Introduction

Living in New Zealand and accessing healthcare services can feel complicated at first. This article provides a practical, step-by-step guide covering the differences between public and private healthcare, registration with GPs and treatment flow, how to lodge an Accident Compensation Corporation (ACC) claim, emergency procedures, tips for traveler’s insurance claims, prescription and pharmacy use, and chronic disease management. We aim to connect these topics to all aspects of life in New Zealand, including visas, banking, and transportation, for easy understanding.

1) Summary of Differences Between Public and Private Healthcare and Out-of-Pocket Costs

Public Healthcare (Public Hospitals, Emergency Rooms, etc.)

• Eligibility: New Zealand citizens, permanent residents, and certain visa holders can access public healthcare benefits. There may be differences based on visa type, so make sure to check your eligibility.
• Costs: Generally, treatment in emergency rooms and public hospitals is free or subsidized if eligible. Visitors or temporary residents who are not eligible for a visa may be charged for public treatment.

Private Healthcare (Private Hospitals, Clinics, Specialists)

• Shorter waiting times and broader choice (doctors, times). Quick bookings are available for surgeries and treatments.
• Costs: Costs for private consultations and surgeries are borne by the individual (depending on insurance coverage). Without private insurance, costs can be high.

Examples of Typical Out-of-Pocket Costs (Varies by Region and Clinic)

• GP consultation fee: Approximately NZD 20–80 depending on subsidy eligibility (community clinics may be cheaper).
• Emergency Room (Non-eligible visitors): Costs for treatment and tests can range from hundreds to thousands of NZD.
• Ambulance: Charges may apply depending on the area and situation, potentially amounting to several tens to hundreds of dollars or more. Even residents may incur fees in some areas, so check your local situation.
• Prescriptions: Medications covered by PHARMAC (national pharmaceuticals assistance) are subject to low out-of-pocket costs. Non-subsidized medications are fully at the individual's expense.

2) Registration Process for GP (General Practitioner) and Appointment & Treatment Flow

Finding a GP

• Search methods: Healthpoint website, Google Maps, local community (Facebook groups, etc.), recommendations from friends or colleagues.
• Local focus: Most areas have registered GPs, and registering with a GP near your residence can provide lower consultation fees and more convenient management.

Registration Process (Enroll) — Step by Step

1. Visit the clinic or request 'enrolment' via the website/phone.
2. Prepare and submit identification (passport), visa information, address, contact details, and NHI number (if available).
3. Fill out basic health information (underlying conditions, medications, allergies, etc.).
4. After registration, you may be encouraged to create a Patient Portal account.

Appointment & Treatment Flow

• Book an appointment via phone or online. General consultations usually require an appointment (emergency cases can walk in but may incur waiting times).
• During your first visit, provide your medical history and medication list. If necessary, referrals for physical examinations and tests (blood tests, etc.) will be made.
• Issuance of prescriptions, follow-up (repeats), or referrals to specialists can occur.
• Instructions on using after-hours clinics or 24-hour call lines during nights and weekends.

Tips for Using GP Services

• For regular medications, request a 'repeat prescription' in advance to ensure continuity of your medication.
• If possible, activate the patient portal for easy access to test results and documents.
• Check costs and payment methods (card, EFTPOS, etc.) in advance.

3) Eligibility for ACC (Accident Compensation Corporation) and Step-by-Step Registration Process

What is ACC?

• The Accident Compensation Corporation (ACC) in New Zealand is a no-fault insurance system that supports treatment and rehabilitation for injuries resulting from accidents.
• Generally, everyday accidents, workplace injuries, sports injuries, and some traffic accidents are covered.

Eligibility for ACC (General Examples)

• Sudden injuries (e.g., falls, towing accidents, etc.). Diseases and chronic conditions are generally excluded (with certain exceptions).
• Work-related injuries can be eligible for ACC if reported by the employer.

How to Lodge an ACC Claim — Step by Step

1. If first aid is needed, seek treatment from a hospital or GP. Medical facilities often assist with ACC claims.
2. A doctor or hospital can report to ACC (medical facilities may provide electronic reporting or instructions).
3. Self-lodge: Online reporting on the official ACC website or visit/call your local ACC office.
4. Required documents: Identification, a description of the date, time, place, and circumstances of the accident, employer information (if a workplace accident), police report (if required), medical certification and receipts.
5. After ACC processing: Issuance of ACC number (claim number), information on coverage for treatment and rehabilitation costs, and development of additional diagnosis and treatment plans.

Important Notes

• ACC focuses on treatment related to accidents, so disease management and preventive treatments may not be covered.
• The scope of ACC compensation and waiting time may vary by case, so obtain detailed information from the assigned staff immediately after lodging your claim.

4) Emergency Procedures (Emergency Number, Emergency Room Use Procedures, Cost Expectations)

Immediate Actions

• In a serious crisis (shortness of breath, loss of consciousness, severe bleeding, chest pain, etc.): Call 111 (emergency number) immediately to request an ambulance.
• In a minor emergency (not serious but requires immediate treatment): Use the local emergency room (ED) or After-hours GP.

Emergency Room Procedures

1. Upon arrival, check in (simple identity verification and explanation of symptoms).
2. Priority will be determined through triage (more serious patients are prioritized).
3. Evaluation by doctors and nurses, tests (blood, imaging, etc.), and determination of treatment and hospitalization.

Cost Expectations

• New Zealand citizens, permanent residents, and eligible visa holders can receive subsidies for public emergency room treatment.
• For non-eligible visitors: Significant costs (hundreds to thousands of NZD) may be charged for emergency room treatment, hospitalization, tests, and surgeries.
• Ambulance: Charges may apply depending on the area and situation, so it is difficult to confirm in advance. Travelers or temporary residents are advised to check their coverage with travel insurance.

5) Important Considerations When Purchasing Travel Insurance and Steps for Submitting Claims

Verification Before Enrollment

• Coverage Scope: Confirm whether it includes emergency treatment, hospitalization, medical evacuation, repatriation costs, prescriptions, and accident-related liability insurance.
• Exclusions and Exceptions: Be sure to check restrictions/exclusions related to pre-existing conditions.
• Emergency Contacts: Save the 24-hour emergency assistance number and procedures on your mobile.
• Compensation Limits: Verify limits on treatment costs, medical expenses, and mental distress for each item.

Steps for Submitting Claims

1. In an emergency, prioritize receiving treatment, and as soon as possible, contact the insurance company's emergency center (24/7) for guidance.
2. Prepare required documents: Diagnosis records/medical records, hospital receipts, prescriptions, photos (related to the accident), police reports (if available), copies of identification and insurance policy.
3. Submit the claim application to the insurance company: Can be submitted online or by email/post (follow insurance provider's guidelines).
4. Submit additional requested documents from the insurance company and wait for the compensation decision. Keep contactable phone and email information up to date at all times.

Tips

• Keep original receipts and medical records, and back them up with scans or photos.
• Notify the insurance company as soon as possible after the accident for smoother claims and compensation processing.

6) Using Prescriptions and Pharmacies, Managing Chronic Diseases, and Keeping Medical Records Organized