When you see a specialist, you’ll visit a medically trained and registered healthcare professional. In most cases, you need to visit your General Practitioner (GP) first so they can refer you.
Not all specialist care is funded by the government. It depends on the type of specialist you visit and your personal situation, for example the type of care you need or whether you can get publicly funded healthcare.
Medical specialists
Medical specialists are medical practitioners and must be registered with the Medical Council. The Medical Council lists the registration information and qualifications for all doctors practising in New Zealand.
To see a medical specialist you usually need a referral from your GP. If you have health insurance, check with your provider to see if you can contact the specialist directly.
Waiting for an appointment
If you go through the public health system, how long you wait for an appointment to see a medical specialist depends on your situation and how many other people also need to see the same specialist. If there is a high demand and you don’t need help quickly, you may have to wait to go on a waiting list.
Once you’re on a waiting list, you’ll see the specialist within 4 months. Before you visit they may ask you to get tests done - for example — a blood test. Your GP looks after you while you wait for your appointment.
Waiting for surgery
If the medical specialist decides you need surgery, unless it’s really urgent, you go on a waiting list. How long you have to wait depends on how urgent your need is compared with all the other people on the list. For elective services — for example, surgery or treatment that isn’t urgent, the wait is up to 4 months.
You don’t always need a referral from your GP to get help from other kinds of healthcare professionals, for example a physiotherapist, podiatrist, chiropractor or optometrist. Only some services and treatment are publicly funded.
Ask the healthcare professional you’re going to if your treatment is paid for by the government.
Specialist services funded by the Government through your District Health Board (DHB) are free. You can’t choose the specialist and you may have to go on a waiting list first.
If you want to visit a specific medical specialist or want to see someone quickly, you’ll have to pay for your appointment. If you have private health insurance, depending on your policy, you may be able to claim back all or some of the cost.
Check when you book an appointment if the treatment is free for you.
Government help to pay for specialist care or treatment
If you have a disability or long-term illness
If you’re on a low income, you can apply for the Disability Allowance if you need to help with paying for other costs when you see a specialist, eg prescriptions, travel or parking. If you have private health insurance, you may be able to claim the Disability Allowance for part of the cost that isn’t paid by your insurer.
If you need help with managing in your home or you might be moving into a rest home, you’ll have a needs assessment arranged through the Needs Assessment Service Coordination (NASC) team at your local District Health Board (DHB). They can suggest a wide range of specialist help for you, including:
a medical specialist — to make sure you get the right treatment for an illness or disability
a physiotherapist — to work out how to keep up your physical activity, particularly after an injury
a social worker — to support you through your decision-making and make sure you have all the information and support you need
an occupational therapist (OT) — to help with any changes that make it easier for you to manage in your home
a dietician — to advise you about your diet or nutrition needs, and eating patterns
a speech-language therapist — to assess any speaking or swallowing problems
a geriatrician (a specialist in older people’s health) — to look at your health and specific medical issues.
There may be a fee for these specialist services. If you see a therapist or specialist through the public health system and are eligible for publicly funded healthcare, you don’t have to pay.
Specialist treatment after an injury
If you need specialist care to recover from an injury and your claim has been accepted by the Accident Compensation Corporation (ACC), then they may pay for your treatment.
The first step is to contact your case owner to discuss what support you may be able to get.
Some private health insurance policies cover visits to medical and other kinds of healthcare services that are not publicly funded. You can only take out health insurance if you are eligible for care from the public health system — for example, many tourists and international students are not eligible and take out travel insurance to pay for any health treatment they need.
