UniMed Premium and Health Plan Changes

The changes vary depending on your Health Plan. You will receive full details of the changes that apply to your cover, including confirmation of whether you are affected.

The key changes are:

• New three-year no-claiming period for the removal of impacted or unerupted teeth. This means that you must complete three years of continuous cover before you're able to claim for this treatment. If you have already completed three or more years of continuous cover, this will not impact you.
• New three-year no-claiming period for varicose veins treatment. This means that you must complete three years of continuous cover before you're able to claim for this treatment. If you have already completed three or more years of continuous cover, this will not impact you.
• New compulsory excess of $150 for colonoscopy and/or gastroscopy procedures. This applies per procedure. This does not apply to a surveillance colonoscopy and/or gastroscopy where there are no signs or symptoms.
• New compulsory excess of $150 for imaging, such as CT scans, MRI scans and PET scans. This applies per test or imaging. This does not apply to the imaging cover available under the ‘Surgery - Prior/Post Admission Benefit’.
• A new time limit of two years for breast reconstruction to be performed following a required mastectomy.

These changes will apply from 1 August 2026.

This year, we’ve made balanced decisions to keep premiums as affordable as possible while continuing to give you access to quality healthcare. Our focus is on maintaining core benefits, while responding to increases in treatment costs and the overall cost of healthcare, so we can continue to cover our Members’ needs now and into the future.

If you have received prior approval for a treatment that will be affected by the no-claiming period or compulsory excess before you have been notified of these Health Plan changes, this can still go ahead as planned if the treatment takes place within 3 months of the date of issue.

If the treatment does not take place within 3 months of the prior approval being issued, your prior approval will need to be reassessed, and the benefit changes will apply.

A no-claiming period (or stand down) means there is a waiting period after joining before you can claim for certain benefits.

It will apply to Members who have not completed three years of continuous cover at the point of these changes taking effect, which is 1 August 2026. If you have already completed three or more years of continuous cover, this will not impact you.

An excess is the amount you contribute towards the cost of a claim before your cover applies. If you have a treatment that an excess applies to, you’ll pay a contribution towards the cost to your healthcare provider.

The $150 compulsory excess for colonoscopy and/or gastroscopy procedures applies to all Members on Hospital Select and Major Surgical Health Plans, even if you do not currently have a voluntary surgical excess.

The $150 compulsory excess on imaging applies to all Members on the Hospital Select Health Plan, even if you do not currently have a voluntary surgical excess.

If you have a colonoscopy, gastroscopy, or imaging such as a CT scan or MRI scan, you’ll pay $150 towards your claim, which is paid directly to your healthcare provider.

Colonoscopy, gastroscopy and imaging services are important procedures that are commonly used. Because they are widely used, they have an impact on premiums for all Members, so introducing an excess means we can support Members to access these procedures while helping to keep premiums affordable for all Members.

The average cost of these procedures is much higher than the $150 compulsory excess:

• A colonoscopy typically costs between $2,000 and $4,000
• A gastroscopy typically costs between $1,500 to $3,000
• Having both a colonoscopy and gastroscopy together usually costs between $5,000 and $6,500
• CT scans typically cost between $1,250 and $1,500
• MRI scans typically cost between $1,800 and $2,500
• PET scans and angiograms typically cost between $2,500 and $3,500

If you have chosen a voluntary surgical excess for your Health Plan, it doesn't apply to imaging or colonoscopy/gastroscopy procedures.

With this change from 1 August 2026, a $150 compulsory excess will now apply to these benefits. This will apply even if you do not currently have a voluntary surgical excess for your Health Plan.

Yes. If the treatment takes place on or after 1 August 2026, it will either be assessed against the no-claiming period or will have a $150 excess applied.

Treatment prior to 1 August 2026 is not impacted by these changes.

You can still have treatment, however you will not be able to make a claim for the treatment, if it takes place on or after 1 August 2026, until you have completed three years of continuous cover. You cannot claim for events that happen during the no-claiming period.

In addition to the Health Plan changes outlined on this page, we’ve also made some wording changes to existing benefits to make it clearer and easier to understand. There is no change to your cover.

For example:

• Radiation Oncology has been renamed to Radiotherapy/Radiation Therapy.
• Obesity Surgery has been renamed to Weight Loss Surgery.

You can find specific details about these wording changes in your Summary of Health Plan Changes.

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 and in this fact sheet.

Please get in touch with your question – we’re here to help.

For Members who are insured individually with us, 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 shortly after 1 August, meaning that their age-related premium will adjust soon after their annual premium. Closer to the time of your policy renewal, you will be contacted about your age-related premium change.

Group insurance schemes will have their premium and benefits reviewed at their next annual renewal on or after 1 August.

We know that any increase in premiums can be concerning, especially at a time when affordability is front of mind for many of our Members.

In recent years, more Members have needed to rely on private healthcare services due to strain on the public health system. 

At the same time, both general inflation and medical inflation have driven up the cost of treatments significantly. Together, these factors have led to higher claims costs at a level we haven’t seen before – although the good news is that we’re starting to see improvements.

Our focus remains firmly on long-term sustainability, so we can continue to be there for Members when they need us most. We’re carefully balancing price increases with benefit changes to manage costs responsibly, while protecting the value of our cover.

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 may pay a higher premium than a Member aged 35, because Members in older age brackets generally incur average claims costs that are considerably more than Members in lower age brackets.

We’ll contact you to confirm your new premium 45 days before your first billing date on or after 1 August 2026. You will also get a notice about your direct debit or credit card change, or an invoice – depending on your payment method.

There are a range of options to help manage your premium, including changing to a different Health Plan, adding or increasing your excess, or removing optional modules.

Please read our fact sheet about Plan Changes to understand how different changes may affect your cover and then email us at sales@unimed.co.nz for more information.

We have a range of suspension options if you’re facing financial hardship, taking parental leave, travelling overseas, or being seconded overseas for work (if you’re part of a group insurance scheme).

Please refer to our fact sheets for more information and get in touch when you’re ready to talk through the support options we can offer.

Please contact us to cancel your policy – this request needs to be made by the Primary Member.

Please decide carefully if you wish to cancel. You will have 30 days from the cancellation date to reconsider and reinstate your policy. After that time, if you want to re-join, this may require a new application and health declaration to be completed. This means you will likely lose cover for any pre-existing conditions that were previously covered. New personal exclusions and no-claiming periods may apply and you will lose any loyalty benefits for which you were eligible.

We recommend discussing with your financial adviser if you are considering cancelling your policy. If you do not have an adviser connected with your policy, you can find one using Financial Advice New Zealand’s (FAANZ) Find an Adviser tool.

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.

As a not-for-profit mutual society, premium increase decisions are never made lightly.

When we review our premiums, we consider a range of factors present at the time of the review, 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.

For example, we are enforcing reasonable charges with providers who are charging more than we think is fair. Please refer to our fact sheet about reasonable charges to find out more.

Insurance premiums cover the cost of providing protection and access to cover if or when you need it, whether or not you make a claim. 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.

We are happy to provide you with quotes. Please email us at sales@unimed.co.nz for more information and refer to our fact sheet about Plan Changes.

If you're an existing Member and you use the quote tool on our website, please be aware that quotes have not taken into account any underwriting or personal exclusions that may apply.

If you are considering your options, it's worth connecting with an insurance adviser, who can help you review your cover. They can also assist you in selecting a policy that best suits your needs. If you do not have an adviser connected with your policy, you can find one using Financial Advice New Zealand’s (FAANZ) Find an Adviser tool.

• Your Membership Certificate
• Terms & Conditions
• Your Health Plan document
• Documents and any correspondence you may have provided us including your Application
• The following documents, which may be updated from time to time:
  • The List of Approved Healthcare Services and the List of Unapproved Healthcare Services
  • Eligibility criteria for certain medical treatment or procedures
  • Rules of UniMed.

These documents are available through your Member Portal, in the Important Documents section, or by contacting us for a copy.

We have a range of Member Offers through our trusted partners. These are available to all Members and do not impact your premium increase. Current offers are: 

• 20% 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