nib Ultimate Health Max vs Partners Life Private Medical Cover at a glance 

Source: nib Ultimate Health Max policy document and Partners Life Private Medical Cover benefit sheet

Key differences

Eight differences matter to you here, and the two biggest are non-surgical cover and non-Pharmac drugs. Other differences, based on the overview table above, include:

• Diagnostics
• base cover vs paid options
• excess
• stand-down periods
• pre-existing conditions

Let’s look into each of these differences.

Surgical and non-surgical limits compared

Both plans pay up to $600,000 a year for surgery but they differ on non-surgical treatment: nib Ultimate Health Max pays up to $300,000 a year, and Partners Life pays up to $500,000.

If you're weighing the headline numbers, remember Partners Life's larger figure comes with a condition attached.

• Partners Life's $500,000 is a single shared pool. The Private Hospital Benefit and the Serious Illness Benefit both draw on it, so cancer treatment costs and a non-surgical admission in the same year compete for the same money.
• Partners Life's $600,000 surgical limit is also shared, with the reconstruction and prophylactic (preventive) surgery benefits.
• nib doesn't fold a serious-illness benefit into its shared $300k/$600k pool the way Partners Life does. Instead, it offers a separate lump-sum Serious Condition Financial Support Option as an add-on.

Non-Pharmac drug cover for cancer treatment

In base cover, Partners Life pays up to $25,000 a policy year for non-Pharmac drug cover, while nib's base cover carries no separate cap and draws non-Pharmac costs from its main $600,000 or $300,000 limits. Partners Life only reaches the higher $500,000 to $600,000 drug-cover figures by buying the Non-Subsidised Drugs Option.

Stated side by side, so the comparison is like for like:

• nib, base cover: covers Medsafe-approved medicines Pharmac does not fund, both in hospital and at home for up to six months after a private admission.
• nib, paid option: the Non-PHARMAC Plus Option adds a separate limit chosen from $20,000, $50,000, $100,000, $200,000, or $300,000 a year, with no excess and no waiting period.
• Partners Life, base cover: the $25,000 sits inside the main surgical and non-surgical limits, and includes administration costs.
• Partners Life, paid option: the Non-Subsidised Drugs Option lifts that cap to $600,000 under the surgical limit and $500,000 under the non-surgical limit.

It's worth checking what your quote includes.

Diagnostics and specialist cover compared

nib covers unlimited major diagnostic investigations in base cover, with no limit per investigation and no admission required. It includes the following:

• Arthroscopy
• capsule
• endoscopy
• colonoscopy
• colposcopy
• CT scan
• CT angiogram
• Cystoscopy
• Gastroscopy
• MRI scan
• Myelogram
• PET scan (including PET/CT scan)

Meanwhile, Partners Life's Major Diagnostic Benefit caps its own list of base-cover diagnostic procedures at $200,000 a year; a standalone specialist visit without a hospital admission needs a paid option on either plan.

• nib base cover includes specialist consultations within six months either side of a private admission, plus a second opinion, though the second opinion only triggers once a related claim has been paid under the paid Specialist Option's Specialist Consultations Benefit. A standalone specialist visit otherwise needs the Specialist Option.
• nib's Specialist Option adds unlimited standalone specialist consultations, routine imaging (x-ray, ultrasound, mammogram) to $3,000 a year, and cardiac investigations to $60,000 a year, with no excess.
• Partners Life base cover includes the Major Diagnostic Benefit at $200,000 a year, with the excess being your policy excess or $250, whichever is less.
• Partners Life's Specialist and Tests Option carries a combined $10,000 a year limit, and applies its own $250 excess separate from your policy excess

Optional add-ons

nib Ultimate Health Max offers six paid options, and Partners Life Private Medical Cover offers five, but the count matters less than what each insurer leaves in base cover. nib sells a GP Option that Partners Life has no equivalent of, while Partners Life puts several benefits behind an option that nib includes as standard.

• Everyday care. nib's GP Option pays for up to 12 GP or nurse-practitioner consultations a year at $55 each, prescriptions at $15 an item to $300 a year, and physiotherapy to $400 a year. Partners Life offers nothing comparable, and its exclusions rule out GP, physiotherapy, and prescription costs unless a specific benefit covers them.
• What sits in base cover. nib includes overseas treatment benefits, a public hospital cash payment of $300 a night from the third night, and ACC top-up cover as standard. Partners Life places its overseas benefits and public hospital cash inside the paid Overseas Coverage and Health Journey Support options. Partners Life has no dedicated ACC top-up benefit; ACC contributes first, and only the portion ACC actually recovers is excluded, unlike nib's dedicated ACC Top-Up Benefits.

A cheaper Partners Life quote may just have fewer options included. It's worth checking what your quote includes.

Excess options

Partners Life publishes its excess bands, and nib does not. Partners Life lets you choose $0, $250, $500, $1,000, $2,000, $5,000, or $10,000 per life assured, set when the policy starts, and different people on the same policy can carry different excesses.

nib's wording gives the mechanics without a band list: you elect an excess, applied once per insured person per policy year on each accepted claim, with your own dollar options shown on your Acceptance or Renewal Certificate.

• Partners Life waives your excess automatically in base cover for cancer, coronary artery surgery, heart attack, or stroke, where the policy definition is met, and there is a qualifying admission or serious illness treatment.
• nib has no event-triggered waiver. Instead, a defined list of benefits carries no excess at all, as do five of nib's six options in full. The sixth, the Serious Condition Financial Support Option, pays a lump sum rather than reimbursing costs; an excess would apply.
• Partners Life can offset your excess against what another health insurer pays. ACC is specifically excluded from that offset.

Stand-down periods

Neither nib Ultimate Health Max nor Partners Life Private Medical Cover imposes a general stand-down when you start the policy; both attach waiting periods to specific benefits, options, and loyalty milestones instead.

Benefit-level waiting periods differ because nib has far more benefits carrying one:

• nib: one year for removal of impacted teeth, two years for the sterilisation loyalty benefit, three years each for weight-loss surgery, breast-reduction surgery, and the check-up loyalty benefit, 90 days on the GP Option, and six months on the Dental/Optical/Therapeutic and Proactive Health options.
• Partners Life: two continuous years for the sterilisation loyalty benefit, six months on serious illness dental treatment, and a 13-month limitation on funeral support in the case of suicide (Health Journey Support Option).

A newborn on a Partners Life policy isn't on a waiting period at all: cover is automatic and free for the first six months, with a six-month deadline to register them so cover continues. nib also covers dependent children to age 21 before converting them to adult cover.

See our guide to health insurance for kids for what to check when adding children.

Here’s a sample quote:

How each plan treats pre-existing conditions

Both nib Ultimate Health Max and Partners Life Private Medical Cover exclude pre-existing conditions unless you declare them at application and the insurer accepts them, and both use a near-identical test based on symptoms, prior investigation, and what a reasonable person would have sought advice about. Neither plan lifts an exclusion automatically after a set period of cover.

Having pre-existing conditions doesn't mean you can't get cover at all, or that they'll be automatically excluded. Cover varies by insurer and by policy. Our guide to health insurance and pre-existing conditions covers how that assessment works.

One difference sits on nib's side. Where someone moves to Ultimate Health Max from a policy nib considers comparable, nib recognises any waiting period already served on that earlier policy. No equivalent commitment appears in Partners Life's published policy document.

The Insurance & Financial Services Ombudsman Scheme warns that conditions you developed while insured with your current provider will generally be treated as pre-existing by a new one, and cover for them has to be requested as part of the new application.

How claims and pre-approvals work with each insurer

Partners Life gives an indicative claim timeframe, and nib does not. Partners Life says a claim may take up to 15 to 20 working days, and commits to responding before your procedure date if you supply it. nib publishes no processing window, confirming a pre-approval outcome by phone or email without a set timeframe.

Both insurers ask you to seek pre-approval before treatment, with different emphasis:

• nib strongly recommends pre-approval for surgical claims and any claim over $1,000, submitted through the my nib portal.
• Partners Life strongly recommends pre-approval and makes it mandatory for medical tourism, overseas treatment, and overseas waiting list claims. Using an adviser is offered rather than required.

If a claim gets complicated, Policywise can advocate with either insurer on your behalf.

nib and Partners Life compared as insurers

nib entered the New Zealand market in 2012, while Partners Life was founded here. Both are now backed by larger overseas parents, worth knowing if an insurer's track record matters to your decision. Both hold strong financial strength ratings, though the two agencies use different scales.

nib publishes a health-specific claims figure. Partners Life's health-specific claims data is not yet available from an approved source, so their published claims figures are not directly comparable.

Which plan is the better fit for you?

Neither plan is better outright. nib Ultimate Health Max suits you if you want overseas cover included as standard, everyday GP care available as a paid option, no separate cap on non-Pharmac drug cover in base cover (still drawn from the main limits), and unlimited standalone specialist visits available as an option. Partners Life suits you if a larger, though shared, non-surgical pool and an automatic excess waiver on major conditions matter more.

• Base cover decides what you can actually claim on, not the option list. A paid-option limit only applies if you buy that option; a base-cover benefit applies regardless.
• Switching insurers means a fresh health disclosure, and anything that developed under your current policy may become a pre-existing condition on the new one.
• Excess is worth comparing as closely as any other feature. Partners Life publishes bands up to $10,000. nib sets yours on your certificate instead.

nib recommends an independent adviser for comparing nib's products against other insurers.

That is the part Policywise does. We are not tied to either company, so we can quote both on the same options and help you disclose your history properly before you switch. To see the two priced side by side, talk to a Policywise adviser or start with our guide to comparing health insurance in New Zealand.

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