What you pay for visiting your doctor
The care provided by family doctors or general pracitioners (GPs) is partially subsidised by the Government but in most cases you will still need to pay a copayment. This fee is set by the GP and can vary from clinic to clinic.
Most New Zealanders are now enrolled with GPs who are part of a Primary Health Organisation (PHO). Being enrolled in this way usually means the GP can provide cheaper visits and services to those patients. Some practices may also provide free standard consultations for children under six years (after-hours charges may still attract a cost) - ask your local practice if they are part of this scheme.
If you are a beneficiary or are on a low income, you may be eligible for a Community Services Card, or CSC. A CSC can entitle you to additional healthcare subsidies. Your doctor or practice nurse can tell you if you qualify, or you can call Work and Income on freephone 0800 999 999.
The same applies to people who use health services often and have long term illnesses. These people may be eligible for a High Use Health Card (HUHC), which allows subsidised healthcare. There is more information on the CSC and HUHC below.
The nurse at your GP's practice may provide some services at lower cost than the GP. Ask about cervical screening, blood pressure checks, injections and other procedures that can be carried out by the nurse.
Basic dental care for eligible school children is free up to 18 years of age.
Pregnancy and childbirth services
Care in pregnancy and childbirth is free for New Zealand citizens and permanent residents, or for their partners or spouses, except for care provided by private obstetricians and at private hospitals. This care covers the diagnosis of pregnancy, antenatal care, childbirth, postnatal care and miscarriage.
Women who are not eligible for publicly funded health services may be charged for antenatal, labour, birth and postnatal services provided to them. Also, babies born from 1 January 2006 will only be eligible for New Zealand citizenship if at least one of their parents is a New Zealand citizen or permanent resident. If you are not eligible for publicly funded maternity services and your baby is not eligible to be a New Zealand citizen, you will also pay any costs for your baby. For more information on eligibility see the Ministry of Health's website or the Department of Internal Affairs' website.
District Health Boards are required to purchase abortion services, which are free of charge to the woman. These services can be provided locally or, sometimes, outside your area. Contact your GP, midwifery centre or local family planning clinic for more information.
Specialist and hospital care
If your GP refers you to a specialist or hospital you can choose to go publicly or privately. Almost all essential medical services are provided free through the public health system (excluding dentistry and optometry).
If you go privately, you must pay. If the doctor suggests a private specialist or hospital, but you would prefer to use public services, ask for a public referral.
Always contact the public service yourself and ask about waiting times in your area. There are wide variations in waiting times depending on location and type of health service required. Don't assume that you will "never be seen in time".
Private specialists and consultants charge for their services. Some services are only available publicly (such as radiotherapy) but you can still see a specialist privately.
If you wish to find out more about health insurance, which is often taken out by individuals and families to cover the costs of private care and other regular medical bills, see our everybody topic Making Sense of Health Insurance.
Accident treatment
Treatment for accident-related injuries is subsidised by the Accident Compensation Corporation (ACC), as long as this care is provided by a registered health professional. There may be a user part-charge for visits to GPs, or for physiotherapy, chiropractic and other recommended treatments.
Laboratory tests and x-rays
Mostly, laboratory tests and x-rays are free. But private radiology clinics charge for all tests undertaken - unless they have been contracted to provide them by a local District Health Board service. Breast screening is free for women between the ages of 45 and 69 years of age. Cervical screening is free for women aged 20 years or more and under 70 years who have ever been sexually active.
Blood tests are mostly funded by the District Health Board and will not cost you any money.
Drugs or medications
Some medicines are subsidised for patients in New Zealand. Pharmac, a government organisation, specifies which medicines will be subsidised (ie, these are the medicines on the Pharmaceutical Schedule).
Adult New Zealanders will usually pay $3 per item for subsidised medicines from a community pharmacy, though this may cost up to $15 if the prescription is from a specialist. Prescription medicine for children under six years is often free.
For some medicines you also pay an extra part-charge. Some drugs are not subsidised at all, and must be fully paid for. Your doctor can tell you if a drug has an extra charge or is not subsidised. Non-prescription (over-the-counter) medicines must be paid for in full.
People who live in households with low incomes or which have high healthcare needs can apply for a Community Services Card (CSC) or High Use Health Card (HUHC). CSC or HUHC allow adults and older children to pay a lesser charge per item for medicines and nothing for children under six years.
A guide to prescription charges and an Interactive Schedule - a prescription cost calculator - for items on the Pharmaceutical Schedule can be found on the Pharmac website www.pharmac.govt.nz.
Eligibility for Community Services Card
The CSC is available to low income individuals or those receiving a benefit, and their dependent family members. Eligibility is based on family size and income. Phone the Community Services Card national centre freephone 0800 999 999 for more information or visit www.workandincome.govt.nz
Eligible senior citizens and veterans will receive a SuperGold Card instead (which has the same entitlements as a CSC) - see further below for details.
Eligibility for High Use Health Card
The HUHC gives an individual access to a higher government subsidy on visits to the doctor. To be eligible for this card an individual needs to have visited the doctor 12 or more times in one year. This card is not means tested. Your doctor will have a record of your visits, and he or she can make an application for your HUHC. Phone the HealthPAC Contact Centre 0800 252 464 for further information.
The HUHC Card gives the same amount of subsidy as the Community Services Card on GP visits and prescription charges. (If you already have a CSC, there is no advantage in having a HUHC because the subsidy is the same.) However, if you already have a HUHC, there is an advantage in also having a CSC, because the CSC gives subsidies to all dependent family members, while the HUHC is only for an individual.
- Adults with a HUHC get a subsidy of $15 for a visit to a doctor.
- Children aged 6 to 18 get a subsidy of $20 for a visit to a doctor.
- For prescriptions, the government prescription charge is reduced (but when the medicines themselves are only partly subsidised there will still be additional charges).
Pharmaceutical Subsidy Card
The Pharmaceutical Subsidy Card (PSC) allows the cardholder and named family members to pay a lower amount on the government prescription charges. There is no income testing. The purpose of the card is to help people who face high prescription costs but who do not have a CSC or a HUHC.
Your pharmacist should have a record of your family's prescriptions. Your pharmacist will issue a PSC once a family unit has paid for 20 subsidised prescription items since l February of any year. If you use several pharmacies, keep your receipts until they number 20 in total. More on the PSC.
SuperGold Card
The SuperGold Card is available to eligible senior citizens and those on the Veteran's Pension. The SuperGold Card entitles the person to the same health subsidies as the Community Services Card. Holders of a SuperGold Card need to present this card to receive subsidies (it replaces the CSC for eligible senior citizens.) More information can be found on www.supergold.govt.nz
Other services
- Independent nurse practitioners charge for their services, except when they are contracted to hospitals or DHBs to provide free or partly subsidised services.
- Dentists charge for their services. Limited dental services are available in public hospitals in some areas. Basic dental care for eligible school children is free up to 18 years of age.
- Physiotherapists, osteopaths and chiropractors will charge you. This may be a part-charge if your doctor has referred you.
- Complementary or natural therapy is not subsidised so you must pay for the whole service, unless that care is being provided by a practitioner who is also a doctor or midwife. For example, some doctors provide acupuncture and homeopathy services.
- Long-term residential care for older people is asset-tested. To find out what you are entitled to, contact the local branch of New Zealand Income Support Service.
- Ambulances are provided by non-profit community-based services in most parts of New Zealand, as well as hospitals and private providers. There is a part-charge that ranges from $45 to $67.50. However, there is no charge for the Wellington Free Ambulance Service or for patients covered by ACC.
Health insurance
Health insurance entitles those insured to get refunds for specific health services. The size of the refund and the services covered depends on the policy. There is often a shortfall between the amount of the refund and the actual cost of the service. While this sum may be small for some services (for example, a visit to a GP), for major surgery the shortfall may be very large.
As some health services are only available in public hospitals, health insurance is of no benefit in particular circumstances. Many cancer treatments, intensive care and major trauma and accident treatments are examples of services not provided by the private sector. See our topic Making Sense of Health Insurance.
Non-New Zealand residents
Health services are funded for New Zealand residents. People who are not permanent residents can be charged for their healthcare. Nobody can be refused emergency care because they cannot pay, although they may be sent a bill later.
Treatment after an accident is free or heavily subsidised for all people whether or not they are New Zealand residents. If you have been granted refugee status, you have the same rights as New Zealand residents. If you have been granted a temporary permit while your application for refugee status is processed and you intend to remain in New Zealand for two years or more, you have the same rights as New Zealand residents.
If you are not sure whether you are eligible for publicly funded healthcare, you can contact the Ministry of Health or visit the Ministry of Health's website page on Eligibility for Publicly Funded Health and Disability Services.
Registration
New Zealand has no compulsory system of registration to receive healthcare. However, many New Zealanders who have used health services have been automatically registered on the National Health Index (NHI) and have been allocated an NHI number.
There are a number of other registers: The National Cervical Screening Programme has a register for women aged 20 to 70 years, which can be used only for cervical screening (freephone 0800 729 729) or see www.cervicalscreening.govt.nz
BreastScreen Aotearoa offers a free breast cancer screening programme for women aged 45 to 69 (freephone 0800 270 200) or see www.breastscreen.govt.nz
Some GP practices keep practice registers. This information should be confidential to the providers involved in your care. If information about you is to be passed on to any other agency, you must be told of this when the information is collected.
Your privacy
Under the Privacy Act 1993, you have a number of rights with regard to health information held about you. In general, you have a right to see that information.
If you have concerns about the privacy of your health records phone the Privacy Commissioner's Hotline Auckland phone (09) 302 8655, and other areas freephone 0800 803 909, or check the website of the Office of the Privacy Commissioner.
Health And Disability Commission
The 1994 Health and Disability Act is expressed as being "to promote and protect the rights of health consumers and disability services consumers, and, in particular, to secure the fair, simple, speedy, and efficient resolution of complaints relating to infringements of those rights" (s 6). This objective is achieved through the implementation of a Code of Rights, the establishment of a complaints process to ensure enforcement of those rights, and the ongoing education of providers and consumers.
Complaints about the health services you receive can be directed to the Health and Disability Commissioner - freephone 0800 11 22 33, website www.hdc.org.nz. See the Code of Health and Disability Services Consumers' Rights.
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Original material supplied by everybody. Information current as of December 2007.
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