Setting the record straight on what health insurance really covers

With so many providers, plans and opinions out there, it’s easy to feel overwhelmed when it comes to health insurance. There can be assumptions that it’s too expensive, doesn’t cover pre-existing conditions, or simply isn’t worth it. But that’s not the case.

To help clear things up and help you make more informed decisions, here’s a breakdown of five of the most common health insurance misconceptions.

1. Health insurance is too expensive

It’s a common misconception that health insurance is just another bill to add to the pile. But in reality, it can help you avoid bigger expenses down the line. Without cover, unexpected medical costs like surgery, specialist care, or cancer treatment can add up quickly and become a financial burden if you have to pay out of pocket through the private health system. Health insurance helps you manage those costs and gives you fast access to care through private healthcare when you need it most.

Plus, insurance plans are designed with flexibility in mind. They take into account factors like your age, health and lifestyle, with options available to tailor your cover to suit your needs and budget, such as adjusting your excess. With nib’s Standard Hospital + Standard Everyday combined plan starting from as little as $34.24* a week, for example, having that peace of mind might be more affordable than you think.

There may also be benefits beyond claims available through your policy. At nib, we offer a range of Health Management Programmes, free of charge, to help eligible members make simple lifestyle changes to minimise health risks and improve their wellbeing. Our Wellness Coaches can help you better navigate an unexpected diagnosis, our Cancer Care Programme supports you through the treatment and recovery process, and our Diabetes Care helps you tackle ongoing conditions so they don’t get worse. And that’s just a few of them!

2. You don’t need health insurance if you’re already healthy

Even if you’re currently healthy, an unexpected illness or injury could happen at any time. Having cover in place means you get treatment ASAP and can focus on getting better, instead of navigating long wait times in the public health system or dealing with the financial stress. The same goes for your loved ones. Imagine you’re in a single income household and your partner is unable to work because they get sick – will you have fast access to the care you need, when you need it?

Plus, many insurers also offer benefits for people who lead an active lifestyle, such as nib Balance and our Health Management Programmes, so members can continue taking a proactive approach to their wellbeing.

3. I can just use the public health system

The public health system is designed to support everyone, but growing demand means it’s getting harder to access timely treatment.

A combination of funding issues, workforce shortages, and increasing patient numbers means wait times are blowing out. Emergency departments are under strain, specialist appointments are delayed and, in some cases, clinics are even being forced to close.

That’s left many Kiwis wondering how they’ll access reliable healthcare when they need it. Health insurance is a way to access private healthcare without the upfront costs, allowing you to avoid public waitlists and get more options. In the case of some serious illnesses, getting the treatment you need within a reasonable timeframe can make all the difference to your recovery.

4. Health insurance is confusing

Some may assume that health insurance is full of confusing jargon, but that’s not the case with nib. We’ve made sure that our plans are clearly laid out to help you understand exactly what you’re getting, so you can choose the cover that best suits your needs.

Our Hospital plans are designed to help cover major health events, like surgery or cancer treatment, giving you fast access to private healthcare. Our Everyday plans help with day-to-day health costs like GP visits, dental care, and prescriptions, making it easier to stay on top of your health.

You can even combine plans to get the benefits of both Hospital and Everyday cover in one policy. And if you’re looking for something extra, you can add an option (like non-PHARMAC Plus) to eligible plans at any time, not just when you first join.

Our website has easy-to-read policy documents, benefit summaries, and helpful resources, so you can feel confident, not confused, about your health cover. Plus, they’re downloadable!

5. I can’t get cover if I have a pre-existing condition

This isn’t always the case. Your health insurance policy may cover many of your pre-existing conditions (such as asthma, mental health conditions or a historic injury) after the applicable waiting period – get in touch with your provider or check your policy document to understand the conditions.

Once you’ve been with nib on either a Premium Hospital or Standard Hospital policy for three years, following your join date, some pre-existing conditions are covered, allowing you to claim on them. This is a loyalty benefit and our way of saying thanks for being with nib.

The more you know, the better protected you are

Understanding the facts behind common health insurance misconceptions can make a real difference when deciding what’s right for you and your whānau. While weighing up the pros and cons of different private healthcare plans, it’s worth remembering that insurance is ultimately about peace of mind, knowing you’ll have support in place when the unexpected happens.

Explore our flexible, comprehensive health insurance options today by visiting our website.

*Based on a 25 year old male, non-smoker with a $250 excess on Hospital cover, including 2% direct debit discount, as at August 2025.