Private Hospital and Specialist Cover

Comprehensive care when you need it

Private Hospital and Specialist Cover

Private Hospital and Specialist Cover is our most comprehensive cover, taking care of specialist consultations, diagnostics, surgery, and treatments in private hospitals. Even if you're fit and healthy, it's important to have a plan in place for unexpected medical expenses to help you get access to the right support when you need it most.

  • Specialist Consultations**
  • $300,000 Surgical cover per person each year**
  • $200,000 non-surgical and cancer cover per person each year**
  • Cover for many pre-existing conditions after three years
  • Your choice of nil, $500, or $1,000 excess options
  • 5% AA Member discount available if you provide a valid AA Membership number for you or someone named on your policy*

Apply for yourself and your family through our quick online application, at an AA Centre or over the phone with our New Zealand based team.

Get a quote

non-PHARMAC Plus

non-PHARMAC funded drugs can be lifesaving but could possibly cost up to hundreds of thousands of dollars. The non-PHARMAC Plus option can be added to Private Hospital or Private Hospital and Specialist Cover, and helps you cover the cost of some drugs that are Medsafe approved and prescribed under the Medsafe guidelines but aren’t funded by PHARMAC at the time of your treatment#.

With non-PHARMAC Plus, you may have access to wider treatment options and cover for approved drugs used to treat cancer and other types of health conditions.​ 

Find out more

Be confident knowing what your policy covers

We want to make sure you're confident knowing what you are and aren't covered for. That means reading your Policy Wording to understand the benefits as well as your responsibilities, and the cover limits and exclusions of your policy.

  • Surgical Benefit

We will pay up to a total maximum of $300,000 for each insured person every policy year, less any excess for any of the surgery related benefits under this cover.

  • Non-Surgical Benefit

We will pay up to a total maximum of $200,000 for each insured person every policy year, less any excess for the non-surgical and cancer related benefits under this cover. Individual limits may apply to each of the benefits.

  • Specialist Consultation Benefit

We will cover all eligible claims for specialist consultations up to your Surgical or non-Surgical Benefit limit every policy year.

Private Hospital and Specialist Cover

Annual Benefit limits^

Standalone benefits

 

Surgical Benefit

$300,000

Includes oral surgery, mohs surgery and varicose vein treatment

Includes extraction of unerupted or impacted teeth after a 12-month waiting period

Non-surgical Benefit

$200,000

Included under standalone benefits

 

Cancer Treatment

In Hospital: up to Non-Surgical Benefit

At Home: $10,000

Non-PHARMAC Cancer Treatment

$10,000

Follow-up Investigations for Cancer Benefit

$3,000

Specialist Consultations

Up to Surgical/Non-Surgical Benefit

Doesn’t need to relate to hospital admission

Diagnostics Tests

If related to hospital admission, up to the Surgical/Non-Surgical benefit limit

If not related to hospital admission, up to $15,000

CT, MRI and PET Scan Benefit

If related to hospital admission, up to the Surgical/Non-Surgical benefit limit

If not related to hospital admission, up to $5,000

Physiotherapy Benefit

$750

Must relate to and be within 6 months after hospital discharge

Must have a referral from the specialist who treated you while you were in the hospital

Therapeutic Care Benefit

$250

Must relate to and be within 6 months after hospital discharge

Home Care Benefit

$150 per day, $6,000 per year

Must relate to and be within 6 months after hospital discharge

Ambulance Transfer Benefit

Up to Surgical/ Non-Surgical limit

From public/private to closest private hospital

Travel and Accommodation Benefit

Accommodation

Up to $300 per night

Travel

Surgery/medical treatment:

Up to $3,000

Cancer treatment:

Up to the Surgical/Non-Surgical Benefit

Parent Accommodation Benefit

$200 per night, up to $3,000

High-Risk Pregnancy Benefit

$2,000 per pregnancy

For monitoring recognised risk factors only

Pre-existing cover for newborns

Pre-existing conditions (except congenital conditions) are covered when a child is added within 4 months of birth

General exclusions apply

GP Surgery Benefit

$750

Includes 1 pre and 1 post consultation and related biopsies

Skin lesion Surgery

$6,000

Surgery by a specialist, as well as related biopsies

Eye injections Benefit

$3,000

ACC Top Up Benefit

Up to Surgical/Non-Surgical Benefit

ACC Treatment Injury Benefit

Up to Surgical/Non-Surgical Benefit

Waiver of Premium Benefit

Premiums waived for 2 years or until surviving insured person turns 70

Loyalty – Suspending your cover Benefit

Unemployment, redundancy, parental leave, or overseas travel or residence

After 1-year continuous cover

Loyalty – Sterilisation Benefit

 $1,000 per lifetime

After 2 years continuous cover

Pre-existing Conditions

Pre-existing conditions are covered after 3 years of continuous cover

Cardiovascular, cancer, hip or knee, back, transplant surgery and reconstructive or reparative surgery will never be covered

Permanent exclusion doesn’t apply to cancer if it is pre-malignant and has been appropriately treated by a GP or specialist who is suitably qualified to carry out that treatment

Apply now

Things you should know

  • Benefit limits and excesses apply per person and refresh each policy year.
  • 100% of your eligible cover amount can be claimed if you select a provider from the nib First Choice Network. You can still choose a provider outside of the network; you will just need to make a 'gap-payment', as these provider rates aren't standardised and regulated through the group.
  • There's a 14-day cooling off period that gives you peace of mind in knowing that if you change your mind in this time, we'll refund 100% of premiums paid.
  • Waiting periods apply before you can access some benefits under your policy. See the above table and Policy Wording for more information.
  • Many pre-existing conditions are covered after a 3 year waiting period. Some pre-existing conditions are never covered including cancer and cardio conditions. Please check the Policy Wording for full details.
  • Premiums are based on the age, gender, and for some, smoking status of customers on the policy.
  • It's possible for all premiums to increase in the future. We will always give you 30 days' written notice if that happens.
  • For more information on non-PHARMAC Plus, see the non-PHARMAC Plus Policy Wording

AA Health Insurance Policies

To assist with your day-to-day medical expenses including GP and dentist visits, physio, chiro and osteo, eye exams and eyewear. Add Everyday Cover to your policy or purchase on its own.

Covers you for the bigger stuff, like diagnostics, surgery, and specific treatments in a private hospital, with higher excess and lower premium policy options. 

Optional Hospital Cover add-on which covers the cost of some drugs that are Medsafe approved and prescribed under the Medsafe Guidelines but aren't funded by PHARMAC#.

Making claims easy

We make the claims process simple so you can focus on recovering while we look after your claim. To make your claim hassle-free, some First Choice network healthcare providers can submit pre-approvals and claims on your behalf. Plus, by choosing a First Choice network healthcare provider, you'll have 100% of your eligible costs covered (up to your benefit limit, subject to any excess payable and in line with your policy terms).

For more information on making a claim, visit our Make a claim page.

Make a Claim

The Insurer

AA Health Insurance policies are brought to you by the New Zealand Automobile Association Incorporated (AA) and are issued and underwritten by nib nz.

Financial Strength Rating

nib has been given an A (Strong) Financial Strength Rating issued by S&P Global Ratings Australia Pty Ltd.

Financial advice

Our website provides general information about products and services to help you make choices when it comes to protecting the things in life that really matter. The information doesn’t take into account your specific financial situation, needs or goals and is not intended to be financial advice.

If you'd like to receive financial advice, you can get professional advice from a registered financial adviser.

More information

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Policy Wordings
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Terms and Conditions


*If provided after your policy has commenced, the discount will apply from your next billing date after you provide us with a valid AA Membership number and is applicable while you (or someone named on your policy) remain an AA Member.
**All costs paid under this benefit are deducted from your balance remaining in the same policy year on your Surgical or Non-Surgical benefit limit (whichever applies). 
^Benefit maximum is for each insured person every policy year, unless stated otherwise. Benefit limits and excesses apply per person and refresh each policy year.
#Policy terms and conditions, exclusions, and benefit limits apply. For more information on non-PHARMAC Plus, see the non-PHARMAC Plus Policy Wording.