Private Hospital

What is Private Hospital health insurance?

Kiwis with nib Private Hospital cover get fast access to the private health care system. We've made it simple to choose the right hospital cover for you, which is how it should be. Having Standard or Premium Hospital with nib means you are covered for the big things like cancer treatment, surgical procedures and diagnostic investigations, plus a whole lot more.

It's easy to join online, or we’re here to discuss further if you need it
Balance the cost of the cover you need by choosing an excess option that suits you
Cover for most pre-existing conditions after three years ¹;
The benefits of nib's First Choice network which can help keep claim costs down and help make premiums more affordable in the long term

Compare Private Hospital plans

Standard

From $10.54 / week ²

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Premium

From $13.27 / week ²

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Overall benefits limits (Benefit limits are per person per year):

Overall benefits limits

Surgical related benefits

Up to:

$300,000

Up to:

$300,000

Non-surgical related benefits

Up to:

$200,000

Up to:

$200,000

Benefits (Benefit limits are per person per year):

Benefit limits are per person per year

Cancer Treatment

Cover for and relating to cancer treatment including:

Chemotherapy
Radiotherapy
Brachytherapy
Hospital accommodation (e.g. admitted patient’s bed, a private room)
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, needles, bandages)
Hospital pharmaceutical prescriptions

We pay up to the hospital medical benefit limit.

Cancer surgery is covered under the surgery in hospital benefit.

PHARMAC funded chemotherapy drugs for the treatment of cancer at home are covered under the cancer treatment at home benefit, for which we pay up to $10,000 each year.

Cover for and relating to cancer treatment including:

Chemotherapy
Radiotherapy
Brachytherapy
Hospital accommodation (e.g. admitted patient’s bed, a private room)
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, needles, bandages)
Hospital pharmaceutical prescriptions

We pay up to the hospital medical benefit limit.

Cancer surgery is covered under the surgery in hospital benefit.

PHARMAC funded chemotherapy drugs for the treatment of cancer at home are covered under the cancer treatment at home benefit, for which we pay up to $10,000 each year.

Surgery in hospital

Benefit: Up to $300,000

Cover for surgery in a private hospital, including costs for:

Surgeon’s operating fees.
Anaesthetist’s fees.
Operating theatre fee.
Surgically implanted prosthesis (in line with the prosthesis schedule).
In-hospital pharmaceutical prescriptions.
Hospital accommodation (e.g. the admitted patient’s bed, a private room, excludes suites).

Benefit: Up to $300,000

Cover for surgery in a private hospital, including costs for:

Surgeon’s operating fees.
Anaesthetist’s fees.
Operating theatre fee.
Surgically implanted prosthesis (in line with the prosthesis schedule).
In-hospital pharmaceutical prescriptions.
Hospital accommodation (e.g. the admitted patient’s bed, a private room, excludes suites).

Specialist consultations

Diagnostic investigations

Cover for diagnostic investigations up to 6 months before and after a related hospital admission.

We pay up to the Hospital surgical or hospital medical benefit limit (whichever applies).

TIP: This benefit is more comprehensive on Premium Hospital than Standard Hospital, see below.

Cover for diagnostic investigations, whether or not they relate to admission to a recognised private hospital.

For diagnostics not related to a hospital admission, we cover

up to $5,000 for CT, MRI and PET scans and
up to $15,000 for all other diagnostics

For diagnostic investigations related to a hospital admission we pay up to the hospital surgical or hospital medical benefit limit (whichever applies).

Follow-up investigations for cancer

Travel and accommodation - Cancer

Benefit: Up to $5,000*

Cover for travel costs for you and a support person, and accommodation costs for a support person when you need to travel further than 100km from where you live for treatment.

*We pay up to $200 a night, up to a maximum of $5,000 for both travel and accommodation for each insured person every policy year.

Benefit: Up to $5,000*

Cover for travel costs for you and a support person, and accommodation costs for a support person when you need to travel further than 100km from where you live for treatment.

*We pay up to $200 a night, up to a maximum of $5,000 for both travel and accommodation for each insured person every policy year.

Melanoma surgery in hospital

Oral surgery

Waiting Period:

12 months (for removal of unerupted or impacted teeth).

Cover for oral surgery in a private hospital performed by a registered oral or maxillo-facial surgeon.

We will cover for removal of unerupted or impacted teeth (e.g. wisdom teeth) when performed by a registered oral or maxillo-facial surgeon.

We pay up to the hospital surgical benefit limit.

Waiting Period:

12 months (for removal of unerupted or impacted teeth).

Cover for oral surgery in a private hospital performed by a registered oral or maxillo-facial surgeon.

We will cover for removal of unerupted or impacted teeth (e.g. wisdom teeth) when performed by a registered oral or maxillo-facial surgeon.

We pay up to the hospital surgical benefit limit.

Non-surgical hospitalisation

Cover for medical treatment (not involving surgery) in a recognised private hospital in relation to a medical condition (e.g. heart disease, asthma, pneumonia or diabetes).

We also cover the cost of associated intensive nursing care, X-rays, disposables and consumables, dressings and in-hospital pharmaceutical prescriptions. In addition, this benefit covers less invasive procedures as an alternative to surgery.

We pay up to the hospital medical benefit limit.

Cover for medical treatment (not involving surgery) in a recognised private hospital in relation to a medical condition (e.g. heart disease, asthma, pneumonia or diabetes).

We pay up to the hospital medical benefit limit.

GP surgery

ACC top up

ACC Treatment Injury

Ambulance transfer

Post-hospital physiotherapy

Varicose veins surgery

Registered specialist skin lesion surgery

Podiatric surgery

Travel and accommodation – surgery and medical treatment

Benefit: Up to $5,000*

Cover for travel costs for you and a support person, and accommodation costs for a support person when you need to travel further than 100km from where you live for treatment.

*We pay up to $2,000 for travel and up to $200 each night for support person accommodation, up to a maximum of $3,000.

Benefit: Up to $5,000*

Cover for travel costs for you and a support person, and accommodation costs for a support person when you need to travel further than 100km from where you live for treatment.

*We pay up to $2,000 for travel and up to $200 each night for support person accommodation, up to a maximum of $3,000.

Parent accommodation

Benefit: Up to $1,000*

Cover for accommodation costs for a parent or legal guardian accompanying an insured person age 20 and under who is being treated in a recognised private hospital.

*We pay up to $200 per night for parent or legal guardian accommodation, up to a maximum of $1,000.

TIP: This benefit is more comprehensive on Premium Hospital than Standard Hospital, see below.

Benefit: Up to $3,000*

Cover for accommodation costs for a parent or legal guardian accompanying an insured person age 20 and under who is being treated in a recognised private hospital.

*We pay up to $200 per night for parent or legal guardian accommodation, up to a maximum of $3,000.

Pre-existing cover for newborns

Funeral support benefit

Gym and sports no claims bonus

Benefit: Up to $150 after each 24 month period of continuous cover

Waiting Period:

This benefit is payable if no claims were paid in the preceding 24 month period.

Reimbursement towards the following:

membership of a gym or sports club; or
sports/fitness equipment purchased from a sporting retailer.

TIP: This benefit is more comprehensive on Premium Hospital than Standard Hospital, see below.

Benefit: Up to $300 after each 24 month period of continuous cover

Waiting Period:

This benefit is payable if no claims were paid in the preceding 24 month period.

Reimbursement towards the following:

membership of a gym or sports club; or
sports/fitness equipment purchased from a sporting retailer.

Waiver of premium

Suspension of cover

Waiting Period:

12 months

You can put your cover on hold for:

Up to six months due to unemployment or redundancy; or
Up to 24 months for travel outside New Zealand; or
Up to 12 months for parental leave.

Waiting Period:

12 months

You can put your cover on hold for:

Up to six months due to unemployment or redundancy; or
Up to 24 months for travel outside New Zealand; or
Up to 12 months for parental leave.

Non-PHARMAC chemotherapy drugs

Obstetrics

Intravitreal eye injections

Post-hospital therapeutic care

Post hospital home nursing care

Sterilisation

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How much does treatment cost?

These are costs you could expect to pay if you’re treated in a private hospital without health insurance.

Head

Cataract surgery $3,200 - $5000
Removal of the cloudy lens from the eye affecting vision

Endoscopic sinus surgery $12,000 - $22,000
Surgical repair of the facial sinuses

Wisdom teeth removal $3,000 – $5,500
Surgical removal of wisdom teeth (third molars)

Thyroidectomy $10,500 to $16,000
Surgical removal of the thyroid gland

Heart

Angioplasty $17,300 – $27,400
Insertion of a catheter to unblock artery with a stent or balloon

Single valve heart operation $55,000 – $75,000
Surgery to repair or replace a heart valve

Heart bypass $35,000 – $55,000
An operation to rechannel blood flow to the heart

Body

Mastectomy $12,000 – $17,000
Surgical removal of the breast

Spinal fusion $20,000 – $65,000
Surgery to join two or more vertebrae together

Gastroscopy $1,100 – $1,600
A diagnostic procedure to look at the mouth, throat and stomach

Cholecystectomy $9,000 – $13,000
Surgical removal of the gall bladder

Colonoscopy $2,000 – $2,600
A diagnostic procedure to look at the large bowel and sample tissue

Hysterectomy $14,000 - $22,000
Surgical removal of the uterus

Appendectomy $6,000 – $10,300
Surgical removal of the appendix

Hernia repair $7,000 – $18,000
Surgical repair of weakness in the abdominal wall

Leg

Total hip joint replacement $22,000 – $30,000
Replacement of the hip joint with an artificial joint

Resection of endometriosis $9,000 – $22,000
Surgical removal of the uterine cells from the pelvis or abdomen

Robotic Prostatectomy $30,000 – $60,0000
Robotic surgical removal of the prostate

Total knee joint replacement $22,000 – $35,000
Replacement of the knee joint with an artificial joint

Varicose veins (both legs) $7,000 – $11,000
Laser or surgical removal of varicose veins

Important things to know ³

What are some common treatments?

Cancer treatments

Removal of cancerous skin lesion $1,000 – $6,500

Chemotherapy $15,000 – $210,000

Radiotherapy $20,000 – $45,000

Diagnostics

PET Scan $2,000 – $2,800

MRI Scan $1,500 – $2,500

CT Scan $1,300 – $1,700

Ultrasound $400 – $500

Children 0-20 years

Grommets $2,500 – $3,500
Insertion of tubes in the eardrum

Adenotonsillectomy $4,000 – $5,500 Surgical removal of adenoids and tonsils

Important things to know ⁴

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Important things to know

Benefit maximums: just in case you thought you needed to share, benefit maximums are for each insured person every policy year, unless stated otherwise. Excess applies per person each policy year too.

Waiting periods: waiting periods apply to some benefits on your hospital cover. This is the time after you start a new policy that you have to wait before you make a claim.

nib First Choice network: use the nib First Choice Directory to check which providers in your area are part of the nib First Choice network for any health services you need. When treated by an nib First Choice provider, 100% of eligible costs will be covered, up to your benefit limits and in line with your policy. You can still choose to see a recognised provider who is not in the nib First Choice network but nib will only pay for treatment from that recognised provider up to a defined limit (the Efficient Market Price).

Pre-existing conditions: you won't be covered at any time for pre-existing conditions that relate to the following conditions: cardiovascular, cancer, hip or knee, back, transplant surgery, reconstructive or reparative surgery. Please refer to the policy document for further information.
Price includes our 4% direct debit discount.
Price based on: 25 year old male, non-smoker with a $500 annual excess.
nib claim statistics as at June 2018. This is an illustration of treatments and costs you could expect to pay if treated in private hospital. This is not representative of conditions covered on your policy or the amount that would be paid by nib nz limited in the event of a claim.
nib claim statistics as at June 2018. Representation of treatments and costs you could expect to pay if treated in private hospital. This is not representative of conditions covered on your policy or the amount that would be paid by nib nz limited in the event of a claim.

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Private Hospital

What is Private Hospital health insurance?

Compare Private Hospital plans

How much does treatment cost?

What are some common treatments?

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