Eligibility explained

Being eligible gives a person a right to be considered for publicly funded health or disability services (ie, free or subsidised).

It is not an entitlement to receive any particular service. Individuals need to meet certain clinical and other assessment criteria to receive many services.

Who is an eligible person?

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 checks 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.

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