One way to afford non-Pharmac funded treatments

As New Zealanders, we’re fortunate enough to rely on a heavily subsidised public health system, with healthcare being mostly free or low cost. But as great as this system is for urgent care, when it comes to non-urgent treatments, it can only extend so far.

Health insurance is designed to help Kiwis fill in the gaps, with some policies even providing cover for non-Pharmac funded medications. So, what is Pharmac and how can health cover benefit you? Read on for some key things to know.

And remember, if you’re exploring your health insurance options for the first time, an adviser can help you navigate the solutions available and recommend relevant policies based on your needs.

What does ‘non-Pharmac’ mean?

You may have heard of Pharmac before: it’s the Government agency that decides what medicines to fund, based on a fixed annual budget, what needs there are and maximising the number of people they can help.

It’s important to note here that Pharmac doesn’t approve medicines; it’s up to Medsafe to ascertain the safety, effectiveness, and quality of a treatment. Pharmac then selects which ones to fund, and because the agency works on a limited budget, it can often take a long time (if ever) before Medsafe-approved treatments receive the ‘green light’ for funding.

This, unfortunately, includes some life-extending cancer medications that are already in use overseas.

So, can you still access these treatments?

Theoretically, yes. But keep in mind that New Zealand hospitals and pharmacies (and consequently the patient) pay full price for non-Pharmac funded medications.

At the time of this writing, for example, lung cancer patients who’d like to access Keytruda in New Zealand must fund it themselves. And costs can quickly add up: according to media, some Kiwi families have reportedly spent over $110,000 on this life-extending medicine. Many need to turn to crowdfunding platforms to raise money for treatments.

The good news is, there’s one way for you to secure future access to non-Pharmac funded treatments – and that’s health insurance.

How health cover can help you

When you think about your ideal healthcare experience, what comes to mind? It may be the flexibility of choosing the treatment you need, when you need it, at a price you can afford.

This is what health insurance can help you with, by providing faster access to treatment and diagnosis, so you don’t have to wait in line in the public healthcare system.

And many health insurance policies provide some level of non-Pharmac cover. Limits and benefits can vary a lot from provider to provider (generally from about $10,000 to about $500,000), so it’s a good idea to discuss your options with an insurance adviser. Which brings us to the next point…

Like to discuss your needs?

Not all health insurance policies are created equal. Some offer cover for everyday medical costs – like GP visits and dental check-ups. Others are designed to fund private medical treatments like scans, surgery and specialist visits. And as we’ve seen, some policies can even pick up the non-Pharmac bill for you.

Now, what insurance cover is best for you entirely depends on your needs, goals, and budget. Not sure where to start? By taking the time to understand your circumstances, an insurance adviser can recommend one or more options that are appropriate for your situation. Not only will they research on your behalf, saving you time, but they will also guide you through the application process and explain all about your cover in plain English.

This way, you can have peace of mind that you have the cover you need, at a price you can afford.

Like to get the conversation started? Click here to find a financial adviser specialised in Personal Risk near you today.

Disclaimer: Please note that the content provided in this article is intended as an overview and as general information only. While care is taken to ensure accuracy and reliability, the information provided is subject to continuous change and may not reflect current developments or address your situation. Before making any decisions based on the information provided in this article, please use your discretion and seek independent guidance.