Diabetes & NZ Health Insurance
Diabetes is treated as a pre-existing condition by every NZ health insurer, but their disclosure rules and exclusion handling differ materially. Picking the right policy with a known diabetic history matters.
Diabetes & Health Insurance NZ
Diabetes is one of the most common chronic conditions in NZ. Most health insurance treats diabetes as a pre-existing condition with specific rules around disclosure, stand-down periods and permanent exclusions for related cardiovascular complications. This page shows how each NZ insurer handles diabetes verbatim from their policy wordings.
23 active retail products from 6 insurers
Looking for the topic comparison? /topics/pre-existing-conditions/ shows the cross-insurer breakdown for this topic on a single page.
How each insurer covers this
Each section below is verbatim from the insurer's current policy wording PDF. Where a product doesn't address this specifically, we show "Not on file" rather than guess.
Easy Health
Wording effective 2019-12-19 · confidence no data
No specific rule for this topic on file.
Source: https://www.nib.co.nz/Documents/Document/EasyHealthBrochure.pdf
Ultimate Health
Wording effective 2019-12-19 · confidence no data
No specific rule for this topic on file.
Source: https://www.nib.co.nz/Documents/Document/UltimateHealthBrochure.pdf
Ultimate Health Max
Wording effective 2018-12-23 · confidence no data
No specific rule for this topic on file.
Source: https://www.nib.co.nz/Documents/Document/UltimateHealthMaxPolicyDocument20170701.pdf
AA Health Everyday Cover
Wording effective 2026-05-16 · confidence inferred
No specific rule for this topic on file.
AA Private Hospital Cover
Wording effective 2023-10-01 · confidence inferred
Any sign, symptom, treatment, or surgery of any condition that happened on or before the insured person's join date that the policyowner(s) or another insured person were aware of, had an indication that something was wrong, sought investigation or medical advice for, or would cause a reasonable person to seek diagnosis, care, or treatment. In the first three years following your join date, we won't pay any claims that directly or indirectly relate to any pre-existing conditions. After three years of continuous cover, eligible pre-existing conditions are covered. Some pre-existing conditions are never covered, including: pre-existing congenital or acquired cardiovascular conditions (with additional carve-outs for certain diabetes/cholesterol risk factors); pre-existing cancers (with limited exceptions for certain pre-malignant cancers with appropriate prior treatment); pre-existing hip or knee conditions; pre-existing back conditions; any prior transplant surgery; and any prior reconstructive or reparative surgery. If a dependent child is added within four months of birth, their pre-existing conditions are covered under Base Cover (general and personal exclusions including congenital conditions still apply).
Waiting period
- pre existing: 1095 days
Related exclusions (2)
- weight loss or bariatric investigations or treatment (for example: gastric banding, sleeve, and bypass), even if the purpose is to treat other health conditions (for example: diabetes or cardiovascular conditions)
- mechanical tools or appliances (for example: insulin pumps, CPAP machines and equipment, pacemakers)
AA Private Hospital + Specialist Cover
Wording effective 2026-05-16 · confidence inferred
A pre-existing condition is any sign, symptom, treatment, or surgery of any condition that happened on or before the insured person's join date that the policyowner(s) or another insured person were aware of, had an indication that something was wrong, sought investigation or medical advice for, or would cause a reasonable person to seek diagnosis, care, or treatment. In the first three years following the join date, no claims that directly or indirectly relate to any pre-existing conditions will be paid. After three years of continuous cover following the join date, eligible pre-existing conditions are covered. Some pre-existing conditions are never covered, including: pre-existing congenital or acquired cardiovascular conditions (with additional risk-factor exclusions for diabetes, hypercholesterolaemia, BMI ≥30); pre-existing cancers (with limited exceptions for certain pre-malignant conditions that have had appropriate treatment); pre-existing hip or knee conditions including degenerative conditions, disease or injury; pre-existing back conditions including any condition of or injury to the back; transplant surgery; and reconstructive or reparative surgery performed before the join date. A dependent child added within four months of birth has pre-existing conditions covered under Base Cover (congenital condition exclusions still apply).
Waiting period
- pre existing: 1095 days
Related exclusions (2)
- weight loss or bariatric investigations or treatment (for example: gastric banding, sleeve, and bypass), even if the purpose is to treat other health conditions (for example: diabetes or cardiovascular conditions)
- mechanical tools or appliances (for example: insulin pumps, CPAP machines and equipment, pacemakers)
Health Positive
Wording effective 2016-01-22 · confidence no data
No specific rule for this topic on file.
Hospital Select
Wording effective 2018-01-25 · confidence no data
No specific rule for this topic on file.
ParentStay
Wording effective 2025-10-01 · confidence inferred
Pre-existing conditions are not covered unless accepted by us. A pre-existing condition means any health or medical condition you are aware of, or any signs or symptoms that you are currently experiencing or have experienced in the past, that occurred before the start of your policy, or a medical event that occurred before the start of your policy. Applicants must disclose all pre-existing conditions on application. If untrue or misleading information is provided or pre-existing conditions are not disclosed, we may decline related claims and/or apply additional personal exclusions (which may be backdated to policy start). Any personal exclusions are listed on the Membership Certificate. Personal exclusions do not apply to the Medical Repatriation or Return of Remains benefits.
Related exclusions (2)
- Weight loss or bariatric investigations or treatment, including when such treatment is intended to manage, treat, or improve other health conditions (for example: diabetes, cardiovascular or gastrointestinal conditions)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/ParentStay-Health-Plan-2025.pdf
UniCare Advantage
Wording effective 2025-08-01 · confidence low
For Accident Surgery, UniMed must receive written confirmation from ACC regarding their decision to accept or decline the claim before qualifying surgical procedures are undertaken. If ACC accepts the claim, UniMed provides 'top-up' coverage to the benefit levels applicable to the Private Hospitalisation Surgical Benefits section. If ACC declines the claim, UniMed will, at its sole discretion, either assist with the total cost of surgery or pay the difference between the actual cost of surgery and what ACC would have contributed had the claim been accepted. For non-hospital ACC top-up, the shortfall between actual costs and ACC refunds for out-of-hospital expenses incurred as a result of qualifying personal injury or employment related conditions are covered to the limits shown under the General Medical Expenses and Minor Surgery benefit sections; ACC must have provided financial assistance towards treatment costs for a claim to qualify.
Source: https://www.unimed.co.nz/assets/PlansAndDocs/Health-Plans/UniCare_Advantage_Plan.pdf
KidSmart
Wording effective 2026-05-16 · confidence inferred
A pre-existing condition is any health or medical condition that you or any child was aware of, or were experiencing signs or symptoms of, before the start of the policy, or a medical event that occurred before the start of the policy. All pre-existing conditions must be disclosed at application. Personal exclusions may be placed on the policy certificate for pre-existing conditions; these last for varying periods (from 1 year to life). Children added under 6 months of age may be added with no personal exclusions placed due to their medical history. A Medical report is required within the first 5 years of the Hospital & Surgical base plan or Specialist module if the child was added after 6 months of age and their complete medical history was not supplied at application. We may decline a claim or add a backdated exclusion for any non-disclosed pre-existing condition.
Related exclusions (1)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
SmartCare
Wording effective 2026-05-16 · confidence inferred
A pre-existing condition is any health or medical condition that you're aware of, or were experiencing signs or symptoms of, before the start of your policy, or a medical event that occurred before the start of your policy. All pre-existing conditions for all Members must be disclosed at application. Underwriters assess the application and may place personal exclusions on the policy certificate; exclusions last for varying periods (from 1 year to life) depending on the medical condition. After the exclusion period has passed, the member can then claim for that condition. If a pre-existing condition is not disclosed and a claim arises relating to it, the claim may be declined. Undisclosed pre-existing conditions may be added as excluded conditions at any time, potentially backdated to the policy start date. A Medical report from the GP holding the patient's medical history is required when claiming within the first 5 years of the Hospital & Surgical base plan or Specialist module for a condition not previously claimed.
Waiting period
- pre existing: 0 days
Related exclusions (1)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
SmartCare+
Wording effective 2026-05-16 · confidence inferred
A pre-existing condition is any health or medical condition that the member is aware of, or was experiencing signs or symptoms of, before the start of the policy, or a medical event that occurred before the start of the policy. All pre-existing conditions must be disclosed at application. The underwriters assess each condition and may place personal exclusions on the policy certificate, which last for varying periods (from 1 year to life) depending on the medical condition. Claims may be declined for undisclosed pre-existing conditions that the member knew about or should have known about, and any such exclusion may be backdated to the policy start date. For example, a hernia present at policy start would result in a 5-year personal exclusion. Medical reports are required for claims within the first 5 years of the Hospital & Surgical+ base plan or Specialist+ module where the member has not previously claimed for that condition.
Related exclusions (1)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
SmartStay
Wording effective 2026-05-16 · confidence inferred
All pre-existing conditions must be disclosed at application. A pre-existing condition is any health or medical condition the member was aware of, or experiencing signs or symptoms of, before the start of the policy, or a medical event that occurred before the start of the policy. Pre-existing conditions are excluded unless accepted by the underwriters. Personal exclusions are listed on the policy certificate and may last from 1 year to life depending on the medical condition. If a member does not provide their complete medical history at application, a Medical report from the GP holding the medical history is required for any new condition claimed within the first 5 years of the Hospital & Surgical base plan or Specialist module. UniMed reserves the right to exclude any declared or non-declared pre-existing condition or congenital condition at any time, with the exclusion potentially backdated to the policy start date. Example given: a pre-existing hernia attracts a 5-year personal exclusion.
Waiting period
- pre existing: 0 days
Related exclusions (1)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
StaffCare
Wording effective 2026-05-16 · confidence verified
Pre-existing conditions are excluded unless accepted by the insurer. With group insurance schemes, cover for pre-existing conditions may be offered in certain circumstances. If a full application is required, all pre-existing conditions must be disclosed. Personal exclusions may be placed on the policy certificate for pre-existing conditions, lasting from 1 year to life depending on the condition. After the exclusion period has passed, the member can then claim for that condition. If a pre-existing condition is not disclosed and a claim is made relating to it, the claim may be declined. The insurer reserves the right to exclude any declared or non-declared pre-existing condition or congenital condition at any time, backdated to the start of the policy if necessary.
Related exclusions (1)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
StaffCare+
Wording effective 2026-05-16 · confidence inferred
Our Health Plans are set up to cover treatment of signs, symptoms and conditions that arise after your policy has started. However, with group insurance schemes we offer cover for pre-existing conditions in certain circumstances. If not offered cover for pre-existing conditions on application, all pre-existing conditions must be disclosed for all Members. A pre-existing condition is any health or medical condition that you're aware of, or were experiencing signs or symptoms of, before the start of your policy, or a medical event that occurred before the start of your policy. Underwriters assess all previous and current signs, symptoms and conditions; any excluded conditions are listed on the policy certificate. Personal exclusions last for different lengths of time (from 1 year to life), depending on the medical condition. After the time period listed with the exclusion has passed, you can then claim for that condition. We may decline a claim if treatment is for a pre-existing condition not included on the application form that you knew about or should have known about. We reserve the right to exclude any declared or non-declared pre-existing condition or congenital condition at any time, which may be backdated to the start of the policy.
Related exclusions (1)
- Surgical or medical appliances; for example, glucometers, oxygen machines, respiratory machines, diabetic monitoring equipment, or blood pressure monitoring equipment
KiwiCare
Wording effective 2026-04-01 · confidence verified
We don't cover any costs related to, or incurred as a consequence of, any pre-existing conditions unless we've clearly stated otherwise on your membership certificate. This exclusion doesn't apply to cover provided under the 'Day-to-day treatment' benefit if you have the RegularCare plan. Pre-existing conditions that the policyholder has made us aware of are listed on the membership certificate.
RegularCare
Wording effective 2026-04-01 · confidence verified
The policy does not cover any costs related to, or incurred as a consequence of, any pre-existing conditions unless clearly stated otherwise on the membership certificate. This exclusion does not apply to cover provided under the 'Day-to-day treatment' benefit for RegularCare plan holders. The policyholder must disclose any health conditions, signs, symptoms on application. Pre-existing conditions may be noted on the membership certificate.
UltraCare
Wording effective 2026-04-01 · confidence inferred
Pre-existing conditions are excluded unless clearly stated otherwise on the membership certificate. This exclusion does not apply after 3 years of continuous cover on this plan, and does not apply to cover under the 'Day-to-day treatment' benefit or the 'Vision and Dental' benefit (UltraCare 400 plan). Pre-existing conditions disclosed by the policyholder are listed on the membership certificate. If information on the membership certificate contradicts this policy document, the membership certificate takes precedence.
Waiting period
- pre existing: 1095 days
Wellbeing Modules
Wording effective 2026-04-01 · confidence low
No specific rule for this topic on file.
Wellbeing One
Wording effective 2026-04-01 · confidence inferred
Pre-existing conditions are excluded unless clearly stated otherwise on the membership certificate. This exclusion does not apply to cover provided under the optional modules. The prophylactic treatment allowance is not available if the person was confirmed as having a high risk of developing the disease the prophylactic treatment is designed to prevent before their original date of joining, unless the membership certificate specifically states otherwise.
Wellbeing Two
Wording effective 2026-04-01 · confidence inferred
We don't cover any costs related to, or incurred as a consequence of, any pre-existing conditions unless we've clearly stated otherwise on your membership certificate. This exclusion doesn't apply to cover provided under the optional modules. Pre-existing conditions that the policyholder has made us aware of are listed on the membership certificate.
AIA Private Health
Wording effective 2025-08-05 · confidence no data
No specific rule for this topic on file.
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GET /api/topic/pre-existing-conditions/summary.md— same content as MarkdownPOST /mcpwith toolget_topic_comparison(pre-existing-conditions)- Per-product:
/api/product/{insurer}/{product}/facts.json
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