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Our responsibilities regarding health costs

While inpatient hospital care is free to all New Zealanders, there are a range of circumstances where the patient or child is expected to make a contribution or to meet the cost of the health service.

This resource outlines which health related charges should be met by Oranga Tamariki and which are the responsibility of the caregiver or residence.

Principles

Oranga Tamariki is expected to meet the cost of health services where a child or young person's parent would normally be responsible for meeting that cost.
Children and young people in the care of Oranga Tamariki are not eligible for a Community Service Card.
Where a health service is an elective service (not required within seven days of the determination that the service is required), Oranga Tamariki will consider the need for the health service before agreeing to the funding.
In considering if it will fund the service, Oranga Tamariki will take into account the need for the service, the urgency of that need, other options available to meet the health need, and the consequences for the child of not having the health service.
Site managers will approve all funding for health services.

Examples

The following table outlines a number of areas where Oranga Tamariki would be expected to pay for or contribute to the cost of health services:

Service	Part payment	Full payment	Example	Explanations
General practitioner visits	√		Part charges to see a general practitioner or nurse	Medical practices often raise a part charge for children Charges are lower if the child or young person is enrolled with that practice Primary care costs are fully covered in the residences
Consumables		√	Bandages, band aids, dressings	Not covered by Health payments ACC may meet some of the cost when provided by a general practitioner or nurse Non-first aid items are covered in residence health contracts
Medications	√		Prescription part charges	There is often a part charge on prescriptions
		√	Over the counter medications e.g. Clearasil, Sunburn cream	Most over the counter medications are not subsidised by health
	√		Blister packaging	Covered in residence health contract, but not otherwise
Complementary and alternate medicine		√	Vitamins, minerals, supplements	Not subsidised by health
Medical devices	√		Asthma spacer, crutches	Health or ACC meet the cost of some devices
Specialist visits		√	Private specialist clinics	Specialist visits in a hospital are free Health does not usually pay for privates specialists ACC may pay if it is for a covered injury (eg orthopaedic specialist)
Counselling		√	Trauma and sexual abuse counselling	Visits to Child and Adolescent Mental Health Services, within District Health Boards, are free There is no health payment for private counselling ACC may cover the costs if the child or young person is covered for sexual abuse
Physiotherapy, chiropractic, osteopathy, acupuncture	√		Injury related	ACC may meet all or some of the cost
Physiotherapy, chiropractic, osteopathy, acupuncture		√	Non injury related	Health does not contribute to these costs
Dental	√		Routine dental treatment	Health meets the cost for dentists with CDA agreement, through school dental service or through the hospital dental service
	√		Dental injuries following an accident	ACC meets most of the costs associated with injuries
		√	Orthodontic (or specialist) dental care	Usually no health funding. Some special treatments may be funded if prior agreement by Dental Officer
After hours doctor	√		Accident & Medical Clinic charges	Part charges are usually higher after hours. Free at Emergency Departments
Laboratory	√		Blood tests, urine tests	Health funding may mot meet all the costs of some laboratory tests
X-Ray	√		Injury related	ACC meets most of the cost of the X-ray. Usually a part charge
X-Ray		√	Non injury related	Health does not generally fund x-rays unless provided at a public hospital
Optometry (glasses)	√		Vision check and glasses	Health offers a maximum contribution for CSC holders. Remaining charges are met by Oranga Tamariki
Audiology (hearing)		(√)	Hearing testing and haring aides	Primary health agreement covers the cost of hearing assessments (waiting times) Cost of private providers are not met by Health

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Our responsibilities regarding health costs

Principles

Examples

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