Welcome to our first Competency Corner article, designed to refresh your knowledge of our products. First up in the series is Base Cover and its associated benefits.
Chris Carnall (nib Head of Distribution) presents: Introduction to Competency Corner
The Basics of Base Cover Benefits
Our most popular policies (Ultimate Health Max, Ultimate Health, Easy Health and Premier Health Business) have a similar structure — a Base Cover plus any Options your client has chosen with the help of your advice. In other Competency Corner articles we’ll take a look at the benefits included in the Options.
Private hospital treatment
When your client requires health treatment in a private hospital, it’s likely they’ll be claiming under one or more of the Base Cover benefits. The majority of hospital treatments trigger claims under the Surgical and Non-Surgical Benefits and these are part of your client’s Base Cover.
A few examples of treatments under the Surgical Benefit include:
- heart surgery
- joint replacement
- hernia repair
And examples of treatments under the Non-Surgical Benefit include:
- chemotherapy
- brachytherapy
- heart disease treatment
- asthma treatment
- diabetes treatment
Some health conditions like cancer can involve claims under both the Surgical and Non-Surgical Benefits. For many of your clients, cover for these treatments is a primary concern and the reason for having private health insurance.
Consultations and diagnostics
Private hospital treatments will often include medical consultations, diagnostics and tests before, during and after treatment. There are Base Cover benefits to cover many of these.
- The Hospital Specialist Consultations Benefit covers consultations associated with treatment and the Hospital Diagnostic Tests Benefit covers diagnostics and tests, both for up to six months before and six months after hospitalisation.
- The Diagnostic Investigations Benefit covers specific tests and diagnostics, even if your client is not then hospitalised for treatment.
Treatment away from your client’s hometown
Some clients will face challenges or have preferences concerning where they can or where they would prefer to get treatment. For example:
- Clients living in rural New Zealand – these clients may be interested in the Travel and Accommodation Benefit because they may need to travel within New Zealand due to treatment not being available in a local private hospital.
- Clients who have recently emigrated to New Zealand may prefer to have treatment in their country of origin, where they have the support of family and friends. The Medical Tourism Benefit provides treatment overseas under specific benefits, including the Surgical, Non-Surgical and Cancer Treatment in Hospital Benefits. This benefit is only available under Ultimate Health Max and that’s one of many reasons for recommending this specific product when talking to these “new Kiwis”.
Recovery and rehabilitation made easier
A fast and full recovery is a big concern for many clients, since this reduces disruption, both to the client and to their family and it’s also likely to result in less time off work and lost income. There are a number of benefits that assist with recovery that you can discuss with your clients, for example, the:
- Home Care Benefit
- Physiotherapy Benefit
- Therapeutic Care Benefit, for osteopathic, sports physician, and other treatments
Recommending the right cover
Generally, Ultimate Health Max has the most comprehensive range of Base Cover benefits. The benefit terms and benefit limits differ between the products for some of the benefits. The Health Cover Overview provides you with an easy way to compare these products at a high-level, with detailed information in the relevant policy documents.
It’s important to remember that when you’re talking to clients about cover for themselves and for other members of their immediate or extended family, each person can decide which Base Cover and excess is most suited to their needs. Your advice is important and can help them save money and avoid confusion.
Test your knowledge
Let’s see if you’re on top of nib’s Base Cover benefits. The answers to the following questions can be found in this article or in the Health Cover Overview and the policy documents. You can check your answers at the bottom of this article.
- TRUE or FALSE: Base Cover benefits are all identical across Ultimate Health Max, Ultimate Health, Easy Health and Premier Health Business.
- TRUE or FALSE: Your client can only ever claim under a Base Cover benefit if they are going to be, or have been, admitted to a private hospital.
- TRUE or FALSE: All four products (Ultimate Health Max, Ultimate Health, Easy Health and Premier Health Business) include the Funeral Support Benefit, though the benefit limits and terms may differ between the products.
Got all three right? Great! If not, or you just want a refresher, have another look at the Health Cover Overview or visit our nib adviser training hub: NZ Adviser Module 3 - nib Base Cover Benefits and Group Module 2 - nib Premier Health Business Base Cover.
Thanks for reading — remember, under the Code of Professional Conduct for Financial Advice Services and the terms of the nib Intermediary Agreement you work under, you are required to have complete and up to date knowledge about the products you are advising on. This article and our online resources are designed to make that easy for you.
Answers: 1. False 2. False 3. True