Top 85 Visitors Health Insurance

Top 85 Visitors Health Insurance is our comprehensive cover, with benefits for an extensive range of hospital, medical and extras services.

Hospital component

What's covered?

We cover all services where a Medicare benefit is payable, including:

• Ambulance services
• Appendicitis treatment
• Removal of tonsils and adenoids
• Surgical removal of wisdom teeth (for hospital charges only)
• Knee reconstruction surgery and investigations
• Shoulder reconstruction surgery and investigations
• Heart-related services
• Obstetrics-related services, eg. pregnancy
• Fertility treatment eg. IVF & GIFT programs
• Hip and knee joint replacement surgery
• Renal dialysis
• Major eye surgery – including cataract and lens-related services
• Plastic and reconstructive surgery (excludes cosmetic surgery)
• Psychiatric treatment
• Rehabilitation treatment
• Palliative care
• All other in-hospital services recognised for Medicare benefit purposes.

For the services listed above, we pay benefits towards (less any applicable hospital excess):

• Private hospital accommodation
  • Overnight accommodation in a private or shared room
  • Same day admissions
  • Intensive care
  • Theatre fees

• Public hospital accommodation as a private patient
  • Overnight accommodation in a private or shared room
  • Same day admissions (shared room only)

• Surgically implanted prostheses and other items on the Federal Government's Prostheses Schedule
• Doctors' fees for in-hospital medical services when you are treated as a private patient.

Please note that any charge above your benefit will form part of your out-of-pocket expenses

What's not covered?

Medibank does not pay benefits towards cosmetic surgery.

Your hospital excess

An excess is an amount that you must pay towards your hospital treatment. A $300 hospital excess applies per person per calendar year for Top 85 Visitors Health Insurance but doesn't apply to any children on the membership.

Prescription only pharmaceuticals – important information

You may incur significant out-of-pocket expenses if high cost pharmaceuticals are required for your treatment when in hospital. This is because Top 85 Visitors Health Insurance only pays limited benefits for pharmaceuticals.

Most international visitors to Australia are not eligible for subsidised pharmaceuticals under the Pharmaceuticals Benefits Scheme (PBS).

Pharmaceuticals used in oncology (cancer) and other treatments can be very expensive for people who do not have access to subsidised pharmaceuticals.

For more information on the PBS visit health.gov.au or Things worth knowing

Medical component

The medical component pays benefits towards medical services that are listed under the Medicare Benefits Schedule (MBS) and provided either in or out of hospital by a doctor (eg. general practitioner or specialist).

The MBS lists a standard fee for most medical procedures (MBS fee). The amount of benefit you can expect to receive from us is calculated as a percentage of the MBS fee.

With Top 85 Visitors Health Insurance you'll generally receive more than 100% of the Medicare Benefits Schedule Fee. However, you'll have to pay any additional cost if the doctor charges more than the benefits we pay you.

With Top 85 Visitors Health Insurance you will generally receive higher benefit payments from us for medical services than with Young Visitors Health Insurance or Intermediate 70 Visitors Health Insurance.

In-hospital medical benefits

We pay benefits towards medical services provided by a doctor or specialist that are included under your hospital cover, and listed under the MBS. For example, surgeon’s fees and anesthetist’s fees. No benefits are payable for services that are excluded under your cover.

Out-of-hospital medical benefits

We pay benefits towards medical services provided by a doctor or specialist that are listed under the MBS. For example, doctor’s visits and pathology. No benefits are payable for services that are excluded under your cover.

Extras component

Extras cover helps you with the cost of services that are not usually provided by hospitals such as dental, physiotherapy and optical items.

View the comparison table to see all the services and items for which you can claim benefits and to find out about the waiting periods and annual limits that apply.

Mi Health support services

Medibank member's with hospital cover have access to Mi Health, a range of health support services that include being able to speak to Medibank nurses 24/7 on our health advice line, online health information and tools, in hospital support* and mobile health apps.

* for overnight stays at selected Member's Choice hospitals. Not available in all areas. Please call us on 134 190 for details.

Is this cover right for you?

Top 85 Visitors Health Insurance is designed for visitors, temporary residents, residents of Norfolk Island and other residents in Australia who are not eligible for full Medicare entitlements.

If at any time you gain access to full Medicare entitlements or your visa status changes, (eg. you are granted permanent residency), Top 85 Visitors Health Insurance may no longer be suitable. In these instances, you should notify us of the change in your circumstances. Medibank can still remain an important part of your private health insurance plans as we offer a range of other covers to suit your needs.

If you are coming to Australia on a student visa Top 85 Visitors Health Insurance will not satisfy your visa requirements. You should consider our Overseas Student Health Cover

If you are coming to Australia as a sponsored worker and are required to purchase private health insurance to obtain a subclass 457 visa, Top 85 Visitors Health Insurance will not satisfy your visa requirements. Instead you should consider one of our Working Visa Health Insurance covers

Things Worth Knowing

Before you join it's important that you should read and retain this information and Things worth knowing for details on things like waiting periods (including the waiting period for pre-existing conditions) and other benefit assessment information.

If you are unsure of a term or phrase used, check out our Glossary