People First: How Health Coaching within a Health Insurance Setting in NZ Drives Better Outcomes for All
By Rebekka Costello – Registered Nurse, PreKure Certified Health Coach, working at nib Health Insurance NZ and the HCANZA Health Equity Award Winner for 2025.
Kia ora, my name is Rebekka Costello, the HCANZA Health Equity Award Winner for 2025.
I’m a Registered Nurse and PreKure Certified Health Coach, working at nib Health Insurance NZ as a Health Coach and Clinical Advisor. Every day, I walk alongside nib members and their whānau, helping them navigate the health system, make informed choices, and find their own pathway to better wellbeing.
This is a story about thoughtfully delivered health coaching within a health insurance setting in New Zealand can create meaningful impact for individuals, families, and communities…while also offering an inspiring and rewarding career path for health coaches.
From RN to Health Coach: Finding the Fence at the Top of the Cliff
My career began with a love of frontline care. I trained as a paramedic, moved into nursing, and eventually joined the emergency department, where I learned to juggle complex priorities, support people in crisis, and make decisions with limited time and imperfect information.
During the pandemic, my maternity leave was cancelled and I returned to Level 4 lockdown, long shifts, and relentless demands. I didn’t get COVID — but I did get burnout.
A coaching conversation changed everything.
I was asked, “If money and failure weren’t barriers, what would your perfect workday look like?”
That question helped me reconnect with my values and gave me the courage to carve my own path. I discovered health coaching, applied for a role at nib NZ, and began a new chapter.
In Finding Health Coaching, I Found My Health Again
At nib, I found a system designed to support people early — not just when things go wrong. Our purpose is simple: your better health and wellbeing.
We see ourselves not only as a health funder, but as a partner in health. We invest in prevention and early intervention because it’s better for everyone: members experience improved quality of life, chronic disease burden is reduced, and costs remain sustainable.
It’s the fence at the top of the cliff — not the ambulance at the bottom.
What Makes nib Different: Protect, Connect, Empower
We call our approach “Payer to Partner,” and it’s more than a tagline. It changes how we show up in people’s lives:
- Protect:We strive to make care accessible and affordable, so members don’t delay essential treatment or rehabilitation.
- Connect:We simplify the journey — linking members to clinicians, programmes, and community resources that match their needs and timing.
- Empower:We build health literacy and confidence, so people can make decisions that reflect their values and goals.
We focus on prevention, early detection, and personalised support — helping people stay well through education and digital tools, identifying risks early, and providing one-to-one coaching for those who need it most.
Last year, over 21,700 members engaged with these services — each interaction an opportunity to remove a barrier or spark a first step toward better health.
Behind those numbers are countless moments of human connection: a question answered, a barrier removed, a first step taken.
Health Management Programmes: Coaching Embedded Where It Matters
nib offers 11 Health Management Programmes through trusted partners, many with coaching built in to support behaviour change.
Health coaching is one of these programmes and often acts as the thread that connects navigation, clinical support, and real-world action.
What Health Coaching Looks Like at nib: A NZ Health Insurance Setting
Our members have access to six sessions with a health coach. Coaching calls last 45–60 minutes, giving us time to slow down and truly listen.
We support members to set meaningful goals, track progress, celebrate wins, and stay accountable in ways that feel safe and achievable.
Goals can be small — but powerful:
- Eating an apple again after years of dental issues — unlocking nutrition, confidence, and self-care
- Returning to Christmas dinner after throat cancer treatment — reclaiming joy and family connection
- Hosting a Sunday meal while living with depression and anxiety — building social confidence and routine
- Adding vegetables and walking to work — reducing chronic pain, improving sleep, and lowering blood pressure
In FY25, nib’s two health coaches spent 530 hours on calls supporting 192 members — and that’s before counting the “invisible” work of coordinating providers, documenting, following up, and advocating within systems.
By tracking these hours and the outcomes they contribute to, we generate the evidence leaders need to clearly see our impact, ensuring the value coaching brings to the business is recognised and celebrated.
Aroha’s Story: The Ripple Effect of Coaching, Clinical Support, and Funded Care
I’d like to share a brief case study about a coaching client I’ve been working with. All names and identifying details have been changed, and this story is shared with permission.
Aroha is a young Māori mother of three, referred to me by our health navigators after a routine check-in. She had been booked for a diagnostic gynaecology procedure in the public system but didn’t fully understand what it was or why it was needed. We talked through the process, recovery, and reasons behind the advice.
She declined coaching at that point — and that was fine. Our role is to meet people where they’re at.
Two weeks later, I received a text:
“Kia ora Rebekka, can you call me?”
The procedure had led to a diagnosis of early cancer. She needed a hysterectomy.
Her BMI was 66.2, placing her at high anaesthetic risk. The surgical team advised lowering her BMI to around 40 before proceeding. She felt lost, unsupported, and overwhelmed.
We began by understanding barriers.
Aroha had experienced domestic violence and was carrying significant mental health distress. She had severe joint pain, pre-diabetes, and struggled with stairs. Her children weren’t attending school because she didn’t feel safe when they were away.
Together, we built a support network:
- Mental health and primary care:Therapy sessions were funded via her cover, then continued under alternative funding arranged by her psychologist. We cleared historic bills blocking access and helped her enrol with a new, supportive GP.
- Specialist and clinical input:Full cover enabled referral to a private gynaecologist for a second opinion and closer follow-up, while an endocrinologist reviewed her records, identifying and treating severe anaemia and vitamin D deficiency.
- Practical engagement:We normalised rescheduling, phone/video consults, and messaging — simple shifts that boosted engagement.
- Lifestyle coaching:We worked on sleep routines, nutrition recommendations from her dietitian, gentle outdoor movement, and social reconnection.
A few months later, Aroha mentioned she’d taken the kids on a road trip up north — a goal we’d set together. We celebrated.
The children returned to school and thrived. She enrolled in a course and passed her first exams. She could run up and down the stairs, bought herself a pair of jeans, and said she felt confident.
She asked about dental cover — her policy included it, and she received much-needed care.
Her weight-loss goal was reached. Surgery was booked.
Across roughly 15 hours of calls and provider coordination (plus uncounted admin), Aroha’s life changed in tangible ways. The ripple effect touched her children and her wider whānau.
This is the impact of health coaching when it’s woven together with clinical knowledge, navigation, and funded access: it multiplies outcomes that matter in real life.
This approach reflects a commitment to whānau wellbeing and culturally responsive care.
Wisdom We Live By
On the elevator doors at nib, you’ll find a Māori proverb.
Here is the English translation:
It is not the work of one.
We stand together.
We stand, we thrive.
This is the work of many.
What is the most important thing in the world?
It is people.
It is people.
It is people.
Every conversation, every connection, every piece of support matters — because it’s the work of many.
In health, the most important thing will always be people. And when coaches stand together with clinicians and communities, we don’t just survive — we thrive.
For Coaches: Track Your Value, Carve Your Path
If you’re a health coach, you don’t have to go it alone or spend all your energy hustling for clients. Find places where health coaching already belongs — primary care, insurers, community programmes, corporate wellbeing — and show the value and impact you bring.
Track what matters:
- Goal progress and wellbeing changes before and after engagement
- Productivity metrics (sessions, hours, admin time)
- Feedback and testimonials that capture real stories
This isn’t self-promotion — it’s how we make our work visible, credible, and sustainable.
Be brave and carve your own path. If what you’re doing isn’t working, revisit your values, set new goals, and invest in coaching for yourself — it’s one of the best decisions you’ll ever make.
Let’s Keep the Kōrero Going
Have you experienced the impact of health coaching in your workplace or community? I’d love for you to share your thoughts or stories with the HCANZA community — your perspective helps strengthen and grow our profession.
To learn more about what quality health coaching looks like across New Zealand and Australia, explore the HCANZA website. You’ll find resources on training standards, professional support, and pathways to accreditation — tools that help coaches, clinicians, and organisations stand together for better health outcomes.
To learn more about approved training programs, visit HCANZA’s directory
To find a coach https://hcanza.org/find-a-coach/
About the Author
Rebekka Costello is a Registered Nurse and PreKure Certified Health Coach. She works as a Health Coach and Clinical Advisor at nib Health Insurance NZ, supporting members across Aotearoa to achieve better health outcomes through personalised coaching and clinical guidance.
With over a decade of nursing experience across emergency care and health advisory roles, Rebekka brings deep clinical insight and a compassionate, person-centred approach to her work. As a busy working mum with ADHD, she understands the realities of balancing health, family, and everyday life, using that lived experience to connect authentically with others.
Her mission is to help people create sustainable health changes through self-awareness, evidence-based strategies, and genuine human connection.
LinkedIn: https://www.linkedin.com/in/rebekka-costello-aa8481203/?originalSubdomain=nz
