- By joining your policies together it means that in the event of a death of a member between 21 and 70, there is a waiver of payments for 3 years for those on the policy.
- There is no cost to join your policies together
- The payment plan you are currently on will stay the same, nothing will change with the payment side of things.
- You will receive new policy docs in which you will both have the same policy number
No, you will need to take out separate travel insurance for overseas travel. Onemedifund covers NZ and Australia only.
You can add any claim that comes under the excess amount of $250 to any additional claims within a 12 month period of the date of first appointment/test. The excess amount is only payable once in the 12 month period.
You can either place a claim straight away and it will be kept on record or send all documentation through with the next claim.
Individual policies can be joined when getting married. Do do this, complete the Policy Joining Form.
Both husband and wife will need to sign the bottom of the form then submit your form here
Read the disclosure statement here: Partners Life – Disclosure Statement
Why is disclosure statement required ?
The Financial Markets Authority requires all advisers when providing financial advice to provide a disclosure statement.
The disclosure statement informs you of Partners Life Limited contact details, the type of services and products and general description of how the Partners Life Advisers are paid.
The document also provides the name of the Partners Life external dispute resolution scheme and process for contacting dispute resolution scheme.
Read Partners Life – Disclosure Statement
You should allow at least 5 working days for pre-approval
Would a condition diagnosed within the first 4 months following birth which was fully corrected with surgical treatment at the time be considered a congenital condition and therefore excluded?
If the condition was corrected by surgical means, we would no longer consider this a congenital condition. Any future medically necessary surgical or non-surgical hospital treatment would be considered to be for a ‘new’ condition and would be covered.
For businesses wishing to purchase cover for their employees and/or their families, the standard application form must be completed for each person.
Additionally, the business needs to complete the Business Payment Schedule and the Direct Debit Authority form.Steps for Business Application
- Business or Employee completes the standard application form. The billing account name MUST be completed correctly
- Business completes the Business Payment Schedule
- Business completes the Direct Debit Authority
- All forms are returned to – UBT/ONEMEDIFUND, PO BOX 5206, TERRACE END, PALMERSTON NORTH 4441
Form Downloads
Application Form
Direct Debit Authority
Business Payment Schedule
This depends on your individual circumstances and is a question that requires what is called ‘personalised advice’. You should speak to the insurance adviser that helped put your original cover in place or alternatively, ring 0800 663 633 (ONEMED) and we will arrange for an insurance adviser to discuss your individual needs.
If the heart tests are being administered for the purposes of screening on the basis of family history alone (i.e. to check if LQT is present), then this would not be covered as routine screening is not covered.
If the condition is suspected or has already been diagnosed, then the tests and any subsequent covered costs (including Surgery) would be covered.
When, how-often and to what degree is the onemedifund policy reviewed?
For example: While $300k seems a reasonable amount per life per year at this moment in time, in another 10-20yrs this amount may be inappropriate due to inflation, rises in cost of medical treatment etc. so what revision of policy is there in the future?
The Onemedifund policy includes a feature called the Guaranteed Upgrade benefit. This means that any enhancements made to the Partners Life Private Medical Cover product will automatically be retrospectively added to the Onemedifund policy upon release (provided this does not incur an additional premium charge).
This means that the Onemedifund policy is guaranteed to keep up with any product advancements and enhancements made in the retail space, including higher annual limits for example.
If the pump requires surgical implantation, then we would cover the costs of that procedure and the device.
If the pump is simply an external delivery mechanism of insulin as an alternative to injections, this would not be covered under the Serious Illness Benefit.
For full details on this benefit, please see the policy wording.
With a condition such as Epilepsy, if there is a drug or treatment available which can improve the standard of living beyond what is offered by the public system, can this be accessed through Onemedifund?
This policy does not cover drug treatments for chronic conditions such as Epilepsy which do not pose a serious or imminent threat to life; and which are typically medically managed or controlled rather than having an expectation of being able to be arrested or cured; and/or for which treatment is typically required indefinitely.
If surgical treatment, or major diagnostic testing is required for the treatment of Epilepsy then these would be covered.
What is covered in the way of eye treatment/surgery? Is it only cataract removal, or does it cover laser if deemed medically necessary?
Vision correction would not be covered, however medically necessary treatments for medical conditions of the eyes such as cataracts, retinal detachment, glaucoma etc. would be covered (including laser surgery).
There are a number of benefits provided under Private Medical Cover which are not subject to an excess. In these circumstances the excess will not be deducted from the amount payable.
Some examples of the benefits that are not subject to an excess include the Public Hospital Cash Grant, Transfer Costs benefit, Medical Misadventure benefit and the Second Opinion benefit. For a full list, please see the policy wording.
There are no specific tax incentives for any insurance benefits in New Zealand. Please see your tax agent for more comprehensive tax advice.
Partners Life is a New Zealand owned and operated company providing a range of insurance products including private health insurance. Partners Life insures over 75,000 New Zealanders and has paid out over $12 Million in claims over the last 3 years.
Some of the major differences are;
Guaranteed Wordings
Cover for Medsafe approved non-Pharmac subsidised drugs
Guaranteed upgrade of cover to your plan where new benefits are introduced and do not cost more.
The best time is as soon as possible – just in case anything occurs before you have the cover which you then need treatment for.
You then have the choice of and access to treatment, your expenses covered, and the timing and location options are in your hands.
There is no requirement to obtain pre-approval but it is highly recommended. If you can obtain pre-approval prior to any treatment or procedure, Partners Life can then deal direct with the provider.
Please allow at least 5 working days for pre-approvals.
If a dental specialist has advised a root canal or maybe a tooth crown procedure as the only option to rid an infection, will this be classed as a medical procedure and be covered by insurance?
Oral surgery that is a medically necessary treatment for an underlying medical condition is covered (this might include the removal of a root canal or impacted wisdom teeth).
IMPORTANT: For any oral surgery to be covered, a specialist would be required to declare it to be medically necessary treatment in order to treat an underlying condition – in this case an infection of the jaw for example. If this is the case, then this treatment would be covered.
A dentist advising that a root canal is required due to a rotten tooth for example would be considered routine dental work and hence not covered.
With Partners Life’s Private Medical Cover we have one excess that applies to the base plan and another that applies to the Specialist and Tests Option if this is selected. Each excess applies only once per annum which means that once an excess is deducted, no further excess will apply for all treatment costs incurred under the applicable benefit for the following 12 months even if the costs are for a different medical condition.
In other words only one excess will be deducted for all costs relating to the base plan and one excess for all costs relating to the Specialist and Tests Option in any one 12 month period – irrespective of the number of claims made in that period.
Under the Excess Waiver Benefit if your admission or surgery is as a result of a heart attack, stroke, coronary artery disease or critical cancer (as defined in the policy wording) you will not be required to pay an excess.
A further example of how the excess works, if you have selected the Specialist and Tests Option and you have a specialist consultation or test done, an excess of $250 is payable. If you are admitted to hospital or have surgery which is directly related and within 6 months of the Specialist visit or test this will be covered under either the Surgical or Private Hospital Benefit in which case only the base excess is payable. If your base excess is the same as $250 no further excess is payable, if your base excess is higher than $250 then the difference will be payable.
However if you have a Specialist consultation and/or Test covered under the Specialist and Tests Option and this does not result in a hospital admission or surgery the Specialist and Tests Option Excess is payable. If you then consult a Specialist for a completely unrelated matter and this does result in a hospital admission or surgery then the base plan excess will be payable for this. So you will in fact have paid Specialist and Tests Option Excess and the Base Plan Excess.
Routine Dental and Orthodontic care is not covered under the Onemedifund scheme as these are not medically necessary treatments for a medical condition.
ACC will generally cover the first incidence of a given injury where the root cause is an accident however it is important to note that there are some restrictions in regards to how ACC operate.
Even if ACC will pay for treatment costs, you are still subject to the limitations of the public system. This means you may required to consult only ACC approved medical professionals and treatment providers. You will be subject to waiting lists. The treatment provided will be the government subsidised option regardless of whether or not this is the most effective treatment for your individual situation.
In addition, where you may have suffered a previous injury in the same site as the injury caused by an accident (whether related to the current accident or not), ACC will often either limit funding or decline your claim on the basis that the previous injury contributed to your current injury and as such you have a ‘degenerative condition’.
The role Onemedifund plays with regards to accidents is that it allows for immediate access to the best treatment for you, regardless of what ACC will (or will not) pay. If your accident is covered, or partly covered by ACC, Onemedifund will still pay for you to access the private system immediately and will deal with ACC behind the scenes to make the process as easy as possible.
In the USA there is a procedure that can be performed inserting a stent up through the groin. This is not available in NZ yet.
If someone required a heart valve replacement under this scheme and they opted for this treatment instead of NZ treatment what cover would they get?
If your medical professional recommended this alternative treatment as the best option for you and the treatment is not available at all within New Zealand, the Overseas Treatment benefit would pay for your treatment costs along with the transport and accommodation costs required for you to receive this treatment overseas.
This benefit will also pay the transport and accommodation costs for a support person to travel with you. This benefit will pay up to $30,000 per person, per annum.
If a person is on medication for cholesterol and a new drug is made available that was not Pharmac funded can you access this through Onemedifund?
In this specific scenario, current medication for cholesterol is essentially ‘symptom management’ and would not be considered a medical treatment.
This aside, if a new drug became available that was granted Medsafe approval as a safe and effective treatment for an underlying medical condition, then this would be covered under the Onemedifund policy regardless of whether or not Pharmac elects to fund the drug.
There is a specific Medical Misadventure benefit in the Onemedifund policy which will pay up to $30,000 (on top of any treatment costs) in certain cases of medical misadventure. As a general rule, the costs of any complications arising from covered treatments or surgical procedures will also be covered.
Are medical procedures for congenital conditions covered by Onemedifund? (for example Friedreich’s Ataxia)
This is a great example of where our definition of congential conditions out-matches the conventional wording available elsewhere on the market.
As this is an inherited, genetic disorder there is no way to develop this condition after birth. Therefore, in the medical sense this would be a ‘congenital disorder’ and the majority of medical insurance policies would exclude the condition on this basis.
Partners Life define ‘congenital’ as being a medical condition that is present at birth and diagnosed within 4 months following birth, however the symptoms of Friedreich’s Ataxia for example, do not generally manifest before the age of 5. This means that unless the defective gene responsible for the disorder is identified within the first 4 months (which is highly unlikely without any accompanying symptoms), this condition would be covered despite meeting the medical definition of ‘congenital’.
Question:
If I take on a new employee and want to provide medical insurance for him/her, is there a 3 month joining window (with no health assessment) available from the time of employment?
Answer:
Yes. Any new employees have a 3 month joining window to be covered for pre-existing conditions from the date they become eligible to join the Onemedifund scheme.
Yes – Where a treatment has been recommended by an appropriate medical professional that is not available within your local community, the Onemedifund policy will pay the transport costs associated with transferring you to and from the nearest appropriate private hospital which offers that treatment.
In addition, the Onemedifund policy will also pay for the transport and accommodation costs for a support person to accompany you while you receive this treatment.
If the business provides the benefit to staff and pays for the benefit, our understanding is that the premiums will be subject to FBT. Please see your tax agent for comprehensive tax advice on the matter.
Question:
If I have an expensive year with my health, does Onemedifund reserve the right not to renew my policy following an expensive year?
Answer:
No – the contracts are guaranteed once the policy is in place and will automatically renew at anniversary unless cancelled by the insured member.
Onemedifund also do not reserve the right to re-price for an individual’s claims experience – premium rates are based on the experience of the scheme as a whole.