |
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Skin surgery under general anaesthetic or sedation, and Mohs |
Refunded as per surgical procedures |
X |
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Skin surgery with local or no anaesthetic |
$5,000 (includes $1,000 per claims year when performed by a GP) |
X |
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GP minor surgery |
$1,000 (excludes consultations and skin lesion services) |
X |
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Post-mastectomy allowance to achieve breast symmetry |
$6,500 per lifetime |
X |
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Overseas treatment allowance |
$30,000 |
X |
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Diagnostic imaging and tests |
$60,000 |
X |
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Cardiac tests |
$5,000 |
X |
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Diagnostic tests |
$3,000 |
X |
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Primary care (GP consultations, nurse consultations, prescriptions, annual health checks) |
Optional add-ons |
$250 |
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Dental care |
Optional add-ons |
$500 |
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Eye care |
Optional add-ons |
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Ear care (audiologist consultations, hearing tests) |
Optional add-ons |
$300 |
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Self-care (physiotherapy, osteopathy, chiropractic, registered massage therapy, acupuncture, dietitian or nutritionist, Rongoā Māori practitioner) |
Optional add-ons |
$250 (exclusions apply) |
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Psychiatrist consultations |
$750 |
X |
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Other benefits |
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Please note: Terms and conditions, as well as exclusions, apply to all Southern Cross products. It's important to review your policy carefully to understand the specific terms of cover, benefits, and any limitations. This ensures that you have a clear understanding of the protection provided by each product. If you have any questions or would like some help finding the right policy, book a callback with a Policywise adviser; it's fast and free.
Why choose Policywise?
Policywise is a 100% free service which tells you which medical, life, and disability insurance provider best fits your needs. We offer fast, comprehensive, and easy-to-understand comparisons of all leading providers, and a simple summary clearly recommending which insurer is best for your situation.
Not all insurance policies are the same. Policywise can help you sort out the duds, avoid the lemons, understand the fine print and exclusions, and get the right insurance for you and your family.
We make the important decision of where to buy your insurance super easy. We’ll answer your questions, provide experienced advice, quotes, and comparisons, and manage all the back and forth throughout the application process. Taking out your cover through us means you'll have our lifetime support and claims advocacy, and we'll help you negotiate a positive outcome at claim time. We can also take care of lodging any claims on your behalf and back you up if the going gets tough.
Check out the reviews on our homepage for how other New Zealanders have found our service, because now is the time to get your comprehensive or everyday health insurance sorted. Give your family or someone you love the most outstanding financial support possible. Book a 5-minute callback with Policywise today; our service is fast and free.
Disclaimer: All information on this page or website is general information only, not intended as advice, and does not take into consideration your personal circumstances. We recommend consulting a Policywise adviser before making any insurance decision.
Please note: Policywise advisers are licensed by the Financial Markets Authority to provide financial advice in relation to health insurance, life insurance, and disability insurance. You can learn more about this on our Public Disclosure page. All insurance covers are subject to the insurer’s approval of your application.
Insurance policies and their built-in and optional benefits may be subject to stand-down periods, exclusions, terms and conditions, and premium loadings not listed on this website. Optional benefits also have additional premiums. Please refer to the insurance product’s policy document for full details. Insurers may alter these details at any time.
Therefore, nothing in our product pages is intended to be definitive or binding. Where there are discrepancies between any policy wording on this website and the policy wording provided by the insurance company at the time your cover is approved, then the insurance company’s wording will be deemed the correct version.