Enjoy greater value from our Members’ Choice network
Our Members’ Choice network enables us to provide you with greater value by paying higher benefits for treatment, as well as through discounts and capped fees that lower any out-of-pocket costs you may have.
We’ve negotiated agreements with the majority of private hospitals and many extras providers across Australia so you can receive greater value from your cover.
Members’ Choice hospitals
Relevant for the following covers:
- Basic Visitors Cover
- Essential Visitors Cover
- Optimal Visitors Cover
- Working Visa Health Insurance
- Working Visa Health Insurance Hospital & Medical
With Members’ Choice hospitals, you can expect:
- Convenient billing for the payment of benefits, with your invoice sent direct to Medibank Private
- To be informed of any out-of-pocket expenses prior to admission, where possible
- Pre-admission advice, for planned treatment, to help you understand what to expect from your stay in hospital
- Discharge planning advice, covering aspects such as medication instructions and scheduled follow-up appointments and services.
What you’re covered for at Members’ Choice hospitals
At the vast majority of Members’ Choice hospitals you will also be covered for expenses related to:
- Private hospital accommodation
- Private room (where applicable)
- Same day admission
- Intensive care
- Theatre fees
- In-hospital services (provided by the hospital) such as physiotherapy, occupational therapy and speech therapy to aid your recovery
- Devices such as crutches and braces to aid your recovery while in hospital
- Local phone calls, TV and access to newspapers, where available.
In addition to any out-of-pocket expenses, you will have to pay any applicable excess.
Limited out-of-pocket expenses at Members’ Choice hospitals
In a Members’ Choice hospital you may need to pay some out-of-pocket expenses.
Please check with your hospital before treatment commences. Your out-of-pocket expenses should be limited to:
- Your excess (if applicable)
- Any difference between your doctor’s charges (including pathology and radiology fees) and the benefits we pay you
- Any difference between the amounts you are charged for pharmaceuticals (including drugs issued on discharge from hospital) that are not covered by our agreement with the hospital and the benefits available to you under the extras component of your cover for pharmaceutical prescriptions (this excludes Basic Visitors Cover & Working Visa Health Insurance Hospital & Medical as these covers don’t have an extras component)
- The gap for surgically implanted prostheses and other items on the Federal Government’s Prostheses Schedule. We call these gap prostheses
- Costs for procedures not recognised for Medicare benefit purposes, for which significantly lower benefits or no benefits are payable. Please note benefits are not payable for cosmetic surgery
- Costs for services not covered, or not fully covered by our agreement with the hospital
- Costs for services, such as physiotherapy, occupational therapy and speech therapy, not covered in a small number of Members’ Choice hospitals.
Treatment in a non Members’ Choice hospital
If you are treated in a non Members’ Choice hospital you may incur significant out-of-pocket expenses. These expenses may vary between hospitals and are typically not subject to a maximum limit.
Search for a Members’ Choice hospital
For full details of benefits paid for admission to non Members’ Choice hospitals, please call us on 132 331.
Members’ Choice extras providers
Relevant for the following Visitors Covers only:
- Essential Visitors Cover
- Optimal Visitors Cover
- Working Visa Health Insurance
If you choose to be treated by a Members’ Choice extras provider you may get more from your cover. This includes capped fees and, in most cases, higher benefits than if you were treated by a non Members’ Choice provider (subject to annual limits and sub-limits). Our Members’ Choice network includes a wide range of extras providers including dentists, dental prosthetists, optical retail outlets, chiropractors, physiotherapists, podiatrists, naturopaths and acupuncturists.
With general dental, when you visit a Members’ Choice dentist you can take advantage of a free check-up, scale and clean, and fluoride treatment if clinically necessary, twice every calendar year.
We’ve also negotiated great deals with our Members’ Choice optical retail network, including:
- 20% minimum discount off the normal retail price of frames
- 15% minimum discount off lenses, contact lenses, add-ons and sunglasses
- No out-of-pocket expenses on a selected range of glasses for most members (subject to annual limits and sub-limits).
Please note Members’ Choice extras providers are limited in number and may not be available in some areas. Arrangements with providers may vary depending on their location.
Visiting a non Members’ Choice Extras Provider
For services provided by recognised providers who are not with the Members’ Choice network, benefits are payable at a fixed amount (for most services or items). Benefits are only paid for extras services provided by recognised providers.
Finding your nearest Members’ Choice provider
If you would like to know the nearest Members’ Choice hospital or extras provider for the services you require, search for a Members’ Choice extras provider.
For benefits paid by Members’ Choice providers call us on 132 331 or if calling from outside Australia +61 3 8622 5780.