It is expected that your fee is paid immediately after the consultation, or a payment plan arranged with reception before leaving. Not paying for a service is not an option. Running accounts has proven to be too expensive and have been discontinued other than by arrangement including an accounting fee.
The cost of a consultation varies according to time taken, equipment and skills used as well as eligibility for Accident Compensation (ACC) or General Medical Services (GMS) subsidies.
- Accidents -The ACC has not made any effort to cover the real cost of medical consultations (in fact there was a decrease in the subsidy paid and there are now excessive documentation requirements), so a $30-$35 "shortfall" charge applies on all but brief ACC consultations. It is not true that ACC covers all medical costs.
- Quick Consultations (short, one problem): $5 under 6, $20-$30 older children (depending on CSC status), $30 with a Community Services Card, and $40 for adults].
- Community Services Card (CSC) -the government will subsidise some medical care if you have a CSC. To qualify, you need to be on a benefit or have an income under $23,567 (single) or $77,843 (family of 6). Find out more about your Eligibility, [or ring 0800 999 999].
- Brief & follow-up Consultations -such as monitoring a known chronic condition (under 10 minutes), is also $5 for the under 6, $35 for older children, $25 with a Community Services Card, and $45 adults].
- Home Visits -may range from free (part of terminal care) through to $130 (afterhours), less any subsidy. Expect a fee of at least $85 to $110 during the day (a taxi or ambulance is cheaper). Even then, we may still recommend a trip to the surgery or Emergency Department.
- Standard Consultations -a 15 minute consultation is a bit more expensive and will attract a "shortfall" charge for the under six of $15-$20. The "shortfall" is the difference between the cost of the service and the government subsidy. Older children will cost $40-$45, Community Services Card holders $50, and non CSC adults $65. This increase is necessary because of increased costs (such as wages, materials, on-going medical education and computerisation) and the failure of the government to take any responsibility for New Zealanders who are not in PHOs.
- Longer Consultations -a consultation that has multiple unrelated problems is likely to take longer, so will cost more and if there are additional procedures or if materials are used, there will be further costs. Expect significantly higher fees (approx. $55 per extra 15 minutes). A "full medical" could be in the order of an added $50-$65, while a half hour consultation (such as a diving medical) could cost an extra $50. Unbooked extra time is unlikely to be discounted and unless it is very urgent may be "put off" until after booked patients are seen. It is false economy to "save up problems" as ACC & government subsidies don't generally apply to the extra time and it is unfair on booked patients.
- Prescriptions, Forms and Certificates For medicolegal and quality reasons these will not be signed outside a consultation -which for these purposes can often be brief and inexpensive. In rare individual cases they may be signed but an extra fee is likely. Usually I need to see you about the details anyway, so PLEASE bring along any certificates you need filled (off work, disability, diasabled, driving etc) as you will have to come back if you don't.)
- Practice Nurse Consultations -follow-up checks (such as Blood Pressure) will now attract a small fee, and longer consultations, particularly dressings and procedures (eg smears) will attract a fee in proportion to the time and cost of materials. Vaccinations on the Immunisation Schedule, and Influenza Vaccination people over 65, or with many chronic illness, e.g. diabetes, lung disease etc remains free. Fees have had to be introduced because the government has decided not to increase the small Practice Nurse subsidy for non-PHO practices.
- Specialised procedures and Minor Surgery- Fees will depend on the time, materials and type of procedure, but are likely to be somewhat less than specialist fees. Contact Gail (receptionist) to discuss expected fee, and payment options. Also see  full medical,  Minor Surgery,  a new type of Vasectomy and  IUCD & Mirena
I can't afford these fees -I can't afford to run a practice at a loss either. I could close and work at the hospital, but I prefer family primary care medicine, or I could join a Trust and a PHO but I value my independence to work entirely for the good of the patient, so fees are a fact of life in this practice. If you are really struggling to meet medical fees, there are a number of options:
See the How you can afford quality Medical Care page