Understanding Non-Pharmac Cover in Health Insurance: What You Need to Know
When it comes to health insurance, not all policies are created equal. One critical aspect that often gets overlooked is Non-Pharmac funded cover. This type of cover can make a significant difference in the treatment options available to you, particularly for serious conditions like cancer. Let's explore what Non-Pharmac funded cover is, why it matters, and how different insurers stack up.
What is Non-Pharmac Cover?
Non-Pharmac cover refers to insurance that covers medications and treatments approved by Medsafe but not funded by New Zealand's Pharmaceutical Management Agency (Pharmac). Pharmac decides which medicines and treatments are publicly funded, which means that if a drug isn't on their list, it can be incredibly expensive for patients to access.
Why Non-Pharmac Cover Matters
Having Non-Pharmac cover can provide access to a broader range of treatments, including some of the latest and potentially most effective medications that may not yet be funded by Pharmac. This is particularly crucial for serious illnesses like cancer, where new treatments can sometimes make a significant difference in outcomes.
Comparing Non-Pharmac Cover Limits
Different insurers offer varying levels of Non-Pharmac cover, and these limits can significantly impact your out-of-pocket expenses.
Partners Life: Comprehensive Non-Pharmac Cover
Partners Life stands out by offering up to $600,000 per policy year for Non-Pharmac funded treatment. This extensive cover ensures that you have access to a wide range of potentially life-saving treatments without the financial burden. For example, if a new, cutting-edge cancer drug costs $200,000 per year, Partners Life's cover would easily accommodate this, allowing you to focus on recovery rather than worrying about the costs. It’s not just limited to cancer either, Partners Life will cover any medically necessary treatment not funded by Pharmac.
NIB Private Hospital Cover Plus, AA Health and Southern Cross Wellbeing One & Two: Limited Non-Pharmac Cover
In contrast, AA Health, some NIB and Southern Cross Wellbeing One & Two medical insurance plans offer only up to $10,000 per policy year for Non-Pharmac cover. While this is better than having no cover at all, it might not be sufficient for more expensive treatments. For instance, if the same $200,000 cancer drug is needed, these policies would leave you with a substantial financial gap to cover on your own.
AIA Private Health cover
AIA covers up to $500,000 per year of Non-Pharmac funded cover. This is for Cancer only but linked with their strong policy wordings gives consumers the option to add their AIA Vitality wellness programme to lower premiums and help make the cover affordable.
Real-World Impact
Consider the case of a patient diagnosed with a rare form of cancer that requires a Non-Pharmac approved drug costing $150,000 annually. With AIA or Partners Life's cover, this patient would be able to receive their treatment without worrying about the financial implications, thanks to the high cover limit. Conversely, with a policy from AA Health or Southern Cross Wellbeing One & Two, the same patient would face a daunting $140,000 shortfall each year.
Making an Informed Decision
There are many other providers and legacy products to consider as well. We can help you make an informed choice when it comes to your health insurance options.
Conclusion
Non-Pharmac cover is a vital component of comprehensive medical insurance. With significant variations in cover limits among insurers from as low as $8,000 per year to $600,000 per year or even more with some older closed products, ensure you choose a policy that aligns with your needs and provides adequate financial protection in times of health problem.
For more personalised advice and to explore the best insurance options for your needs, contact us at NZ Advice Group.