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Hair Raising Adventures of Medical Insurance

Business owners will have had a medical procedure or know of someone who has.

Twenty years ago, it was fine to have no medical insurance as the public system did not have waiting lists and MRI, CT Scans and PET Scans could only be done in the public system. If you have an unexpected major accident or sickness, the ambulance will go to one of the public hospitals to an accident and emergency section. However, as a business owner, you have limited time.

Issues began several years ago, when I had both wrists broken in two freak accidents.  One wrist was broken when sliding on a wet deck, the wrist hit a ceramic dish and chopped it in half. The other was a result of falling on black ice.  A&E did a wonderful job putting the one displaced wrist back in the correct position.  The challenge occurred when going to the radiology section.

“There is a 2 hour wait” stated the administrator. “I run a business and don’t have 2  hours to spare”.  The response; “that is your problem not ours”.  Finally after a 3 ½ hour wait, the arms were x-rayed.  Two weeks passed and the hospital asked for me to come in again.  An overseas doctor was waiting “I have looked at the x-rays and you need a plate put in your left wrist which was the displaced one. There are shards of bone in this x-ray.”  I refused. This caused some disagreement but eventually I was seen by a surgeon.  After looking at the x-ray, he said everything was fine and healing well. Why had the overseas doctor wanted to do the operation?  They need experience in surgery in New Zealand so they can get practice to qualify here.

Four weeks passed and it was time for another x-ray before the casts were removed.  After arriving at the radiation ward, again there would be another unacceptable long wait.  Suddenly I remembered the medical insurance. The happy conclusion was I took my ACC number to Southern Cross and waited 5 minutes for the x-ray.

This is not uncommon and after discussing with two clients, this was their story.  They both had to have medical procedures, one to remove a malignant tumour and the other to have an eye operation. The cancer client had medical insurance and after diagnostic tests, was operated 2 weeks later and enjoyed having a private room, good food and a television set. The other had to wait a year for the cateract operation and the result has not been ideal.

The suggestion is that if medical insurance is too expensive, take a $250, $500 or$1000 excess which means that in the event of surgery, you only pay the one excess and any other illnesses or accidents that year, have no excess.  Taking an 80% cover means you could be paying up to $20,000 for an operation.

Be aware that when filling in an application for medical insurance that you must list all known existing illnesses.  Non-disclosure means that no medical insurance payments will occur. Once you have a medical condition, it is best not to change insurers as the pre-existing medical condition will not be covered.

As a business owner, it is important that risk management is in place rather than reacting to an unexpected situation. Included in the budget for insurance should be cover for hospital, specialists and tests which are where major medical costs occur.