How can non-citizens use New Zealand’s public healthcare?

by Brett Andrews

About Healthcare in New Zealand

New Zealand uses a universal, publicly funded healthcare system. It covers citizens, permanent residents, and expats on a work visa of two years or more, though certain treatments are free to all. Services include inpatient, outpatient, mental health, and long-term care, along with prescription drugs. About ⅓ of New Zealanders carry private health insurance to supplement the public system.

Enrollment in New Zealand’s public system takes about three months to process once you have your permanent residency or extended work visa. Health coverage extends to Australia, Ireland and the UK as part of a reciprocal agreement, though it excludes the US. Visitors and undocumented people are treated as private-pay patients under New Zealand’s public healthcare system, including for emergency services.

New Zealand’s public healthcare system uses copays but no deductible. Copays for GP and other doctor visits usually range from $10 – $34 USD, and there’s no fee for hospitalization. Prescriptions require a $3.40 USD copay for the family’s first 20 medications of the year; additional medications are then issued at no charge. 

Private health insurance fills in the gaps left by the public plan, or even replaces it entirely. As with many countries, private coverage pays for private clinics and hospitals, which may offer faster service or more individualized care. It also fills in coverage gaps for residents using the public health system, adding coverage for adult dental care, optometry, and physiotherapy.

Pharmacies, or chemist shops, are plentiful, much like in the United States. Prescriptions must come from a New Zealander physician in order to get filled, but you can bring up to a 90-day supply of your medications over the border. Expats taking ADHD medication or other controlled substances may require a new diagnosis in New Zealand, though this may be challenging for adults.

Finding a Physician

Finding your new general physician (GP) in New Zealand is fairly direct. You can search Healthpoint, a local healthcare tech company, to see if any local GPs are accepting new patients. You can also check the White Pages or ask others in your local Facebook expat groups. GPs usually belong to networks of medical providers called primary health organizations (PHOs).

Legally, you can see a specialist without a GP’s referral, though it goes against the country’s primary care model. You’ll want a referral from your GP or walk-in clinic to see a specialist under both public and private health systems. Walk-in clinics are common choices for non-urgent care or if you don’t currently have a GP.

Public Healthcare

Public healthcare is available to all permanent residents and expats on long-stay work visas. There’s no out-of-pocket fee for public hospital stays under New Zealand’s public health scheme. However, copays do apply for physician visits, prescription drugs, and some hospital discharge aids like crutches. 

Expats can register for New Zealand’s public healthcare after getting your permanent residency visa. Expect a three-month turnaround time when you apply for the public system. The Health New Zealand website can answer more in-depth questions about the enrollment process.

New Zealand’s public health system covers a range of services. In addition to preventive and hospital care, the public system covers maternity services, physical therapy, mental health, long-term care, hospice, and disability support.

Private Healthcare

Private health insurance offers many benefits: cover out-of-pocket fees; access to private providers; no-cost ambulance service; coverage for medical care outside the public health system like dental or podiatry. About one-third of residents keep private health coverage.

Private health insurance comes with the usual perks these plans have in countries with universal healthcare: private clinics and hospitals, shorter wait times, and offset out-of-pocket costs. Private plans also fill in the coverage gaps that expats face with public healthcare. When shopping for a private plan, confirm that your preexisting conditions are covered in any new policy.

Two main types of private health policies exist in New Zealand. Comprehensive policies cover all your medical costs, including GP and medications. Combo-type policies cover combinations of specialist care and elective surgery. Note: you must be eligible for public health care to buy most private insurance schemes, so plan accordingly.

Out-of-pocket Options

Paying out of pocket for medical treatment is certainly an option in New Zealand, though not recommended. Expats paying out of pocket may use both the public and private health systems. Walk-in clinics may provide a cost-effective solution for out-of-pocket care. Uninsured expats are treated as private-pay patients under New Zealand, including for emergency services. Accident-related injuries and HIV treatments are free for everyone, regardless of legal status.

Healthcare Checklist

• Schedule final appointments with your primary care physician and any specialists you see.
• Research your medications for availability in New Zealand and find alternatives where needed.
• Stock up on prescription refills until you can get to the pharmacy in New Zealand. It’s a dance because you’ll save money by filling your prescriptions in country, but it may take time for you to learn your way around. 
• Print out and keep photographic records of all prescriptions. Bring meds in original packaging with a letter from your doctor detailing your condition, the drug, and its generic name.
• Request your medical records and, ideally, upload them to a cloud server where you can access them anywhere. Alternatively, printouts, desktop files, and thumb drives also work.
• Ask your providers for referrals abroad. You never know!
• People often find physicians by word of mouth. Ask for recommendations from your local chemist, neighbors, or expat Facebook group.
• For public healthcare, apply once you’ve got permanent residency or a long-term work visa. Approval takes about three months.
• For private healthcare, apply for private insurance directly. Visit your expat Facebook group to get recommendations.
• See your family doctor and get prescriptions and referrals.