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COVID-19
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To help your clients with questions they may have about their health cover in these unprecedented times, we’ve put together some frequently asked questions.

These FAQs provide information about nib’s private healthcare policies in relation to COVID-19 and were last updated on Monday, 28th September 2020.

We’ll be updating this page regularly, as the situation evolves, to provide you with the most relevant information, including more frequently asked questions and updates. Some other information you may find helpful is:

We want to support our members through this tough time. That’s why we’ve put additional measures in place to assist those members experiencing financial hardship:

Options already available to nib members:

Most policies in our product range already contain benefits or options available to members in the event they are experiencing financial hardship. For example, under Ultimate Health the policy provides for:

  • Suspension of Cover benefit:
    Members who have had a policy in place continuously for more than 12 months, and who are now unemployed or are being made
    redundant, can suspend their policy for a maximum of six months. This means that premiums are not required to be paid while the policy is suspended, however no benefits are payable during this suspension either.
  • Increasing the Excess:
    Members are able to increase the excess on their policy within six weeks of their Anniversary date in order to reduce the regular premium payments. Members can then only reduce their excess on completion of relevant health information.

More details on these options can be found in the corresponding policy document.

New options available to nib members:

  • Excess changes:
    Members can choose to increase the policy excess (payable upon hospital admission) to the maximum allowable level under their policy without needing to be re-underwritten if they choose to reduce their excess as their financial situation improves. The date they can reduce their excess back to original levels without underwriting has been extended to 31 March 2021.
  • Suspension of Cover:
    All nib members (including those who have had a policy in place for less than 12 months) will now have the option to apply to suspend their policy cover for up to six months if they have now become unemployed or are being made redundant, or have had a significant reduction in their regular fixed income as a result of COVID-19. Note that members are able to reinstate their policy at any time within the period of suspension.

Note that every member has different personal circumstances and will have different policy terms specific to the nib policy they have in place. Some conditions apply to the options above, and each request will be assessed on a case by case basis, which would be in line with other policy terms and conditions for the individual member.

If you have a member in this position, please ensure they call the nib team on 0800 123 642 as noted in the FAQs below. And for those advisers with nib group health policies, please get in touch with your nib account manager to discuss options that may be available.

Does my health insurance cover COVID-19?

The Ministry of Health will cover the cost of your hospitalisation if you are admitted to public hospital with COVID-19. This includes any or all of the following:

  • The surveillance of people who are required to be quarantined
  • Diagnosis
  • Treatment of the person’s infectious or quarantinable disease
  • Follow-up services and
  • Contact tracing services.

The extent of the Ministry of Health cover will be determined based on what is appropriate in the circumstances to address the risks to other people and as determined appropriate by a clinician. For more information please visit health.govt.nz


For expenses that aren’t covered by the Ministry of Health you can check your policy details on my nib to see if there may be some out of pocket expenses that nib may cover.

 

However, please be aware that in New Zealand most health insurance policies have an exclusion for acute medical conditions and observations. An acute medical condition means a sign, symptom or condition that needs hospital admission for treatment or monitoring, immediately or within 48 hours.

Does my cover change as a result of COVID-19 being declared a pandemic?

The World Health Organisation declared COVID-19 a global pandemic on 11 March 2020. This declaration does not affect your cover with nib. Your cover will operate as per its normal policy terms and conditions.

Does my policy cover me for doctor and specialist appointments by video or telephone?

If your policy covers you for GP and/or specialist consultations and these need to be conducted by video or tele-consultations due to COVID-19, nib will cover these as an exception to the normal policy requirement that all consultations be in person.

Telephone and video consultations will be treated the same as a standard, in person consultation and will be covered in line with your policy terms and conditions. Members can utilise Whitecoat NZ to locate a specialist or GP near them who is offering telephone or video consultations.

This position will be reviewed to ensure it reflects any changes with the COVID-19 situation in New Zealand and any changes will be notified on the nib website. Standard claim criteria such as the requirement to provide an invoice for a consultation still apply.

If I’ve been financially affected by COVID-19, what should I do?

If you have been financially affected by COVID-19 and are experiencing financial hardship, please call us on 0800 123 642 where we can discuss options to help you maintain your health cover through this difficult period.

What happens if my treatment is delayed or cancelled as a result of COVID-19?

In the event your treatment is delayed or cancelled as a result of COVID-19, your medical practitioner, specialist or surgeon will advise you what the next steps are. Should you need to update your pre-approval to reflect the new date of your treatment, get in touch via email claims@nib.co.nz or phone 0800 123 642.

Am I covered for diagnostics tests for COVID-19?

The Ministry of Health will cover diagnostics tests for COVID-19. Please note these tests can only be ordered by your doctor if you meet the testing criteria. Should you be asked to pay for these tests, you can check your policy details on my nib to see if your policy may cover you.

Will COVID-19 be considered a pre-existing condition?

If you join nib and have any pre-existing medical conditions such as COVID-19, depending on your policy you may need to disclose these at time of joining. Some pre-existing medical conditions may be covered immediately, while others may have a stand-down period or be permanently excluded.

Does my policy cover me to visit my GP if I think I have COVID-19?

The cover provided by your health insurance policy depends on the policy you have selected. For our GP Options, doctors’ visits may be partially covered up to benefit limits and in line with the policy terms and conditions.

If the public health system is at full capacity and turns me away, can I use my private health insurance?

At this stage all hospital treatment related to COVID-19 would be provided by the Ministry of Health through the District Health Boards throughout New Zealand. In the event a large number of the population become infected with COVID-19 District Health Boards will work with their Primary Health Organisations and community primary care providers to create pathways of care that best suit their regions and populations.

Our Hospital cover policies all exclude cover for acute conditions, meaning emergency treatment is not covered at private hospitals and health insurance is not designed to replace, but instead to complement it.

Should I cancel my planned surgery as a result of COVID-19?

It is recommended that you contact your medical practitioner, specialist or surgeon for any questions related to COVID-19 and upcoming procedures. They will be able to advise you of what the next steps are.

How does COVID-19 affect the Ultimate Health Travel insurance benefit?

The situation is rapidly evolving, and we encourage travellers to stay up to date with the latest travel advice from the Ministry of Foreign Affairs and Trade at safetravel.govt.nz.

For nib Ultimate Health Travel Insurance policies issued prior to the dates listed in our Travel Alerts, there may be cover available for claims arising from this event. Policies issued after 7:00pm NZDT 23 January 2020 will not offer cover for this event for travel to/from China, and policies that have been issued after 8:00am NZDT 31 January 2020 will not offer cover for COVID-19 for any destination.

As MFAT has issued a “Do Not Travel” warning for all destinations, travellers who choose to travel or remain overseas at this time will not have cover for the coronavirus COVID-19 outbreak; all “Do Not Travel” bans; or government prohibitions or regulations.

Losses that do not arise from or relate to COVID-19 or the resulting Do Not Travel warning may have cover available as per the terms and conditions of the policy.

Cover is subject to the terms, conditions, limits and exclusions of the policy wording, and will depend on how an individual is impacted.

For more information regarding nib Ultimate Health Travel insurance visit nibultimatehealthtravel.co.nz.

Is nib still offering travel insurance?

There is still complementary Ultimate Health Travel insurance available to new members who take out or renew an Ultimate Health policy. As travel is an annual benefit to Ultimate Health and Ultimate Health Max members, they can still get value after travel restrictions are lifted. However it is important that you follow the advice of the New Zealand Government (https://www.safetravel.govt.nz/).

If you decide to travel against advice, nib will not provide you with cover for any loss or event related to the coronavirus COVID-19 outbreak; all “Do Not Travel” bans; or government prohibitions or regulations.

Please refer to policy document for more information.

Are nib member services still operational? (E.g. Website, mobile app, emails and customer care)

You can find our contact details by clicking here and here to contact your Adviser Partner Manager.

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