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What is Medical Insurance?

Medical Insurance provides quality care as and when required without the need for waiting lists or unnecessary delays. A major medical policy, rather than covering your day to day costs such as doctors’ visits, dentists and optician bills, is tailor made to specifically cover 100% of the costs associated with major medical procedures as well as hospital visits and specialist consultations.

Why do I need Medical Insurance?

The public health system is overloaded and it is only going to get worse. Public waiting lists are getting longer and longer. No one plans to get sick but if you did and you needed medical treatment, wouldn’t you want to be able to access the help you needed quickly? The sooner you can get treatment, the sooner you can get back to living your life.

You can also include cover for specialist visits, this means that you don’t have to wait. You can see a private specialist quickly and get the help you need.

When should I get Medical Insurance?

Get it when you are young and healthy – in other words, before you need it – so the chances of having exclusions on your policy will be minimised.

By adding your children to your policy when they’re born, you can avoid any exclusions. Most insurance companies let you add your child to your policy before they’re three months old without any underwriting or an application form – they usually need a written request and copy of the birth certificate. We can handle all of this for you.

If you let us know when you have little people on the way; we can make a note to remind you to add them to your policy.

What about ACC?

Many people mistakenly assume that ACC will take care of them if they become ill. ACC only provides cover for medical issues that are a result of an accident, not if you need treatment for an illness.

What is a pre-existing condition?

A pre-existing condition is a health issue that you knew about (or suspected) before taking out Medical Insurance. Most policies don’t cover pre-existing conditions, but some companies allow them to be reviewed after a period of time.

Some insurers will cover a pre-existing condition and charge a higher premium. An example of this is if you are significantly overweight. You may still be able to get cover, but will pay a little more.

There’s a lot of variation in the offerings from different insurance companies, your adviser can take you through all the different options to find the one that’s best for you.

Do I have the right cover?

Some Medical Insurance plans may seem like good value for money as they are comparatively less expensive, but you get what you pay for.

Your Medical Insurance could be costing you more than it should, if your policy covers you for GP visits and prescriptions. The cost of premiums for this type of cover is approximately $500 per annum more than a major medical policy. Unless you’re visiting the doctor 8 to 10 times a year (at $40 per visit), it’s simply not value for money. The same applies to cover for dental and optical, unless you are claiming the full amount every year it’s not a strategic decision.

What are my excess options?

Most insurers offer the option of adding an excess – in other words you pay a set amount of the bill and your insurance pays the rest; the higher your excess, the lower your premium.

*Note: excess options vary between companies and you can increase your excess at any time.

How do I claim?

To make a claim, you need to complete a form and send it to your insurer along with any referral letters or other supporting documentation. We can sort and send the paperwork for you, and act as your advocate.

We always recommend you get prior approval for treatments and investigations, so you know for certain that you will be covered, giving you one less thing to worry about.

It’s really important to give the insurance company as much information as possible to allow them to process your claim quickly.


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