¥¥ Some referred services may involve out of pocket costs and waiting periods 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.
Hospital & Extras offer - Track every step with an Apple Watch from Medibank
Join and maintain eligible Medibank hospital and extras cover and you could earn 100,000 Live Better points (couples and families) or 50,000 Live Better points (singles and single parents) to redeem on rewards such as an Apple Watch. Plus, we’ll waive 2&6 month waiting periods on extras. Use promo code: LIVEBETTER. Bands are subject to availability. Offer ends 18 December 2024. New members only.‡
Your cover also includes
Hospital cover
- Cover for a wide range of hospital procedures and investigations including treatment for Back, Neck and Spine
- Rest assured you'll receive the benefits of our gold level of Hospital cover in the event of an Accident⁺
- Better value for families with no hospital excess for kids on a family membership
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). |
---|---|
Nil | |
1 day | |
Nil | |
2 months | |
2 months | |
2 months | |
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
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
- Supporting mums and mums-to-be with cover for antenatal classes and pregnancy compression garments
- Save money with 100% back on extras for kids up to annual limits at Members' Choice Providers**
- You choose the cover to suit your budget and lifestyle - 60% or 70% back from Members' Choice providers
- 100% back on up to two dental check-ups every year (including bitewing x-rays) at any Members’ Choice Advantage dentist1, OR
- 100% back on an annual dental check-up & clean at any Members' Choice dentist, on top of your annual dental limit (excludes x-rays)1
Inclusions | Annual limits per person | Waiting period | |
---|---|---|---|
Claim back percentage: | 60% | 70% | |
Claim back percentage: | |||
No annual limit | No annual limit | 1 day | |
N/A | N/A | 2 months | |
$750 | $1000 | 2 months | |
$400 | $800 | 12 months | |
$100 | $200 | 12 months | |
$200 per person | $225 per person | 6 months | |
Combined limit. $150 per person | Combined limit. $250 per person | 2 months | |
$300 combined limit | $600 combined limit | 2 months | |
2 months | |||
2 months | |||
Combined limit | Combined limit | 2 months | |
$400 combined limit | $1,000 combined limit | 2 months | |
12 months | |||
24 months | |||
2 months | |||
Nil | |||
2 months | |||
2 months | |||
2 months | |||
2 months | |||
2 months | |||
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.1
- 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.
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).
More back for kids
For kids we provide no hospital excess on every one of our family hospital covers. We also offer 100% back on included extras at Members' Choice providers, as part of our Silver Plus Families and Growing Family covers. This only applies to child and student dependants. Annual limits and waiting periods apply.
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.
**100% back for kids applies to child and student dependants only.
^ For ambulance attendance or transportation where immediate professional attention is required and your medical condition is such that you couldn't be transported any other way. TAS and QLD have State schemes to cover ambulance services for residents of those States. Includes transport by air ambulance where pre-approval is obtained from Medibank by the air ambulance provider.
= 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.
# Medibank has Members' Choice providers for these services. Not available in all areas.
~ 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.
+ Covers with Restricted or Excluded services will be treated as Included services where treatment is required for injuries sustained in an Accident that occurs after joining this cover. Treatment must be sought within 7 days of the Accident. Excludes claims covered by third parties such as Workcover and our Private Room Promise. Out of pockets may apply. Refer to your Cover Summary.
1 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.
² For Accidents that occur after your cover starts and for which treatment is sought within 7 days. Excludes claims covered by third parties such as WorkCover and our Private Room Promise. Out of pockets may apply.
³ OSHC members should call the Student Health & Support Line on 1800 887 283.
⁴ Limited to two dental check-ups on all extras annually. Maximum two bitewing x-rays per check-up, where clinically needed. Not available in all areas.
⁵ 6 month waiting period applies. Some lens coatings excluded.
± 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.
‡ For new members on new memberships who join and start eligible combined Bronze hospital and extras cover or above from 7 November – 18 December 2024 and who have not held Medibank health cover in previous 60 days (unless they are dependents coming off their parent’s cover). Must quote promo code ‘LIVEBETTER’ when joining. Excludes Hospital only cover, Extras only cover, Basic covers, Corporate covers, Accident Cover, Ambulance Cover, Overseas Visitors Health Insurance, Overseas Students Health Cover (OSHC), Working Visa Health Insurance, ahm covers and other selected covers. Not available with any other offer. Medibank may end this offer or amend these offer terms and conditions at any time without notice. Medibank employees are not eligible for this offer.
2&6 month waits waived on extras terms: 2&6 month waiting periods on extras waived. Other waiting periods apply (including 12 months on some dental services). If you're switching from another fund and you’ve used any of your current limits (at that fund), that will count towards your annual limits with us. If you've reached your limits at your previous fund you may not be able to claim straight away on extras.
Live Better rewards points terms: Must maintain direct debit and hold eligible product for 28 consecutive days from the policy start date to receive Live Better rewards points. The points will not be issued if you change to an ineligible cover, terminate your cover or suspend your cover during this period. Policyholder will require access to a smartphone and will need to download the My Medibank app. Policyholder will need to have registered a My Medibank account, sign up to Live Better rewards via the My Medibank app and track a Live Better rewards activity within 28 consecutive days from the policy start date. Must be 16 years or over to register for Live Better rewards. Live Better rewards points could take up to 8 weeks from the policy start date to be loaded to the policyholder’s Live Better account. Singles and single parents will receive 50,000 Live Better rewards points, and families and couples will receive 100,000 Live Better rewards points.
Live Better Rewards terms: Must be a Medibank member with eligible 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 or have linked their MyMedibank account with their Live Better rewards account to redeem rewards. Additional terms and conditions may apply to the redemption of a reward depending on the type of reward chosen. Read full Medibank Live Better rewards terms here: https://www.medibank.com.au/livebetter/rewards/terms/
Apple terms: Apple Watch SE requires iPhone Xs or later with iOS 18 or later. Bands are subject to availability. Carrier plan required for cellular service. Contact your service provider for more details. Connection may vary based on network availability. International roaming is not supported. Check apple.com/au/watch/cellular for participating carriers and eligibility. See support.apple.com/en-au/HT207578 for additional setup instructions.