FAQ for Benefits and Premium Changes
Every year, we review our premiums and Health Plans to ensure they remain up-to-date, sustainable and continue to deliver value for the health and wellbeing of our Members.
This page includes FAQs about the changes effective from 1 August 2025 for Members who are insured individually with us (not part of a group insurance scheme).
Premium
How often does UniMed review premiums?
At UniMed we review our pricing twice a year – one is focused on premium and benefits (effective 1 August), and the other is related to a Member’s age (in line with your policy anniversary).
Some Members will have a policy anniversary in the coming months, meaning that their age-related premium will adjust soon after their annual premium. Closer to the time of your policy renewal, you will receive a letter outlining your age-related price change.
Why are premiums increasing significantly?
The level of increase reflects the impact on UniMed of surging claims costs in recent years, driven mainly by Members using private healthcare services more, due to increased pressure in the public health system – at a level the industry has not experienced previously. In addition, we continue to see an impact from high general inflation and medical inflation, and rising treatment costs.
If reserves have been used to smooth premium increases in prior years, can this be done again this year?
This is not a sustainable option every year. We have limited the increases where possible but significant changes are needed to ensure we can continue to pay claims and support you in the future.
The amount of premium income that we spend on paying claims and providing services to Members (claim ratio) has been increasing since 2021. In the 2024 year our claim ratio was 94% and for the 2025 year we are expecting a similar percentage. This means for every dollar we receive in premium, we are paying 94 cents in claims.
As a not-for-profit society, our core purpose is to help working New Zealanders and their whānau to stay in life-long good health.
Our claim ratio target is 85-87% and this allows us to reinvest into the society for the benefit of Members, to enhance and expand our health and wellbeing services.
How does age impact premiums?
Premiums for each age group reflect the historical and expected claims for that group. As people age, they are more likely to use their insurance, and over time treatments become more expensive.
Therefore, a Member aged 60 generally pays a higher premium than a Member aged 35, because Members in older age brackets incur average claims costs that are considerably more than Members in lower age brackets.
When will my premium change?
You will receive a letter outlining your price change, which will be effective at your first billing date on or after 1 August 2025. You will also receive a letter confirming this change to your regular payment method.
What options are available to help manage my premium?
We may have alternative options you can consider to help manage your premium, including changing to a different Health Plan, adding or increasing your excess, removing optional modules, or reducing reimbursement levels.
Please email us at sales@unimed.co.nz for more information and refer to our fact sheet about Plan Changes.
If you are experiencing financial hardship, we encourage you to please get in touch. Our team is here to talk through the support options we can offer.
Can I put my premium on hold?
If you are facing redundancy or financial hardship, UniMed is here to support you at this difficult time with options for retaining your health insurance.
UniMed can offer a suspension period of up to 12 months. This means that your policy will be put on hold – you won’t have a premium to pay, but no claims can be made for procedures or treatment during this time.
Putting your policy on hold
Please contact us by phone or email to let us know if you wish to put your policy on hold and from which date.
Reinstating your policy
When you're ready to reinstate your policy, please contact us by phone or email. We will provide information on your available options and outline the next steps.
We will also check in with you during your suspension period.
If you reinstate your policy within 6 months, you will be able to retain cover for your eligible acquired or developed conditions.
If you reinstate your policy after 6 months, you may need to complete a health declaration. Any new medical conditions will be assessed and may be underwritten, which could result in them being excluded or limited for cover.
How do I cancel my policy?
You can request to cancel your policy in writing (by email or letter) or by phone. Please make this decision carefully as you will not be able to reinstate your policy. If you re-join later, this may require a new application to be completed and could result in a full underwriting review of your health. This means you will probably lose cover for any pre-existing conditions that were previously covered.
Please call us on 0800 600 666, email members@unimed.co.nz or send a letter to:
UniMed
PO Box 1721
Christchurch 8140
What factors are considered when you review premiums?
When we review our premiums, we consider a range of factors such as procedure and treatment costs, utilisation across different types of Health Plans (the frequency at which Members use the benefits on their plans), market conditions, general and medical inflation, and Health Plan changes.
Will premiums continue to increase at this level in the future?
When we review our premiums, we consider a range of factors such as procedure and treatment costs, utilisation across different types of Health Plans (the frequency at which Members use the benefits on their plans), market conditions, general and medical inflation, and Health Plan changes.
Some factors are out of our control, but we are looking at ways we can manage costs relating to the factors within our control.
We are implementing strategies to help reduce the escalating cost of claims now and in the future. For example, we will be focused on enforcing 'Reasonable Charges’ with providers who are charging more than what we think is reasonable.
Why is my premium increasing if I don’t make any claims?
Insurance premiums cover the cost of providing protection and access to cover if/when you need it, whether or not you make a claim.
If you feel like your Health Plan isn't meeting your requirements, we may have options that we can discuss with you to help with managing your premium. Please contact us for more information and refer to our fact sheet about Plan Changes.
When will my premium change?
You will receive an email / letter outlining your price change, which will be effective at your first billing date on or after 1 August 2025. You will also receive an email / letter confirming this change to your regular payment method.
Can you provide quotes so I can compare with other health insurance providers?
As you explore the possibility of changing health insurance providers, it is important to consider coverage for pre-existing conditions. Different insurers may have varying policies on how these conditions are treated, including potential exclusions, limitations, or waiting periods before coverage begins.
It is worth connecting with an insurance adviser, who can help you review this aspect carefully to ensure there are no unexpected gaps in your coverage. They can also assist you in selecting a policy that best suits your needs and to compare quotes from different insurers.
Health Plan Changes
What benefits are changing?
When you receive the letter outlining your price change, this will include the Summary of Health Plan Changes (previously addendum) outlining all changes to your Health Plan effective 1 August 2025.
In addition, we are pleased to be expanding a range of proactive health benefits and programmes to support early intervention and improve health outcomes:
- An app to help detect skin cancer
- At-home bowel screening kit
- Coaching programme for people living with cancer
- Nutrition support
- Fitness and recovery support
- Ask a GP virtual service
- Mental health services
These benefits are in the process of being implemented and we will share more information when they are ready to roll out.
How do I request an at-home bowel screening kit?
At-home bowel screening kits will be available as a new benefit starting 1 August 2025. When the programme launches, we’ll email all eligible Members with information on how to request their kit. If you’re aged 60 or over, you can already request a free screening kit through the .
Why do benefits not increase every year like premiums do?
In the last couple of years we have increased limits on our surgical, GP, nurse, colonoscopy/gastroscopy, physiotherapist, podiatrist and dental benefits. However, increases to benefits result in increases to premiums. In years when premiums are increasing significantly due to higher utilisation and treatment costs, we need to balance the increase related to benefit enhancements.
This year, we are pleased to be introducing a range of proactive health programmes to support early intervention and improve health outcomes, which are outlined above.
In my Summary of Health Plan Changes, it mentions ‘reasonable charges’ – what does this mean?
Our reasonable charges make sure that healthcare providers are fair with the amount they charge for medical treatment or procedures. ‘Reasonable charges’ are the cost for a procedure or medical treatment that we judge to be reasonable and within a range of cost charged for the same procedure under similar circumstances. We will be focused on enforcing 'Reasonable Charges’ with providers who are charging more than what we think is reasonable. Details of this are outlined in our Terms and Conditions.
General
Which documents make up my policy?
- Health Plan document listing your benefits.
- UniMed Terms and Conditions. We are updating our Terms and Conditions, which were previously called Conditions of Membership. We will let you know when the updated Terms and Conditions will apply, and this will then be available on our website or in your online Member Portal.
- Approved Surgical Procedures and Unapproved Medical Services listing the approved surgical procedures covered by your Health Plan and unapproved procedures for which there is no cover available.
- Membership Certificate containing the details of your level of cover and any personal exclusions that you may have. Please ensure you check all your details are accurate and contact us if any updates are required.
- Rules of the Society.
Does my premium contribute to Member Offers?
We offer a range of Member Offers through our trusted partners to support your health journey. These are available to all Members and do not impact your premium increase. Current offers are:
- 15% off travel insurance with Allianz Partners
- 20% off MoleMap checkups
- Free hearing health checkups with Bloom Hearing Specialists
- Offers at Specsavers Optometrists
Find out more
