Recently those living with Melanoma argued for the government to allow them access to the life extending drug Keytruda. The government finally relented but for a long time patients were dying, paying for the drug themselves or relying on Medical Insurance to pick up the tab.

It might seem that those with private health insurance really had it made but did they? Surprisingly most New Zealanders with Health Insurance wouldn’t have been covered for Keytruda. They may have received a month’s treatment, two if they were lucky and then they were on their own.

Why Am I Not Covered?

Simply put, not all health insurance is created equally.

Some health insurance companies, including the most popular, will only cover a small amount of non-PHARMAC funded chemotherapy treatment as well as having maximums on funded chemotherapy.

Changing your policy might not be an option, especially if you have been ill or injured and you don’t want to lose cover you already have. For others the health insurance is through their employer and the policy isn’t looked at too closely.

So What Can I Do?

1 – First thing is to contact your insurance provider and ask them about the limits for cancer cover on your policy. You will want to ask specifically about “PHARMAC” and “non-PHARMAC” covered treatments and you should bear in mind that 12 months treatment of a drug like Keytruda could easily top $120,000.

2 – If you find out that your health scheme has shortfalls and it is through your work then you can point this out to your company. It is unlikely that your manager wants to spend money every month on a benefit that isn’t going to work. You may be doing the boss a favour.

3 – If you have a hole in you cover and can’t change your policy, you can always take out extra health insurance. One which complements your existing employee policy, it probably won’t be as expensive as you think.

4 – The other option is to take out some type of trauma cover. This would give you a lump sum in an event to top up treatments. For an office worker aged 40, severe trauma cover of $100,000 will cost less than a coffee a week. For life saving products the government won’t supply, this seems like a bargain option to me.

Can I Do This Myself?

Getting the balance right isn’t as straightforward as it seems and I would recommend speaking to an adviser so you don’t waste your money

Restrictions on the availability of medicines in New Zealand is here to stay and in the future more new products will be kept from the NZ public. If you are changing policies take this into account, and if you are stuck with a lesser product look to reinforce it.

If you are worried, don’t be. Give me a call on 0800 COVER YOURS or book a meeting here. There is no obligation just straightforward advice.

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