Claims, provider payments and entitlements

Dialysis for eligible patients within New Zealand while on holiday is available free of charge.

New agreements are created by Sector Operations on behalf of the commissioners of health services. These agreements are based on standard templates.

This subsidy is paid to service providers when a patient has had an eye removed.

These payments help to reduce the cost of purchasing breast prostheses and other related products.

Care Plus is a primary health care funding initiative to support people with high health needs.

The Carer Support Subsidy is available for older people and people with other health conditions who need support.

A 3% wage increase for care and support workers from 1 July 2023 has been proposed by Health NZ, peak bodies and unions.

The Community Services Card (CSC) helps people and their families with the costs of health care.

This subsidy is available to optometrists and dispensing opticians if they have an agreement with us.

We provide funding for some child and adolescent oral and dental health services.

GMS are subsidies paid to general practitioners under the Section 88 notice to help reduce patient fees for children and subsidy card holders.

The High Use Health Card (HUHC) gives a general practice a higher government subsidy for patients with high health needs.

A subsidy for GPs who give vaccines to eligible patients and submit claims to Sector Operations.

Home and community support workers can be paid for travel between clients, known as 'in-between travel'.

A laboratory can submit a claim when a medical practitioner, oral surgeon, cervical smear taker, approved nurse or midwife refers a patient to them.

Authorised doctors and midwives can claim for the maternity services they provide to New Zealanders.

The Mental Health Service Payment allows a GP to claim a fee if they are called to assess someone for treatment under the Mental Health Act.

Information on the National Enrolment Service, how it is being implemented, and what this means for PHOs and general practice.

Find out about National Health Index (NHI) numbers, who is entitled to them and how to register a patient for one.

Learn more about National Health Index entitlements

This is the standard national form for Needs Assessment Service Coordination agencies to record eligibility and service coordination information.

The NRT programme aims to reduce tobacco consumption and to improve the health and lifestyle of New Zealanders.

This payment is available when a specialist has opted not to claim on behalf of a patient. The patient pays the full amount and collects the subsidy.

Most people who are eligible for publicly-funded health and disability services will pay a maximum of $5 to pick up each subsidised medicine.

Pharmacy claims cover the medicine subsidy and dispensing costs associated with supplying prescribed pharmaceutical items to patients.

The practice nurse subsidy is available to GPs under the Section 88 notice to help them employ a registered nurse.

PHOs are funded to support general practices to provide essential primary health care services to people enrolled with the PHO.

Sector Operations provides a variety of payment-related services for health providers.

As part of the Primary Health Care Strategy a number of evaluations were carried out. The following information is based on historical initiatives.

People who need long-term supported accommodation due to illness or a disability may be entitled to access one of three subsidies.

Salary subsidies for Wesley Wellington Mission, for doctors employed as medical officers for Wesley Haven and Wesley Ewart hospitals.

Resources such as claim specifications and guidelines.

A key priority for Primary Health Care is to enable groups with the greatest need to access services to improve their health.

Special Authority is an application process in which a prescriber requests government subsidy on a Community Pharmaceutical for a particular person.

The Special Sessional Scheme service payment or ‘subsidy under the Triple S Scheme’ is for GPs supporting community health education programmes.

The Stump Socks Service Payment is available when claiming artificial aids.

About reimbursement for unvaccinated in-home family carers

These payments help to reduce the cost of purchasing and maintaining a wig or hairpiece or other related products.