Leading health insurer, nib New Zealand (nib), has today launched a new health cover option to provide Kiwis with
greater choice and access to potentially life-saving treatments not publicly funded by PHARMAC – the government agency
responsible for deciding which medicines are subsidised as part of our public health system.
The new add-on cover, non-PHARMAC Plus, is available from today through nib’s adviser and group distribution channels with members able to add to their new or
existing hospital cover. 1
Benefit limits range from $20,000 to $300,000 per member per year, allowing members to choose the level of cover that
best suits their health needs and budget.
nib New Zealand Chief Executive Officer, Rob Hennin, said the non-PHARMAC Plus option was developed in response to a growing need for cover that provides members with greater choice, affordability
and flexibility when it comes to modern medicines.
“New Zealand’s public healthcare system is often recognised for the level of care it provides, but we’re also ranked as
having the worst access to funded modern medicines of the 20 OECD countries, 2” Mr Hennin said.
“Without funding, these medicines can often cost hundreds of thousands of dollars, placing Kiwis who are already under
significant stress dealing with an illness, with the added financial burden of paying for treatments out-of-pocket.
It’s why we’ve introduced this add-on option which is designed to better protect our members’ health by making
potentially life-saving treatments more affordable and accessible,” he added.
nib’s non-PHARMAC Plus option provides cover for all medicines that are not funded by PHARMAC, are Medsafe approved and have been prescribed or
administered in line with Medsafe’s guidelines – not just cancer treatments.
“The great part about our non-PHARMAC Plus option is that the add-on benefit also enables our members to ‘future-proof’ their cover so that when new unfunded
medicines become available to treat critical illnesses, they’ll be covered for it,” Mr Hennin said.
The benefit covers the cost of these medicines where nib has accepted a claim for treatment and where the non-PHARMAC
drugs are used in a private hospital or at home for up to six months after being admitted to hospital for treatment. The
benefit also covers any drug administration costs. Additionally, there are no waiting periods if members choose to add
this option to their policy.
“By offering this benefit to our members and the New Zealand community we hope to provide some peace of mind knowing
they can immediately access the treatment they need without the financial burden or the need to wait for public funding
which can often take years to eventuate,” Mr Hennin said.
“An example of this is Tafinlar, a medicine that is used to treat melanoma which can cost over $100,000 per year. While
this has been Medsafe approved since 2013, there is currently no public funding available for it through PHARMAC.
“That’s where we can help, by providing payment towards such treatments so our members can focus on what’s important,
their better health,” he added.
nib’s non-PHARMAC Plus option will be available to all other eligible nib members later this year. Members are encouraged to chat to their
insurance adviser to find out more information.