What you need to know about health insurers – will your varicose veins be approved?

Most health insurers cover varicose veins, ultrasound, skin lesions and arterial conditions, with certain medical criteria. In brief, these medical criteria may include:

  • symptoms for varicose veins like aching legs and bulging veins, ulcers, varicose eczema
  • the ultrasound conducted as part of your varicose vein treatment or for patients on a surveillance programme, eg, to monitor an aneurysm
  • the need for biopsy, cryotherapy or excision for skin lesions.

Note: You do not need a general practitioner (GP) referral for our vein, ultrasound or skin lesion treatments. Some providers ask for a letter for prior approval.

For arterial conditions you will usually be referred to us by your GP. Spider vein treatment will not usually be covered on its own, unless it is in conjunction with your varicose vein treatment, involving sclerotherapy. Most insurers consider spider vein treatment is a cosmetic condition.

We work with many insurance providers in New Zealand, including Southern Cross, Partners Life, NIB, Accuro, AIA and NZ Police Welfare Fund. These insurers work with specialists like us as affiliated providers, which means the processes for approval and pre-approval will help to speed up your claim. We are trusted specialists these insurers rely on and you can, too.

Check your policy’s terms and conditions before claiming

Treatment covered by your health insurer will depend on the cover you have chosen. Whether you can get treatment in the public system is also a consideration. If your GP has referred you we will provide a letter recommending whether you need treatment or not. Generally, if we recommend treatment, and your policy covers it, you can apply for cover. If we have affiliated status with your insurer we can do the paperwork for you.

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Treatment in the public system is also a consideration for health insurers.

Please check your policy terms and conditions and eligibility criteria. In addition, check your policy for exclusions, existing conditions, eligibility, what your excess or shortfall will be (an amount you will need to pay yourself, if applicable) and how to apply.

Health insurers’ policies – what are you getting?

Most insurers offer a number of policies so you can choose what suits you and personalise some add ons. You can often choose the excess you will pay if you make a claim down the line. Policies may be for hospital only cover or cover for all general medical expenses, like GP visits. Many offer a combination of both policies. Following on from this, Partners Life insurer explains some of the differences here.

You can buy private health insurance directly from a health insurer in New Zealand. Often you can do this online or through an independent financial broker. For  some people health insurance is also available through their employer, for example, the Police Welfare Fund.

The websites of the major health insurers in New Zealand provide comprehensive information. One-to-one customer service is usually available to answer queries about your claim.