Visa Update #2: Navigating the New Zealand Immigration Medical Jungle, plus A History of the United States Land Transport Network and A Woman named ‘Thank You’.

As I mentioned in my previous post, last week was both awesome and kind of shitty. If you haven’t already, go back and read the fun one first because it has pictures of ponies and is way more entertaining to read. I’m not even including pictures in this post.

So last week, in addition to hanging out with friends and frolicking with farm animals, I decided to rip off the bandaid (or “plaster,” as they say here) and tackle medical stuff, driver’s license stuff, and bank account stuff.

Medical Stuff:

One of the requirements for Immigration NZ is that I–most people–have to get a “general medical exam” and a chest x-ray. I’ve been researching this for a few years now, so I knew, and had budgeted for, these exams. But it was way more complicated and expensive than I was expecting. Hopefully sharing my experience will help someone down the line so that they’re better prepared than I was.

I quickly figured out that there is no set price for the exams required by Immigration, which….come on, guys, that’s absurd. The immigration process is difficult and stressful and time-consuming enough that I shouldn’t have to spend an entire day doctor-shopping for the best bargain price. But that’s exactly what I did: I spent hours going down the list of Immigration NZ-approved physicians and radiology places (the closest of which were in Hamilton or Auckland, each 2.5 hours away) and emailed or called all of them to ask how much they charge. The price varied by a lot, but everything is so spread out that to drive one place and save $75 would mean spending $75 in gas to get to the other place. I had pages of scribbled notes in front of me and my phone in my hand, plugging various locations into my maps app to calculate the distance.

I finally found an Immigration-approved doctor and x-ray practice in the same area–Manukau City, a suburb of Auckland–and despite my lack of confidence about city driving, I went ahead and contacted the doctor’s office. We had so many emails flying back and forth that I lost count. It didn’t help that the woman I was writing back and forth with used excessive punctuation, which I found incredibly stressful.
They needed a copy of my passport, of course, and then had me fill out paperwork pertaining to which sort of visa I’m applying for. But they didn’t have the actual, official visa names; they had things like “Work Visa with a Job Offer,” “Work Visa Without a Job Offer,” etc. I checked the second one and send the form in.
The woman emailed back “But what do you do for work???” (<—see what I mean about the excessive punctuation??? The entire time I thought she hated me).
I politely explained that I don’t work….because I….can’t work? Because I don’t have a work visa? Which is why I am applying for a work visa?
“But did you not work in the United States???”.
For the love of god, lady. Yes, of course I worked in the States. Is that what you meant? Cuz that’s super unclear on your form. I told her I was a gardener for four years, if that’s what she wanted to know. She replied “That is all that we needed to know!!!!”. (OKAY LADY!!!!!!!!!!!!!!!).
I should mention that she was quite nice, and non-aggressive, in person.

Funny aside: the woman signed each email “Ngā Mihi.” I assumed that was her name, right? But then I received an email from a woman at a completely different place that was also signed “Ngā Mihi.” I’m no detective, but it seems…..unlikely…..that I’d somehow managed, in the span of an hour, to contact two people with the exact same unusual name. Thankfully I googled it, because “Ngā Mihi” means “Thank You” in te reo Māori, so I was *this close* to walking into the doctor’s office and going “Hey, you must be Thank You! Thank you for all of your help setting this up.” I’ve definitely heard “Ngā Mihi” spoken out loud, but I guess I pictured it being one word. The number of things that are new about living in a new country are really astounding.

Finally I appeased the !!!!!overly aggressive but actually very nice in person office manager lady!!!!—-whose name is not Ngā Mihi—and was able to book an appointment for last Monday. I was……surprised……to find that the doctor’s office was located on the upper level of a shopping mall. And they also only took cash for the $150 Immigration exam. I was filled with skepticism, but while I spent time in their waiting room I listened to them field a number of phone calls about immigration medical exams, which was reassuring.

I met with an NP first, who examined my passport, took my blood pressure, put one of those devices on my fingertip to measured the saturation of oxygen in my red blood cells (thank you, Google), gave me a very basic eye exam, took my height and weight, asked if I was pregnant, took down my medication information (I brought the actual bottles with me), and finally had me give them a urine sample, which does not entail peeing into the little plastic cup but in fact involves an awkward little square-shaped plastic container that you pee into and then have to tip into a very tiny vial. Again, the number of new things you encounter in a new country…

The NP was very sweet, and when I told her how stressful I was finding this whole visa process is, she said “My friend, it’s a lot to go through but you’ll get there.” Bless her. Ngā Mihi!

Then I met with the doctor himself. I was prepared for an intense physical, and had even come armed with a PDF of the last 8 years of my medical records, but it was shockingly brief. He listened to my heart, checked my ears, gave me a breast exam, asked if I had any allergies, and asked if I’ve had any surgeries. Easy peasy. The hard part was when we got to my medications.

I’m gonna lay it out for you guys because when I started this blog I promised as much transparency as possible, and also because I’m a big proponent for destigmatizing the social taboos surrounding mental health issues: I take three medications, one of which is an antidepressant and one of which is an anti-anxiety. I knew the latter would likely be tricky, as benzodiazepines are highly controlled in the States, but it did not occur to me that the fact that I was on these medications in the first place would give him such pause. He asked me a number of questions about my mental health history, including voluntary or involuntary hospitalizations (no to both), how long have I felt stable, have I every seen a therapist, etc. He asked if I’ve seen a psychiatrist in the last six months, which I have not, so he said that Immigration may contact me after I’ve submitted my visa and require me to meet with one (UPDATE from April 2024: yep, they did require me to get a psych eval). More appointments, more long drives, more money shelled out. Ugh. And then there was the bloodwork (unrelated to the fact that I take medications) that I apparently also needed to have done, which was something that had not come up in my visa research. He said I had to go to a walk-in lab, and recommended one across town. Yet another unexpected expense. But what choice do I have? And I have to think long term: I’m doing all of this so that I can live here in this extraordinary country with my extraordinary partner. Suck it up, buttercup.

The next day was Waitangi Day, a national holiday which I will discuss in a future post, so I had to wait until the day after to get the chest x-ray ($170 NZD) and bloodwork ($207 NZD). Adding the $150 NZD for the general medical exam and we have a grand total of $527 NZD–about $326 USD–for all of the required medical exams. Plus the cost of the gas to get there and back, which was 215 miles round trip and honestly I don’t feel like calculating that cost but it ain’t cheap. Again, I knew roughly what I’d be spending for the medical exam and x-ray, but the extra charge for the bloodwork was a surprise. And I’m really not psyched about having to wait and see if they flag my application and make me shell out the time, travel, and money for a psych eval. 😔

A few days later, I received an automatic email from the doctor’s office saying that they’d submitted all of my medical files to Immigration (the x-ray and bloodwork place both sent my records to the doctor), and provided me with my New Zealand eMedical Reference number and my Immigration New Zealand Health Case Reference number. I immediately went online typed those numbers onto my visa application, which felt good. Now I can (hopefully) cross off all Immigration-related medical expenses and appointments.

Once I got home from Manukau City, I decided I may as well continue to psychologically and financially torment myself and deal with how I was going to go about getting my pesky prescriptions filled when I run out in about 6 weeks. I’d emailed the local medical center last year, explaining that I would be here on a visitor’s visa for 6-7 months until I could procure a work visa, and asked how I could go about getting my medications refilled. They told me to just come in (it’s a walk-in center) and shell out the Non-NZ Resident fee of $175 NZD (which turned out to be $185 NZD, or $114 USD; they must have raised their prices) to meet with a doctor, and they’d take care of having the prescriptions filled for me for a cost of $3-$5 each. Easy peasy, right? Of course not.

I waited for a while and met with a very nice doctor who explained to me that two of the three medications I take cannot be filled–even by her—before I’ve gone in for a psych evaluation, which is something I have to do every two years. She emphasized that this rule (law?) applies to everyone, Kiwi or Non-Kiwi, who take these two (and probably many other) medications. I knew the anti-anxiety medication would be a bitch to get filled, but I was really thrown for a loop that I couldn’t have my very common antidepressant, which I have been on for twelve years and have the medical records to prove it, filled without seeing someone first. I mean, I feel like people who take antidepressants are ubiquitous, at least in America (which should surprise no one because just read the news and you yourself will need an antidepressant–and a benzodiazepine. I kinda feel like Americans trying to move to New Zealand right now should be given a pass on their mood stabilizing medications). Kidding.
But in all honesty, I do respect the fact that New Zealand doesn’t just throw medications around like confetti. Having to routinely meet with a psychiatrist if you’re on a prescription drug for mental health issues does make sense. I was just throwing a small internal tantrum over having to do it because I knew it meant spending even more money that hadn’t been on my super-thorough list of anticipated visa-related expenses……
Also, now that I’ve had a few days to digest all of this, of course New Zealand would want to send someone on antidepressants for a psych evaluation to make sure they won’t routinely wind up in the hospital, burdening their healthcare system. I just hadn’t thought about that. Now I know–and now everyone reading this knows.

The doctor recommended this practice in Auckland whom she’s worked with a lot; she said they’re understanding and generally just really great. She said she’d send them a referral and a letter saying that I needed a psychiatric evaluation but that in her opinion, I was smart (😊) capable ( 😃) and mentally sound (🤔). She left for a few minutes and when she came back she handed me a copy of a specialist reference letter she’d just sent them.
I called them as soon as I got home, only to find that their next appointment isn’t until mid-April (my medication will run out several weeks before that) and that the hour and a half long evaluation would cost me $560 NZD ($344 USD). What the—?! I said I had to call them back and hung up the phone. I can pay for it, lest anyone feel like they need to wire me money; it was just a shocking price tag. That’s more than all of the medical exams combined, even with the fee for the unexpected bloodwork.
I spoke to a Kiwi friend that night, telling her the story in a “Can you believe that?!” kind of way, and she just sighed and said “Yeah.” She’s heard this before. And in fact I contacted a number of other places who charge more–some up to $1,100. Jesus H.
I’m going to see if at least some of my prescriptions can be filled back home and have one of my parents pick them up and mail them to me (my parents have been doing a bunch of favors/favours for me–thank you both!). But I may have to “suck it up, buttercup” again and pay the fee (and petrol) to go to Auckland if that plan doesn’t work. Plus there’s a chance Immigration may make me get a psych eval anyway, so…….ugh. Like I said, it was a long week. But wait, there’s more! Because now we have the…….

Driver’s License Stuff:

While I was in Manukau City, I figured I’d drop in to the AA Centre (NZ’s DMV) to convert my overseas driver’s license (which just means getting a NZ license; I still keep my Massachusetts one). You can drive on an overseas license for a year here, so technically I don’t need my NZ license until January 2025. But since I’m trying to collect as much solid evidence as possible that I am established in this country, and since I currently have a lot of free time on my hands, and since it was just a 20 minute drive from where I was, I figured I may as well get it done now. (By the way, America is on a list of countries whose drivers do not need to take a road test in order to get a NZ driver’s license, which is odd to me since we don’t even drive on the same side of the road but whatever/yay!).

I’d come prepared with the necessary documents, which is a simple two-page form and a full color copy of my passport and my MA driver’s license. I waited for about half an hour. Oh, the way they wait at the DMV here—or at least at the one in Manukau City–was both baffling and adorable. There’s no machine where you get assigned a ticket number, but there are three rows of plastic chairs, and when you arrive you sit in the one closest to the door, and every time someone is called up, everyone gets up and shifts over. It’s like DMV musical chairs. My seatmates and I giggled about it. Anyway, my turn came around and I skipped up there, all proud of myself for being so organized and getting this out of the way so quickly, but after examining my license the woman handed it back to me and said that I needed to have held a valid driver’s license for at least two years. Which I have, of course; I’ve been driving legally and uninterrupted-ly for nearly 30 years. The problem, however, was that I switched over to a REAL ID* in September 2022, so all that they can see is that I have held a valid driver’s license for 17 months. Shit. This never even occurred to me, but of course she was correct. And my damned license even says it was “issued in” September 2022, not “REissued in.” The woman apologetically told me that I needed to contact the United States Land Transport to procure a certified history of every time my license has been renewed. I sighed, thanked her, and left. Luckily it hadn’t wasted much of my time, since all I had to do was drive across the city and wait for a little while. Still, it would have been really reassuring to cross this off my list.

When I got home I looked over my hastily scribbled notes. The United States……Land Transport? Is that what that says? Okay, so I googled “United States Land Transport” and the first hit was a website about heavy freight transport quotes. Then bulk equipment quotes. The third hit gave me a history of the US transport network, which is a “45,000 mile interstate system known and the Dwight D……”. Yeah, no. So I called NZTA (NZ Transport Agency), waited on hold for a very long time, finally got a very pleasant woman on the phone, explained my situation, and she went “A United States what? I have no idea what that woman was talking about. No, here’s what you need…….” and proceeded to tell me something different.

I just want to take a moment to make this very long post even longer and ask this: is everyone not looking at the same screen? Two people at NZTA told me two different things. Three people at Immigration have told me three different things. Back home I used to have this problem all the time with MassHealth, Verizon, you name it. Why does the answer to your question vary depending on who answers the phone? I mean, I ran an independent bookstore for ten years and no matter which one of us you spoke to about our return policy/ordering turnaround time/what have you, you got the same answer to your question, and we most certainly did not have a manual to refer to. And we were dealing with books; this is immigration, driver’s licenses, healthcare…..get your act together, you guys. (Sorry; I’m just frustrated).

The very nice NZTA woman on the phone explained that I needed something that they here in NZ call a “list of particulars” but she had no idea what it was called in….which state was I from? She’d be happy to try and figure it out with me. Bless her. We never found an actual name for this document, but it boiled down to the fact that yes, that other woman was correct about one thing: I needed a certified history of every time my license has been renewed. She advised me to contact the Mass DMV and wished me luck.

I scoured the MA DMV website, even going so far as to email them despite figuring I’d get a form response in like 12 weeks if I was lucky. I Googled until my fingers bled. I tried every combination and synonym of the words “Drivers” “License” “History” “Renewal” “Rundown” that I could come up with. Nada. And then, wonder upon wonders, the MA DMV emailed me back (mea culpa, Mass DMV, you are much more efficient than I gave you credit for) and sent me this link to something which they said “may or may not” be what I needed but it was the closest thing they could find. So I downloaded the PDF, filled it out (thanks to this nifty free PDF tool I found on Reddit), and emailed it to my Dad along with a copy of my license, asking him to mail it all off with a $5 check, and then look for a piece of mail in about two weeks which he then has to open, scan, and email to me, and it “may or may not” be what I need. 🤞🏼 If it isn’t, I have the option to schedule, pay for, and take a driver’s test to get my NZ license, but if it comes to that I’ll just wait until September.

*For my non-American friends: by May of 2025, every US citizen is required to have a REAL ID in order to fly domestically. It seems like it’s just a souped-up version of a regular driver’s license that has added security measures and a little star in the corner. Originally everyone had to have one by (I think it was) 2020 or 2021, but they kept pushing it back because of Covid. I can’t honestly remember if I needed to convert to a REAL ID in September of 2022 or whether I was just being proactive, but either way: urggggggh.

Bank Account Stuff:

I’ve changed my mind about this part of the post; I can’t even get into the bank stuff right now. Everyone I’ve dealt with at the town’s three banks has been exceedingly nice, but each bank is open (I’m not kidding) ten hours a week, and two people from the same bank gave me extremely conflicting information (Yes I can open an account with them, of course I can, they would welcome me as a new customer!/No, I cannot open a bank account with them because I need to get a visa, even though I can’t get a visa without a bank account*). Again with the question about “is everyone not looking at the same screen…….”.

*Technically yes, I can get a visa without a bank account, but having a bank account goes a long way.

I do want to add, despite this very long and frustrated rant, that every single person I interacted with in this post was either perfectly pleasant or exceedingly nice, even if they ultimately couldn’t help me. I feel that it’s important for me to point this out.

I really appreciate any of you who actually made it through this monster of a post. Man, this whole immigrating-to-another-country thing is NOT easy, but I couldn’t do it without you guys. I mean it.

Ngā mihi. 🥰