As people age, often their health needs increase, but so too do health insurance charges. Julia Proverbs looks at the affordability of health insurance for superannuitants.
What price do you put on your health?
For superannuitant Gayle Shaw it is around $130 a week - a price she cannot afford.
Mrs Shaw, 65, had health insurance for about 30 years but cancelled it after becoming single.
And now she fears she will be faced with costly specialist bills to manage her rheumatoid arthritis.
"It was far too expensive," she said of the insurance premiums, that increased with her age and changing medical status.
However, when she was married with three young children it was invaluable.
Her son had asthma and the comprehensive plan covered his frequent doctor's visits, which at that time were not free.
"Even now, sometimes, I think I should have it. I don't know what would happen if I required a hospital service," she said.
Mrs Shaw, who volunteers for Age Concern Tauranga and Tauranga Citizen's Advice Bureau, said the premiums started to climb after she had two major operations.
"The more I used the health insurance the more it went up ... like house insurance, they put it up because you've used it. That's how it always seemed."
When she recently looked into how much it would cost, the quotes averaged about $130 a week.
"That's a lot to me," she said.
Having moved to Tauranga from Waikato, she said she had been "left hanging" between medical providers and would likely have to pay to see a specialist for her rheumatoid arthritis.
Mrs Shaw is not alone.
Many of her generation cannot afford health insurance at a time when they need it most.
Graham Whittenham, 67, who works at the Tauranga RSA, also cancelled his health insurance after his circumstances changed.
When he was made redundant 10 years ago he pared back his premiums by reducing the level of cover, but eventually gave it up altogether.
"Unless you have a substantial income it's not worth it," he said.
"There's no way I could cover it."
A diabetic, he said his health needs were met by the public system.
"There are good support services."
Annette, 71, and Nicky, 67, had similarly been under company health insurance schemes, but when their husbands left their respective jobs, they too bailed out.
"It was brilliant," said Annette.
She spent five weeks in a private hospital after having a hysterectomy and her husband also received private treatment after being badly burned by sulphuric acid.
But she estimated premiums had since tripled and said it was not something she would consider now.
"Not at my age," she said.
Nicky said she too was unable to afford it, but that she was happy with the public system.
"My partner just had cancer and he was straight in there," she said.
"I think there's more important things to have at my age."
Gary Moynihan, 65, has never had health insurance, nor is he interested in getting it.
"I enjoy fairly good health and have quite an active lifestyle. I've only had a couple of issues, which I've been able to use the public service for."
According to the Health Funds Association of New Zealand, at the end of September there were 141,000 people aged 65 years and over who had health insurance - about a quarter of that age group.
Over the past 12 months they claimed $276 million, mainly on elective surgery.
In comparison about half of those aged 55-59 years had health insurance.
The association would like to see a rebate for people once they reach 65.
"It would help maintain affordability as people retire," said chief executive Roger Styles.
Improving retention rates after 65 would take the pressure off the public health system, which would in turn reduce waiting times, he said.
Home Instead Senior Care managing director Debra Jager said having health insurance gave people choices.
'If they had private insurance it could help towards filling the gap," she said.
But it was not something that was entrenched in our culture.
"We do have a mindset the government will pay. We've always said we would come in with social services and pay for that.
"It's a lot about how we have cared for ourselves in the past," she said.
"And older seniors, some have gone through wars and depressions and have learnt to suffer and get through. The thought of asking for help or care does not come easily."
Krystle Hodges, an insurance advisor with Bay Insurance Brokers, said people could lower their premiums by having a higher excess.
"We find many people with existing covers with no exclusions who now have health issues so can't get a cheaper premium with another company due to these issues are advised by us to either add an excess or increase the existing excess in order for them to be able to keep the cover in place," she said.
They could also consider having a less comprehensive plan, putting aside money for doctor, dental and optical visits, rather than including them in their policy, she advised.
"In some cases they can add a lot on to the premium for the benefit you get from it. You can self-insure that kind of thing, whereas a $10,000 surgery is not money you have available."
Mrs Hodges said over the past six months there had been an increase in older people seeking advice.
"A lot have existing cover and they are finding it too expensive," she said.
However, she cautioned against switching to a cheaper alternative without reading the fine print.
A new policy could contain new exclusions or be structured differently.
"It could be to the client's disadvantage to change."
People should always go for "hospitalisation non-surgical and surgical cover", she recommended.
"With modern technology more and more treatments are becoming available that don't require surgery, however they still come at a high cost."
Shula Newland, manager of Full Balance Personal Financial Coaching, said with New Zealand's public health system, health insurance was not seen as being as essential as it was in some countries.
Those who were struggling financially could look at different levels of cover.
Unless they were going to the doctor a lot, full cover was not worthwhile, she said.
"Going to the doctor and paying $50 will not upset most people's finances. If people are living in poverty $50 will affect it a lot but those are the sort of people who can not pay for health insurance anyway."
Insurance was designed to cover bigger events, she added.
"Insurance is everyone pooling money together so regardless of when it happens you've got that cover. You've got to look at what risk you're covering and what cost would be associated."
However health insurance was not something you could necessarily put a dollar value on, she added.
"Even though medical insurance can be expensive and it goes up with age and how your health is, if you have it when you are older it could be priceless and keep you off waiting lists."
Virtually no waiting lists
You can usually choose your specialist
You get cover when you need it
You can choose a time that suits
Can be expensive
Can become more expensive as you get older
Pre-existing conditions are not always covered
Full cost of treatment is not always covered