Top 85 Working Visa Health Insurance
Medibank Top 85 Working Visa Health Insurance is only available to people who are in Australia on certain working-type visas approved by Medibank.
This includes the following visa sub classes:
- 411 Exchange
- 419 Visiting Academic
- 420 Entertainment
- 422 Medical Practitioner
- 442 Occupational Trainee
- 456 Business Short Stay
- 457 Temporary Business Long Stay
- 470 Professional Development
If you are in Australia on a working-type visa but your visa sub class is not mentioned here, you can contact us to find out if you are eligible for a Working Visa Health Insurance cover.
For more information, see Is this cover right for me?
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
- Plastic and reconstructive surgery (excludes cosmetic surgery)
- Fertility treatment eg. IVF and GIFT programs
- Hip and knee joint replacement surgery
- Renal dialysis
- Major eye surgery – including cataract and lens-related services
- Psychiatric treatment
- Rehabilitation treatment
- Palliative care
- All other in-hospital services recognised for Medicare benefit purposes.
For the services listed above, we pay benefits (less any applicable hospital excess) towards:
- 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)
- Doctors' fees for in-hospital medical services when you are treated as a private patient, and the service is not excluded on your cover
- Pharmaceutical Benefits Scheme (PBS) listed drugs, prescribed according to PBS approved indications, that are administered during and form part of your admitted episode of care (including drugs prescribed upon discharge)
Note: Any charge above your benefit we pay will form part of your out-of-pocket expenses
Your hospital excess
Your excess is an amount that you must pay towards your hospital treatment. With Top 85 Working Visa Health Insurance you have the option to select an excess in exchange for lower premiums. If you select the excess option a $300 hospital excess will apply per person per calendar year and will not apply to any children on the membership.
Medical component
Top 85 Working Visa Health Insurance provides benefits towards medical services, provided either in or out of hospital, that are listed under the Medicare Benefits Schedule (MBS) and provided 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. However, you will have to pay any additional cost if the doctor charges you more than the benefit we pay you.
In-hospital medical
The benefits you receive for medical services provided in-hospital (eg. Surgeon’s fees, anesthetist’s fees).
Out-of-hospital medical
The benefits you receive for medical services provided out-of-hospital (eg.doctor’s visits, pathology).
With our Working Visa Health Insurance covers you'll generally receive higher medical benefits than the benefits paid to a permanent Australian resident under Medicare.
Prescription only pharmaceuticals - important information
Most international visitors to Australia are not eligible for subsidised pharmaceuticals under the Pharmaceutical Benefits Scheme (PBS). Under our Top 85 Working Visa Health Insurance we'll pay you benefits that are equal to the PBS government subsidy in excess of your patient contribution. If high cost pharmaceuticals are required for your treatment when in hospital, you may incur significant out-of-pocket expenses.
For more information on the PBS visit www.health.gov.au or Things worth knowing
Extras cover
Extras cover helps cover the cost of what we call ‘everyday' health services, such as trips to the dentist, optical items and physiotherapy.
Percentage back at Members' Choice
When you have Top 85 Working Visa Health Insurance and visit a Members’ Choice extras provide for eligible services, you’ll get a percentage back of the charge (up to applicable limits).
Fixed benefit
A fixed benefit is the maximum amount we’ll pay for each service or item (up to applicable limits). Usually it will be less than the provider’s charge, which means you may have out-of-pocket expenses to pay.
Annual limits
Our Top 85 Working Visa Health Insurance cover has annual limits. This is the maximum amount of benefit we'll pay for items or services in a calendar year. The benefit we pay for a particular item or service may be less than the annual limit and less than your provider's charge, which means you may have out-of-pocket expenses to pay.
Orthodontic entitlement
You start with an opening balance in the first year and you're topped up with an additional amount each full calendar year of membership up to a maximum lifetime limit for your level of cover. Once you've served your 12 month waiting period, you can claim up to 100% of your balance.
Benefit replacement period
You might need to wait for a period of time from the date of purchase of some items before you're entitled to another benefit to replace the item.
Free dental check-ups
With Top 85 Health Insurance you get one free dental check-up, scale and clean (excludes x-rays) per person per calendar year at a Members' Choice dentist.
View the Extras 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.
Additional service – repatriation benefit
If someone on your membership has to be repatriated to your home country due to a substantial life-altering illness or injury, Medibank may arrange and pay the reasonable cost of return travel with the appropriate medical supervision. The provision of any repatriation benefit is at the discretion of Medibank. Conditions apply, for further information contact us
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.
Top 85 Working Visa Health Insurance is designed for international visitors who are in Australia for business purposes or who are sponsored by an employer and are not eligible for full Medicare entitlements. It helps cover the cost of hospital treatment, medical services (provided in and out of hospital) and extras services.
Having "adequate arrangements for health insurance" is a mandatory condition of subclass 457 visas granted from 14 September 2009. This means that most subclass 457 visa applicants will be required to purchase a certain level of private health insurance for themselves and their dependants for the duration of their visa. Top 85 Working Visa Health Insurance satisfies the requirements for subclass 457 visa applicants/holders.
Note: Subclass 457 visa applicants who propose to remain in Australia for less then 3 months or who are adequately covered by reciprocal health care agreements may not be required to take out private health insurance. For more information, visit the Department of Immigration and Citizenship website at www.immi.gov.au
If at any time you gain access to full Medicare entitlements or your work visa status changes (eg. you are granted permanent residency), Top 85 Working Visa 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 Working Visa Health Insurance will not satisfy your visa requirements. You should consider our Overseas Student Health Cover
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
