Health Insurance can be complex and not all health insurance policies are the same. It’s easy to compare two policies on price, but the cover you get may be very different. So we hosted a webinar about Insurance with Shane King, Monument Financial Adviser. You can watch the full webinar here.

In this blog post, we asked Shane to answer all the questions from the webinar, so take a look below.


1. Does the Major Diagnostic Tests limit reset or is it lifetime? 

It resets annually on the policy anniversary and that is the same time as all benefits reset.

2. Could you name the provider that is Insurance B? They seem to have the best plan!

Unfortunately this was not a financial advice session and these examples were general indicative examples. Depending on your own personal details and circumstances which we don't know, Insurance B may not be the right fit for you.  So we don't want you taking out a policy that may not be right for you.  Therefore, we recommend you seek advise from a financial adviser for your situation. 

3. Why do premiums increase so much as you get older. It doesn’t make sense because you might not be able to afford it when you need it

Premiums are age rated and they are based on the likely hood of a medical event that may result in a claim based on your age band. An important way to manage the future rate increases is by way of saving during your working life so you can select a higher excess as an option.

4. Why difference in male/female premiums?

Insurers operate on risk-based pricing and they are able to rate on statistical data where they can see that a specific gender is higher at claiming on certain benefits at certain ages.  Thus, premium tends to be higher for females of childbearing age when compared to men. However, it is lower for females than for males from the age of 60 onwards. Thus, simply put, the premium differentials are reflective of the claim cost differences.

5. Thank you. Is there any way I could view a recording of the earlier webinar? I missed it!

Here are the links to both of Shane's webinars:

6. Which of these cover dental care and processes?

There are two ways that you can get dental cover. 

  • The first way is with a day to day healthcare plan like our Primary Care Extra Plan.  With our plan you can claim 50% of your costs back up to $350 per year. This includes dental examinations, x-rays, cleaning/polishing performed by a Dentist, Oral Surgeon or Dental Hygienist. Includes fillings and teeth extraction (excluding wisdom teeth) performed by a Dentist or Oral Surgeon.
  • Secondly some Insurers can add a dental module to their Hospital Plans. We suggest that for this option you have a chat with a financial adviser to find out more. Please remember there is no fees in getting advice.

7. Isn’t it better just to save money regularly in a health account? And then use that to fund the treatment?

Self-insuring means that, instead of paying an insurance company, you put money aside yourself for health costs. You opt to let the public health system cover urgent conditions, and if you need other surgery or treatments, you’ll cover them out of your own pocket.  Sounds good... but how quickly can you save the amount you need and have it available when you need it and then replenish it for the next time you need it.

Insurance is a funny thing as if we knew what claims we will have over our life, and how much they would be for we possibly would not need to purchase life, health or house insurance.

On the whole, self-insuring may only be an option for cheaper procedures or treatments. Fairly common surgeries can cost in the order of $20,000 and over, so self-insuring is not going to be a complete alternative to insurance. 

We do see claims in excess of $100k and some recent spinal fusion treatments have exceeded $200k. So the question is how much do you need to save, and how many medical events should you save for. It is due to this unknown that so many people decide to pass the risk onto an insurer than carry the risk themselves.

That being said, setting aside a buffer for health costs can save you money on health insurance, allowing you to opt for a higher excess (the part of a claim that you pay before the insurance kicks in). Insurance companies reduce your premiums if you have a higher excess­­ ­­– you pay up to a certain point; they cover any costs above that.

8. Does trauma cover come under health insurance?

Generally trauma insurance is different to health insurance.  On the surface, trauma insurance and hospital cover might sound like they tick the same boxes, but in reality, they are quite different—and each one is critical to providing care and financial assistance when you fall ill.   

Trauma insurance caters for scenarios when you need funds to pay for treatments that health insurance may not cover. 

Trauma cover is generally a one-off payment.  It covers a range of major medical events such as stroke, a cancer diagnosis, heart attack and life-threatening injury (e.g. severe car accident).  Unlike hospital cover which pays out to the medical provider, trauma is paid directly to the individual that's covered and can be used to ease the financial burden caused by a serious illness

While there is some overlap in health and trauma cover, it is critical to understand the differences between them and how they could apply to you. Having trauma sit alongside your health insurance provides an extra safety net to cover major lifestyle changes and lifesaving treatments that otherwise might be out of reach.

Most of all, having both gives you options.  To ensure that you don't over or under insure we suggest that seeking advice on your need for this benefit is recommended. Also keep in mind that children can get this benefit which helps caregivers with time off work.

9. Do health insurance advisors charge for their services? Or are they funded by commissions from the insurance companies?

We are paid a commission by the insurance company if you proceed to purchase a policy and we do not charge fees for our service. If you seek financial advice and do not take out any benefits we will not charge for this.

10. Are there child birth benefits under insurance or is it generally all covered under the public system?

Generally the cost of childbirth covered under the public system although we have a day to day plan that provides $200 for the birth or adoption of a child. There is some cover under the medical plan but not all plans. Seek advice if this is important to you.

11. Will you name these providers A, B and C?

No for two reasons. The first is not to identify clients we have used in case studies. But also, this was not a financial advice session and these examples were general indicative examples only.

So we don't want you taking out a policy that may not be right for you.  Therefore, we recommend you seek advise from a financial adviser for your situation. At HealthCarePlus, we have access to a nationwide team of  Monument financial advisers who can provide you with more personalised approach. Monument has been our appointed business partner since the early 1990’s to provide financial advice to our members on life and health insurance products (HealthCarePlus is not legally able to provide financial advice).

It won't cost you anything for this chat and there is no obligation for you to do anything following the conversation.  But we do strongly recommend that if you are interested in looking at health insurance further that you seek their advice before making any decisions.

So to speak directly to a Monument financial adviser in your local area, please click below to book a chat with them.


Talk to an adviser, click here to book an appointment


12. Do health insurance providers also cover life insurance, do financial advisors with HealthCarePlus also cover life insurance policies?

Yes Monument financial advisers are licensed and qualified to give financial advice on life and other risk insurance products and to help implement this for you.

Not all insurers in the presentation offer life insurance however we do have access to a range of New Zealand's leading life and health insurers.


Leave a comment