Medibank Special Purpose Fund
The Medibank Private Special Purpose Fund (SPF) was established to provide funding for qualifying applications in relation to certain leading-edge clinical intervention procedures, such as new drug therapies, surgical procedures, and other medical treatments not usually covered under Medibank Private’s fund rules.
A total of $5 million has been committed to the SPF. Once the total amount of $5 million has been expended or committed, no further applications will be considered.
What is the Medibank Private Special Purpose Fund?
The SPF is not top-up funding. It is a discretionary funding arrangement designed for promising new, leading-edge treatment procedures which are not experimental in nature. It is intended to provide our members with access to new treatments which are not currently covered under our current benefit criteria.
Who is eligible to apply to the Special Purpose Fund?
Members of Medibank Private who held a resident hospital cover for 12 months or longer and satisfy certain qualifying criteria. The Special Purpose Fund is not available to members who hold Overseas Student Health Cover, Basic Visitors Cover, Visitor Cover Packages, Working Visa Health Insurance, Ambulance Cover and Extras only covers.
What treatments are covered by the Special Purpose Fund?
SPF will provide funding for certain leading-edge clinical treatments. The intent is to provide members with access to new and innovative treatments, which are ineligible for funding under our current benefit criteria.
Leading-edge treatments must be supported by strong scientific research, have current research and clinical practice results and have clinical expert opinion.
The SPF will not pay for treatments or interventions that Medibank Private would normally pay for on behalf of its members, nor is it available for members to access treatment or interventions that are restricted or excluded under their policy. It does not cover cosmetic or experimental treatments. Further information regarding services excluded from eligibility and consideration for payment from the SPF is detailed in the Notes for Applicants.
How do I apply for funding from the Special Purpose Fund?
The Notes for Applicants can be viewed or downloaded and will assist you in identifying whether the member and treatment may be eligible for consideration of a benefit under the Special Purpose Fund.
If, after reading the Notes for Applicants, you believe that your membership and treatment are eligible for consideration, please print, complete and sign the Special Purpose Fund Application Form. Please note that the Special Purpose Fund Application Form requires that your treating medical practitioner complete specific sections.
Medibank Private will acknowledge receipt of your application in writing. We will process your application and forward it to the independent Approvals Committee if it meets all of the prequalification criteria. If required by the Approval Committee, further information may be sought from you and/or your medical practitioner.
Where can I get more information on the Special Purpose Fund?
The Notes for Applicants contain the details regarding the Special Purpose Fund, including information on eligible and excluded treatments, eligible memberships, and the application and approval process.
Should you require further information, you can email your questions to MedibankSPF@medibank.com.au