Eligibility Direction

You must meet one of the criteria in the Eligibility Direction to be considered for these publicly funded services. If you are not eligible, you are liable to be charged for the full costs of any medical treatment or disability support service you receive during your visit.

The Eligibility Direction describes the groups of people who are eligible for free or subsidised health and disability services in New Zealand.

It's a direction made by the Minister of Health under section 32 of the New Zealand Public Health and Disability Services Act 2000. The direction became effective on 16 April 2011, and applies from that date forward.

Establishing eligibility prior to 15 April 2011

People must meet the eligibility criteria at the time they receive services. If you're questioning whether you or someone else was eligible prior to 15 April 2011, you'll need to check the criteria in the Direction.

 

Who can be considered eligible for NZ healthcare

The Health and Disability Services Eligibility Direction 2011 sets out the eligibility criteria for publicly funded health and disability services in New Zealand. The groups of people who meet the criteria defined in the Direction can receive some or all of publicly funded health and disability services. For foreign nationals, eligibility is largely based on immigration status.

A person needs to be eligible at the time they receive health or disability services for those services to be publicly funded. Eligibility is not retrospective (ie, if a person becomes eligible after accessing services, that eligibility is not backdated to those services).

Who is responsible of checking a person's eligibility

Checking the eligibility of patients is the responsibility of all health providers who administer government-funded care. People can expect to be asked to prove their eligibility, especially if the provider is seeing them for the first time.

Find out more

Find out more about your roles and responsibilities around eligibility as a New Zealand healthcare provider.
  • Eligibility checklists and decision trees

    A quick reference to find out if someone meets the eligibility criteria, and to help you ask them for the right proof of eligibility.
  • Determination of eligibility

    Determination of eligibility is a process to resolve disputes about eligibility for publicly funded health and disability services.
  • Document examples that confirm eligibility

    Examples of documents that might be used to confirm a person’s eligibility, such as refugee and protected persons letters, certificates of participation in the Foreign Language Teaching Assistantship Scheme.