Limited range of publicly funded health services Te māraurau ki te whiwhi i ētahi o ngā momo ratonga hauora me ngā momo ratonga hauā e utua ana e te kāwanatanga

Eligibility

ACC can cover treatment for accidents and personal injuries, regardless of residential status.

Your healthcare provider decides whether a claim should be made. You will need to complete a claim form during treatment. Your claim must be accepted by ACC before they will fund your treatment.

ACC can provide cover for accidents that happen overseas but only to New Zealand residents, and only in limited situations.

Criteria: B26, Health and Disability Services Eligibility Direction 2011

Proof of eligibility

If your treatment does not meet ACC's criteria, your eligibility for publicly funded healthcare must be determined. You will be told of any unexpected cost during this time.

When ACC accepts a claim, you will need to provide details of this cover to any future healthcare providers.

ACCexternal link

Eligibility

You are covered by the New Zealand and Australia Reciprocal Health Agreement if:

• you are on a temporary visit (up to 2 years) to Aotearoa New Zealand
• the healthcare provider believes you need immediate and necessary medical treatment while you are in Aotearoa.

Your medical treatment may be publicly funded as it would be for a New Zealand citizen:

• if your treatment is clinically necessary for your diagnosis
• for pharmaceutical benefits, hospital services, and maternity services.

If you are visiting Aotearoa from Australia, you are not entitled to publicly funded emergency transport by ambulance.

Criteria: B8, Health and Disability Services Eligibility Direction 2011.

Proof of eligibility

You will need to show your healthcare provider 1 of the following:

• your Australian passport
• your passport of other nationality with a current resident visa (including a resident return visa) issued by the Government of Australia
• your Medicare Australia card and your passport to prove that you are the holder of that card.

Eligibility

You are eligible for public funding If you are eligible to receive, or are receiving, compulsory health services under the following Acts:

• Alcoholism and Drug Addiction Act 1966
• Criminal Procedure (Mentally Impaired Persons) Act 2003
• Intellectual Disability (Compulsory Care and Rehabilitation) Act 2003
• Mental Health (Compulsory Assessment and Treatment) Act 1992.

If you are receiving services that are prescribed under the Alcoholism and Drug Addiction Act or the Mental Health (Compulsory Assessment and Treatment) Act, the healthcare provider will provide:

• diagnostic services or assessments to determine whether further compulsory services are required
• inpatient or outpatient care for the illness, including medications, while you continue to meet the criteria for requiring compulsory treatment
• other follow up services such as counseling, during the time that the person meets the criteria for requiring compulsory treatment.

Your citizenship, immigration status, or length of stay are not relevant.

Criteria: B25, Health and Disability Services Eligibility Direction 2011.

Proof of eligibility

If the healthcare provider is not sure if you are eligible, they will refer your case to Te Whatu Ora.

Eligibility

You are eligible if:

• the services are required as the result of an emergency
• the services are necessary to address health risks.

The term "emergency" has the same meaning as in section 4 of the Civil Defence Emergency Management Act 2002.

Civil Defence Emergency Management Act 2002external link

Criteria: B24, Health and Disability Services Eligibility Direction 2011.

The New Zealand Government strongly recommends that people in Aotearoa who are not eligible for publicly funded health services hold comprehensive travel insurance, including health insurance.

Eligibility

You are not eligible unless you are injured in an accident.

The Government you are representing is responsible for covering your health costs. You will still be able to receive medical care but you will have to pay for all medical and associated costs.

If you were injured in an accident, you are covered under the accident compensation scheme and can receive medical treatment under the public system.

Refer any queries to Protocol Division of the Ministry of Foreign Affairs and Trade, Wellington.

Eligibility

Tamariki are eligible for:

• publicly funded immunisations on the Immunisation schedule
• Well Child/Tamariki Ora services.

Criteria: B17, B18, Health and Disability Services Eligibility Direction 2011.

These services are available regardless of citizenship or immigration status.

Eligibility

You are eligible if you have, or are suspected of having, an infectious or notifiable disease.

Infectious and notifiable diseases are those listed in the Schedule to the Health Act 1956, and tuberculosis. 

The services must relate only to all or 1 of the following:

• the surveillance of people who are liable to quarantine under the Health Act 1956 or the Tuberculosis Act 1948
• diagnosis
• treatment of the person’s infectious or quarantinable disease
• follow-up services and 
• contact tracing services.

Your citizenship, immigration status, or length of stay are not relevant.

Criteria: B23, Health and Disability Services Eligibility Direction 2011

Proof of eligibility

If the healthcare provider is not sure if you are eligible, they will refer your case to Te Whatu Ora.

Eligibility

You are eligible for publicly funded health and disability services that are not provided by the prison health system.

Criteria: B27, Health and Disability Services Eligibility Direction 2011.

Proof of eligibility

You will need to show your healthcare provider proof that you are a prison inmate, or are on remand.

If someone is acting on your behalf, then that person will need to provide proof that you are a prison inmate, or are on remand.

These services are available regardless of citizenship or immigration status.

Eligibility

If you are pregnant, you are eligible if you or your husband, civil union partner or de facto partner is one of the following:

• a New Zealand citizen
• a New Zealand resident visa (including residence permit) and permanent resident visa holder
• an Australian citizen or permanent resident who has or intend to live in New Zealand for two years or longer
• a refugee, or someone whose application to become a refugee has been accepted by Immigration NZ, or someone who is in the process of having an appeal for refugee status determined by the Immigration and Protection Tribunal
• someone with protection status, applying to Immigration NZ for protection status or appealing against refusal of protection status
• a Work Visa holder for 2 years or more (your work visa starts on your first day in Aotearoa) or for a length of time equal to, or more than, 2 years (including the time you have legally already been here before getting the visa).

If you are pregnant, you are eligible if your partner is 18 years old or younger, and is in the care and control of a:

• parent
• legal guardian
• person in the process of legally adopting them or becoming their legal guardian.

They must also be either:

• a New Zealand citizen or permanent resident
• an Australian citizen or Australian permanent resident living or planning to live in Aotearoa for 2 years or more
• a Work Visa holder for 2 years or more (your work visa starts on your first day in Aotearoa) or for a length of time equal to, or more than, 2 years (including the time you have legally already been here before getting the visa).

Criteria: B21, Health and Disability Services Eligibility Direction 2011.

Proof of eligibility

You will need to show your healthcare provider:

• your partner's proof of eligibility (a valid New Zealand Passport, Passport with a current Work Visa)
• proof of being the partner of an eligible person.

Examples of proof include:

• your partner’s passport and a marriage or civil union certificate
• a Visa or Permit granted by Immigration New Zealand on the basis of the relationship
• a statutory declaration from both partners that proves they meet the definition of “de-facto partner”.

Maternity services that are funded

Most maternity care is free for eligible pregnant women and includes:

• primary maternity services within the meaning of clause B1 of the Primary Maternity Services Notice 2007 (see Primary maternity services below)
• all maternity services provided by Regional Health Authorities
• any other secondary or tertiary services for a condition of the mother or child that a clinician has determined will significantly impact on the pregnancy or its outcome.

As not all pregnancies are viable, maternity care also includes:

• ectopic pregnancies
• miscarriage services
• pre-eclamptic toxaemia
• Eclampsia
• terminations of pregnancy for fetal abnormality.

Services that may charge a fee

There may be charges for some services such as:

• antenatal or childbirth education classes
• some tests at a private laboratory
• private obstetricians
• private maternity hospitals.

Eligibility

You are eligible if you are pregnant and have been infected with the HIV virus.

Any pregnant person who is infected with HIV has free access to:

• a hospital based lead maternity carer
• blood tests to determine HIV viral load
• a funded course of antiretroviral drug(s), noting that there is no entitlement to ongoing antiretroviral treatment for the person
• information around safe alternatives to breastfeeding
• a caesarean section for those cases where specialist medical opinion considers that a caesarean section is required for delivery to effectively limit the HIV transmission risk to the child
• post caesarean section hospitalisation (approximately 1 week)
• postnatal hospital visits for the child for the purpose of disease exclusion, that is, to determine the HIV status of the child.

Criteria: B22, Health and Disability Services Eligibility Direction 2011.

Proof of eligibility

You will need to show your healthcare provider:

• your passport
• proof of you being infected with the HIV virus (a referral letter from your healthcare provider).

These services are available regardless of citizenship or immigration status.

Eligibility

Under the United Kingdom Reciprocal Health Agreement, you are eligible if you are:

• a UK citizen who is ordinarily a resident in the UK and on a temporary stay in Aotearoa
• needing medical treatment that, in the opinion of a medical practitioner (or dentist for people 19 years or younger),

— needs prompt attention.

— for a condition that arose after arrival in New Zealand, OR became, or without treatment would have become, acutely exacerbated after arrival.

Criteria: B5, Health and Disability Services Eligibility Direction 2011.

Proof of eligibility

You will need to show your healthcare provider:

• your valid UK Passport with a valid visa
• proof of being a resident in the United Kingdom (this can be a return ticket, property lease or ownership papers, proof of employment in the United Kingdom).

The UK Reciprocal Health Agreement does not cover the following:

• UK permanent residents
• A UK passport holder who is not ordinarily a resident in the UK
• A UK citizen who has held a residence visa for any other country prior to arriving in Aotearoa.

The New Zealand Government strongly recommends that people in Aotearoa who are not eligible for publicly funded health services hold comprehensive travel insurance, including health insurance.