No health insurance penalty for those who don't get Covid jab

Consumers in the US face potentially higher insurance premiums if they don't get the jab. Photo / Warren Buckland

Health insurers say those with existing policies will not receive any discount on their premiums for getting a Covid-19 vaccination and nor will they be penalised for not getting the jab.

But those taking out new cover who have had Covid will be expected to declare if they had any symptoms from the virus which required medical treatment.

Covid vaccinations briefly went on hold as the country went into a level 4 lockdown on Wednesday sparked by a community case of Covid-19 but are now back in full swing.

Southern Cross Health Insurance chief medical officer Dr Stephen Child said it made no difference if an existing policyholder got the jab.

"If you are a member already with us ... whether or not you get the Covid vaccination is totally irrelevant."

That's because Covid-19 has largely been handled via the public health system in New Zealand.

In the US private insurers have had to pony up for expensive hospital bills which could mean those who choose not to get a jab could have to pay more for insurance in the future.

Child said the whole healthcare system was different in New Zealand.

"If you get admitted for pneumonia in New Zealand you will get admitted to a public hospital. A lot of the medical illnesses related to Covid will be in the public system.

"So it will have less of an impact in New Zealand on our private healthcare system."

Child said those signing up for healthcare would be asked about any symptoms they had sought medical attention for but not specifically about any viruses they had had.

"There is a lot of media attention at the moment for the Covid virus but remember we have had the influenza virus, the dengue virus, Ebola ... this is one in a long line of pandemics that has encroached on the world."

He said long Covid was not considered to be a pre-existing condition at this stage. Southern Cross had recently commissioned a report into long Covid and decided to make no changes to its policies.

"If you had chronic fatigue and sought medical attention for chronic fatigue that could be listed as a pre-existing condition.

"But long Covid as a unique set of symptoms, which isn't really there yet, will not feature."

Insurers can choose not to cover pre-existing conditions or charge a higher premium depending on what the condition is.

Those with health insurance also won't be covered if they have an adverse reaction to a Covid jab.

Child said adverse reactions should be covered by the Accident Compensation Corporation.

An ACC spokeswoman said a physical injury resulting from the Covid-19 vaccine may be covered by ACC if the criteria for treatment injury is met.

"Under ACC legislation, the injury must be clearly caused by the vaccination and must not be a necessary part or ordinary consequence of the treatment."

That means things like inflammation around the site of the injection which is common with vaccinations (an ordinary consequence) is unlikely to be covered.

While infections (such as cellulitis or septic arthritis) due to the vaccination, and anaphylaxis resulting in injury are not ordinary consequences and are likely to be covered, the spokeswoman confirmed.

Len Elikhis, chief product and Vitality officer at AIA NZ, said it respected people's choice to receive the vaccine.

"Getting the vaccine will not have any negative impact on existing insurance coverage, for example, there will be no loss of coverage under in-force policies if customers choose not to receive the vaccine.

"Currently, patients suffering from the effects of Covid-19 are treated by the public health system. However, if a health insurance customer requires treatment in a private setting (eg a private specialist consultation or private diagnostic tests), they will be eligible to claim in line with the standard terms of their policy."

But Elikhis said the vaccination would accrue points for those who were AIA Vitality members – as it currently did with other vaccines such as the flu vaccine, shingles vaccine and others. The points can be put towards getting discounts on different products and services including its insurance.

A spokeswoman for Nib said it would not be offering any discounts for members who choose to receive the Covid-19 vaccine.

"There will be no impact on a member's policy or premium if they choose to receive the vaccine or not."

A Covid-19 vaccination won't warrant a discount on health insurance. Photo / Bevan Conley

Peter Leitch, a financial adviser with Share NZ, said premiums had not increased due to Covid. "So it is natural that rates would not reduce either because a person has had the vaccination."

Leitch said there was some concern amongst insurers about what the long-term health impact was of limited access to health services due to lockdown measures.

"There is quite a lot in the UK media at the moment about what the impact on the community may be
from the all of the resources of the NHS being focused on Covid and how people who may have had cancer or need heart condition surgery haven't been able to access that so easily because of delays caused by that."

He said that will likely have an impact on the actuarial assumptions that have been made in terms of life expectancy for those who needed treatment and couldn't get it during lockdowns.

"A person who develops a heart condition at 52 - generally insurers think, okay within a year they will have that fixed either publicly or privately and they won't die. Whereas maybe if they haven't had treatment they will die or their condition will get worse so that could mean they pay in other ways."

He said New Zealand insurers may have avoided some of the increased risks that were apparent overseas due to NZ's relatively short lockdowns in 2020.

"I think the impact of Covid for local insurers will be more economic in that they can't get the same return on the money they have invested.

"When you have got zero or negative rates that does impact insurers, they can't take too much risk with how they invest the money."

He said most insurers hadn't really changed rates much in the last 18 months.

"I think that is because there is economic uncertainty in the market, particularly health insurers, for a lot of people it is a very discretionary spend. If it gets too expensive it is sometimes the one people will let go first."