Does ACC Cover Illness in New Zealand?

Something we frequently hear from our clients is that they don’t need health insurance because ACC will cover them. 

While it is true that ACC covers injuries and accidents, there’s a common misconception that it also covers illness. 

This is not the case.  

In this blog, we’ll dive into what ACC is and why understanding its coverage is essential for keeping you and your family healthy.  

What is ACC and How Does It Work?  

ACC, or the Accident Compensation Corporation, is a compulsory insurance program in New Zealand that provides coverage for accidents, injuries, and work-related conditions. Essentially, it’s there to help anyone who’s injured in an accident get the care and rehabilitation they need to recover.  

You might not even realize you’re paying for ACC because, if you’re employed, your employer takes care of the bill. However, if you’re self-employed, you receive an ACC bill annually as part of running your business. There are also ways to ensure you are not paying too much for ACC - it's worth talking with an adviser to discuss your ACC plan and make changes if necessary, it could save you a lot of money.

ACC covers costs related to injuries for everyone in New Zealand - citizens, residents, and even visitors. This means that if you’re injured while hiking or have an accident at work, ACC can cover things like GP visits, surgery, and physiotherapy.  

Does ACC Cover Illness?  

Here’s the short answer: no, ACC does not cover illnesses like diabetes, cancer, infections, or age-related conditions. 

This is because the focus of ACC is on injury-related care. That means it doesn’t extend to general sickness, diseases, or mental health conditions unless they’re the direct result of a covered injury.  

Example Scenario

Let’s say you fall and break your leg. ACC will cover your medical costs, including any necessary surgery and physiotherapy. 

However, if you develop diabetes or need cancer treatment later on in life, you’ll need to rely on the public healthcare system, trauma cover payouts or private health insurance.  

What Does ACC Cover?  

To make things clearer, here’s a quick breakdown of what ACC does cover: 

• Accidental injuries: Falls, sports injuries, car accidents, etc.  
• Work-related gradual process injuries: Issues like repetitive strain injuries.  
• Treatment-related injuries: Adverse reactions to medical treatments.

ACC’s scope is limited, so it’s essential to understand where its coverage ends and where you might need additional support. You can learn more about ACC on their website by clicking here.

What to Do to Protect Yourself

To be properly prepared and protected for the future, it’s important to know what options are available to you outside of ACC.  

Public Healthcare

New Zealand’s public healthcare system offers free care for most illnesses and medical conditions. However, wait times for non-urgent treatments can be lengthy, which delays access to the care you need.  

Private Health Insurance & Trauma Cover

Private health insurance provides faster access to specialists, diagnostic tests, and treatments. With health insurance, you can bypass long wait times in the public system and get the care you need when you need it. This can make a huge difference in managing and treating illnesses effectively and getting you access to the care you need, when you need it. Trauma cover can be more affordable and generally covers conditions that are more serious in nature. This is a lump sum payout that is not taxable and gives you an option of paying for treatment in NZ privately or travelling overseas to be treated. At the same time you may still choose to use the public system for your treatment and use the proceeds another way. Trauma cover gives you options, the funds maybe spent however you wish. Perhaps take time off work, improve your home, take a holiday or similar it's up to you.

Health insurance is designed to fill the gaps that ACC doesn’t cover, particularly for illnesses and elective treatments.  

Benefits of health insurance:

• Coverage for illnesses, chronic conditions, and preventive care. 
• Benefit limits reset annually giving you excellent value for money
• Access to private hospitals and specialists without the long wait times.  
• Peace of mind knowing that you’re covered for unexpected health issues.  

Benefits of trauma cover:

• Coverage for conditions more serious in nature
• Lump sum payment - use proceeds as you wish
• Get treatment overseas
• Improve your financial situation
• Pay for treatment in a private hospital
• Peace of mind knowing that you’re covered for the more serious unexpected health issues such as cancer, heart attack and much more

ACC might help you recover from a sprained ankle after a fall, but health insurance ensures you can see a specialist for that ongoing stomach pain without waiting months for an appointment.  

How Buffer Can Help You Navigate Your Options  

At Buffer, we specialise in helping you find the best health insurance to meet your needs.  

Here’s how we can help:

• Tailored solutions: We’ll work with you to create a plan that fits your lifestyle and health needs.  
• Advisor-only policies: Gain access to options not available directly through insurers.  
• Expert guidance: We help you navigate complex terminology, exclusions, and benefits to ensure you get the right coverage.  

If you’re ready to take control of your health coverage, we’re here to help. Contact us for a free consultation. Our friendly team will walk you through your options and make sure you’re set up with the best possible coverage.   

Take the next step today.

Contact us for a free consultation and let us help you find the right health insurance ortrauma cover plan to complement ACC and protect your health.  

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