+ For Accidents that occur in Australia after your cover starts. Must seek medical treatment within 7 days, and receive hospital treatment within 12 months of the Accident occurring. Excludes Private Emergency Department Benefit, hospital bonus, claims covered by third parties and our Private Room Promise. Out-of-pocket costs may apply.
The amount you can claim back at Members’ Choice providers, up to annual limits. Fixed amounts apply at non-Members’ Choice providers, up to annual limits.
The amount you pay before Medibank contributes to your hospital costs.
Your cover also includes
Hospital cover
- Rest assured you'll receive the benefits of our Gold level of Hospital cover in the event of an Accident⁺
- Unlimited Emergency Ambulance Australia-wide^
What is a waiting period?
The time you need to wait before you can receive benefits for services or items listed in your cover.
When do they apply?
To new members, or when switching to a higher level of cover.
Switching funds?
If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served.
What is a pre-existing condition?
An ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by Medibank, the signs or symptoms existed at any time during the six months before you either took out your new cover, or transferred to a higher level of cover (12 month waiting period applies).
| Inclusions | Waiting period
What is a waiting period? The time you need to wait before you can receive benefits for services or items listed in your cover. When do they apply? To new members, or when switching to a higher level of cover. Switching funds? If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served. What is a pre-existing condition? An ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by Medibank, the signs or symptoms existed at any time during the six months before you either took out your new cover, or transferred to a higher level of cover (12 month waiting period applies). |
|---|---|
| 1 day | |
| Nil | |
| 2 months | |
| 2 months | |
| 2 months | |
| Nil |
| Exclusions |
|---|
Hospital costs explained
Hospital cover helps with the cost of treatments you receive in hospital as a private patient. Of course, everyone is different, and so our Hospital covers come in all shapes and sizes to suit different priorities and stages in life.
For services included under each of our Hospital covers, we’ll pay benefits towards:
- Eligible ambulance services
- In-hospital medical services
- Overnight accommodation in a private hospital, or a shared room in a public hospital as a private patient
- Same-day admission
- Intensive care
- Theatre fees
- The minimum benefit for medical devices and human tissue products as set out in the government's Prescribed List of Medical Devices and Human Tissue Products
Depending on your cover you may need to pay an excess or co-payment before we will pay any benefits towards your hospital admission. Other out-of-pocket expenses may apply.
- Services not included in your cover or for which you are serving waiting periods
- Some high-cost medications
- Services not covered by Medicare
- Medical devices and human tissue products in excess of approved benefits in the Government’s Prescribed List
- Cosmetic treatments
- Certain other items (e.g. streaming services and parking), depending on the hospital you're admitted to. The hospital should discuss any charges with you.
It's a good idea to call us on 132 331 so we can take you through what we will pay benefits for, and let you know of any potential out-of-pockets you might expect for your procedure.
Extras cover
- You choose the cover to suit your budget and lifestyle - 60% or 75% back from Members' Choice Providers.
- Cover to help you look after your day-to-day health and wellbeing, plus a range of extras services to help your body move better.
- 100% back on your first consultation at a Members' Choice provider for one of the following services - physiotherapy, chiropractic, remedial massage or acupuncture.**
- 100% back for kids at Members' Choice providers, up to annual limits.##
- 100% back on annual flu vaccinations up to annual limits.^^
| Inclusions | Annual limits per person | Waiting period | |
|---|---|---|---|
| Claim back percentage: | 60% | 75% | |
| Claim back percentage: | |||
| N/A | N/A | 1 day | |
| 2 months | |||
| $400 | $750 | 2 months | |
| $350 | $450 | 12 months | |
| $150 combined limit | $200 combined limit | 6 months | |
| 2 months | |||
| $200 combined limit | $400 combined limit | Nil | |
| 2 months | |||
| 2 months | |||
| $300 combined limit | $400 combined limit | 2 months | |
| 2 months | |||
| 2 months | |||
| 2 months | |||
| $150 | $200 | 2 months | |
What are annual limits?
The maximum amount of benefits payable towards services, items or groups of services and/or items in a calendar year.
Switching health funds?
Benefits paid under your previous cover will be taken into account in determining the benefits payable under your Medibank cover.
What is a waiting period?
The time you need to wait before you can receive benefits for services or items listed in your cover.
When do they apply?
To new members, or when switching to a higher level of cover.
Switching funds?
If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served.
Extras costs explained
Extras cover gives you money back for non-hospital services such as dental, physio, optical and more.
The amount of money you can claim back depends on the level of cover you have. Generally speaking, the higher the level of cover, the higher your annual limit and higher the percentage you can claim back. Which means more money back in your pocket.
- 100% back on at least one dental check-up and clean each year at a Members’ Choice or Members’ Choice Advantage provider.=
- 100% back on optical items at all recognised providers up to annual limits. Excludes Healthy Living Extras.±
- Access to Members’ Choice, one of the largest health provider networks in Australia, covering more than 12,000 providers. We’ve set maximum prices that these providers can charge, so you’ll avoid any surprises when the bill arrives.
With a Members' Choice provider, you'll receive a fixed % back on services, up to your annual limits.
If your extras provider isn't part of our Members' Choice network don't worry. As long as they're a Medibank recognised provider, we'll still pay a fixed amount for each service or item, up to your annual limits.
Awarded Outstanding Value Health Insurance 18 years running
We're proud to deliver award-winning health insurance products, but don't just take our word for it. Canstar have awarded Medibank an outstanding value award for health insurance in Australia for the 18th year in a row.
Why choose Medibank?
30 day cooling off period
If you're not completely happy with your cover in the first 30 days of joining, let us know and we'll transfer you to a more suitable cover or refund your premiums (as long as no claims have been made).
Unlimited emergency ambulance
No matter which Hospital or Extras policy you choose, you'll have the peace of mind that comes from knowing that your cover includes unlimited emergency ambulance.^
Access to Live Better rewards
Live Better rewards is a health and wellbeing program inspiring, supporting and rewarding you to eat, move, and feel better, all while enjoying the things you do every day.
Medibank members with eligible Hospital or Extras cover could earn up to $400 a year in rewards% by redeeming the points earned for taking healthy actions. Plus, if you shop with our partner brands, you could earn even more points.≈
Want to discuss your options?
Leave your details and a Medibank expert will be in touch to take you through your options. In providing your telephone number, you consent to Medibank contacting you about health insurance.
Things you should know
= Eligible members on Medibank extras (excluding Healthy Living Extras and Gold Ultra Health) can claim a maximum of two 100% back dental check-ups per member, per year at a Members’ Choice Advantage provider (including bitewing x-rays where clinically required). For members on eligible extras, the first two check-ups do not count towards your annual limit. Members with Healthy Living Extras can get 100% back on one dental check-up each year at a Members’ Choice Advantage provider (including up to two bitewing x-rays, where clinically required) or at a Members’ Choice provider (excluding x-rays). Members with Gold Ultra Health can get 100% back on up to three dental check-ups at a Members’ Choice or Members’ Choice Advantage provider. Members’ Choice and Members’ Choice Advantage providers are not available in all areas. Two month waiting period applies. Some products may have other dental benefits, check your cover summary for details.
≈ Must be 16 years or over to register for Medibank Live Better rewards. Must be a Medibank member with hospital cover, extras cover, or hospital and extras cover, be up-to-date with premium payments and have signed up to Medibank Live Better rewards with My Medibank to earn Live Better points for eligible purchases and redeem rewards. Excludes Overseas Student Health Cover (OSHC), Ambulance only cover, ahm covers and other selected covers. Live Better Management Pty Ltd, ACN 003 457 289 has entered into commercial arrangements with Medibank Live Better rewards program partners and may receive commissions. Additional terms and conditions may apply to points earning activities and rewards. Points earning activities and rewards are subject to change and may be subject to availability. Wherever possible, we will give you notice of these changes. Some program partners and earning activities require a person to be at least 18 years of age to be eligible to earn and/or redeem a reward. See full Medibank Live Better rewards terms.
! 20% gym discount with Fitness First and Good Life Health Clubs applies to new, full price 12 & 18 month Platinum memberships purchased by eligible Medibank members with hospital or extras cover. The 20% discount with Zap Fitness applies to any 12 or 18 month membership. Not available in conjunction with any other offers or discounts. To obtain the discount, simply present your photo ID, Medibank Membership Card and the partner offer page within the My Medibank app when signing up at any participating gym. The name and email address used to sign up at the gym or online must exactly match the details attached to your Medibank account in order to earn Live Better points for attending the gym. By signing up to this offer you permit Fitness & Lifestyle Group to share your personal information (including name, date of birth, contact details, gym location and gym attendance records) with Medibank and Live Better. Medibank and Live Better will collect this information to assess your eligibility for Live Better points, award the Live Better points and to monitor uptake of the Live Better program. If you elect not to share this information you will not be eligible for the discounted gym membership or Live Better Points. Medibank’s Privacy Policy (https://www.medibank.com.au/livebetter/rewards/terms/) contains information about how you can seek access to, and correction of, your personal information, or make a complaint about a breach of the Australian Privacy Principle. Full gym membership terms and conditions can be found at https://www.fitnessfirst.com.au/terms-and-conditions/, https://www.goodlife.com.au/terms-and-conditions/ or https://www.zapfitness.com.au/terms/. This offer may be withdrawn at any time.
¥¥ Some referred services may involve out-of-pocket costs and waiting periods may apply.
^ Waiting period applies. For ambulance attendance or transportation to a hospital where immediate medical attention is required and your condition is such that you couldn't be transported any other way. TAS and QLD have State schemes that provide ambulance services for residents of those States.
** Waiting periods apply. Subsequent consultations will have an out of pocket cost.
## Waiting periods apply, including 12 months for some dental services. For Child Dependants (up to 21 years) and eligible Student Dependants (up to 31 years). Members’ Choice providers not available in all areas.
^^ Benefits are payable towards the influenza vaccine only and not payable towards any other fees, including administrative fees or GP consultations. Some individuals may be eligible for free influenza vaccines under a Commonwealth or State scheme, such as the National Immunisation Program, or similar schemes. Benefits are not payable where influenza vaccines are administered under such a scheme.
# Medibank has Members' Choice providers for these services only. By choosing a Members' Choice provider you are guaranteed to receive the percentage back shown on the cover.
~ Some items and services may require a Referral Letter and may have a benefit replacement period. Please see the Cover Summary or Member Guide for more information.
¶ Counsellors must be registered with Australian Counselling Association, Psychotherapy and Counselling Federation of Australia, Australian Traditional Medicine Society. Mental Health Social Workers must hold a mental health accreditation by the Australian Association of Social Workers. Medibank will pay benefits towards pharmacogenetic tests for all conditions. Benefits will only be paid towards pharmacogenetic tests administered in-person, or for approved home kits where supporting documentation from a medical practitioner outlining the clinical purpose is supplied.
± Excludes Healthy Living Extras and select products that are no longer available for sale (for more information check your cover summary or check this page). Applies to prescription glasses and select contact lenses. Some glasses lens coatings and contact lenses are excluded. To find which specific items are included or excluded, call us on 132 331. 6 month waiting period applies.
% Live Better rewards members could earn up to 40,000 Live Better rewards points each calendar year for successfully completing select Live Better rewards points-earning activities. These activities include, but are not limited to, health and wellbeing challenges, the Weekly Goal, onboarding actions, partner activity earn and the daily auto-tracking bonus. This does not include points earned by shopping with Live Better rewards partners or visiting Members' Choice Advantage providers. 40,000 Live Better points could be redeemed for up to $400 worth of rewards from the Live Better rewards store.