by Matthew Martin
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.
PHARMAC is the government agency responsible for deciding which medicines are subsidised as part of New Zealand's public health system.
Some potentially life-saving drugs are not subsidised by PHARMAC, such as the melanoma drug Tafinlar.
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 Rob Hennin says 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.
“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."
Henin says nib’s non-PHARMAC Plus option provides cover for all non-PHARMAC funded medicines which 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.
“As these advancements in medical innovations continue to take place, advisers will play a critical role in educating and informing the public of the various health cover products on the market to help support their clients’ long-term health needs,” he says.
The benefit covers the cost of 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 and 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,” Hennin says.
“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."
nib’s non-PHARMAC Plus option will be available to all other eligible nib members later this year.
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