Enrolled Patient Subsidies

Primary Health Organisations (PHOs) in New Zealand are responsible for ensuring that individuals have access to primary health care services, such as general practitioner (GP) consultations, immunizations, and health education. The government funds PHOs to provide these services, and most people in New Zealand are eligible to enrol with a PHO for free.

Cost Effective Visits

Enrolment with a PHO is typically done through a general practice, and as of October 2022, almost all general practices in New Zealand are part of a PHO. Enrolling with a PHO ensures that individuals have access to a range of health services and can help to lower the cost of some health services.

It is recommended that individuals check with their doctor, nurse, or receptionist to confirm whether their general practice is part of a PHO or check the practice's website for more information.

Zero Fees Under 14's

In New Zealand, on December 1, 2018, the Zero-Fees initiative was extended to include children under 14 years old. This means that children under the age of 14 are eligible for zero-fee general practice visits, including after-hours services and injury-related (ACC) visits. Additionally, they are exempt from the standard prescription co-payment charge of $5 per item on fully subsidized prescriptions.

Prior to the extension of the Zero-Fees initiative, only children under 13 years old were eligible for these benefits. This extension aims to make primary health care services more accessible and affordable for families with children, and to improve health outcomes for children across New Zealand.

Very Low-Cost Access (VLCA)

The Very Low-Cost Access (VLCA) scheme is designed to support general practices with a high proportion of enrolled high needs patients and encourages these practices to keep patient fees at a low level. The VLCA scheme helps to ensure that primary health care services are affordable and accessible to those who may struggle to afford it and aims to improve health outcomes for high-needs populations.

Adults and their dependents aged 14-17 years who are enrolled at VLCA practices pay less than $20 for a standard daytime visit, while children under 14 years are not charged. Patients can check with their doctor, nurse, or receptionist to see if their general practice is a VLCA practice.

Subsidised Prescription Co-payments

In New Zealand, most people pay a prescription co-payment charge of $5 for each new prescription item. However, the Prescription Subsidy scheme is available to help reduce the cost of medicines for families and people who need multiple prescriptions. Once an individual has paid for 20 new prescription items from 1 February each year, they become eligible for the subsidy. After this, they do not have to pay any more prescription charges for the rest of that year (to 31 January). It is important to note that children aged 13 and under are not charged a prescription co-payment, and their items cannot be counted towards the 20-item threshold to receive the subsidy.

Improving Access to Health Information

Patient portals are online services that allow patients to access and manage their own health information, including laboratory test results, repeat prescription orders, and secure messaging with their GP or general practice team. Patient portals are available to patients enrolled with a PHO, and most general practices in New Zealand now offer this service.

Patient portals are designed to provide patients with greater access to their health information and improve their ability to manage their own health. Patients can access their information from any device with internet access and can use the portal to keep track of their health information over time. This can be particularly helpful for people with chronic health conditions who need to monitor their health regularly.

To find out if your general practice offers a patient portal, you can check with your GP, nurse, or receptionist. They can provide you with more information on how to sign up and use the service.