Core Hospital

No matter what hospital excess you pay, the excess will not apply if kids on your membership are admitted to hospital

For ambulance attendance or transportation to a hospital where immediate professional attention is required and your medical condition is such that you couldn't be transported any other way.

Reconstructions to repair ligament tears, remove loose tissue and to treat other damage.

Surgery to treat conditions of the female reproductive system e.g. endometriosis. Excludes IVF

Surgical repair and treatment of a hernia

Admission to hospital for a suspected inflamed appendix (appendicitis) and where appendectomy is not required.

Surgery to remove an inflamed appendix.

Surgery to remove tonsils and/or adenoids.

The surgical removal of wisdom teeth in hospital in order to alleviate symptoms such as pain and infection associated with wisdom teeth. Includes benefits towards hospital accommodation and medical charges raised by doctors (e.g. anaesthetics) only where a Medicare benefit is payable. No benefits are payable under Hospital covers towards charges raised by dentists.

A procedure to examine the lining of the large bowel (colon) to investigate the cause of abdominal pain, bleeding, irregular bowel habits, to remove polyps or detect cancer.

Health care that offers support to people with a life-limiting illness. Its aim is to comfort and to relieve pain and distress for people who are dying. Benefits are only payable where admission to a palliative care unit in a hospital occurs.

The diagnosis and treatment of a wide range of mental health conditions, including addiction. For benefits to be payable, treatment needs to be provided at a Medibank-approved psychiatric facility.

Members that have served the 2 month waiting period for Limited Psychiatric treatment may be eligible to use the once the per lifetime Mental Health Waiver when upgrading (without a break of more than 2 months) to a cover with Included Psychiatric treatment.

Therapy which assists in recovery following a major health-related event, such as a joint replacement or heart attack. Treatment needs to be provided at an approved rehabilitation facility and under an approved program.

The Medicare Benefits Schedule (MBS) lists all the medical services subsidised by the Australian Government through Medicare. This includes thousands of in-hospital services that we pay benefits towards.

Covers which have services that are normally Limited or Excluded will be treated as an Included service where treatment is required for injuries sustained in an Accident that occurs after joining this cover, provided that the treatment is on the Medicare Benefits Schedule. Refer Cover Summary for full details.

Surgery to join two or more vertebrae to reduce pain and improve function arising from disorders of the spinal column.
It may include treatment of conditions such as chronic low back pain, spondylolisthesis, spondylosis and degeneration of the spine. It does not include treatment of developmental deformities such as scoliosis or kyphosis.

Surgery to the stomach which aims to aid weight loss in order to reduce the health risks associated with obesity. Surgery may involve reducing the size of the stomach (gastric banding or stapling), removing a portion of the stomach (sleeve gastrectomy) or bypassing the stomach (gastric bypass). It also includes subsequent surgery such as reversal or adjustment.

Medical and surgical admissions to investigate, diagnose, monitor and/or treat heart-related conditions.
May include services such as open heart and bypass surgery, invasive cardiac investigations and procedures such as angiograms, angioplasties and stent insertions.

Services and treatment provided in hospital that deal with the care of women during pregnancy, childbirth and following delivery. It includes delivery of the baby and complications of pregnancy. This does not include any treatment that the baby may require. 

Treatment provided to an admitted patient in hospital to assist with becoming pregnant. Includes the retrieval and implantation of eggs and collection of semen. In Vitro Fertilisation (IVF) treatment and Gamete Intra Fallopian Transfer (GIFT) are two of the most common procedures.

Such as hysterectomy, prolapse and ovarian surgery.

Surgery which is medically necessary to treat a physical deformity that is either acquired (through an accident, infection, changes in body shape) or congenital (present from birth).

It may include the removal of excess fat or tissue (breast reduction, abdominoplasty), correction of nose deformities, or removal of a scar - where these conditions lead to a medical condition that requires treatment. Medibank does not pay for cosmetic treatment.

Surgery for cataracts, as well as other eye lens related hospital admissions.

Surgery to replace a hip or knee joint with a prosthesis. It includes surgery after fracture, joint deterioration and revision of previous replacement surgery. Any prosthesis provided needs to be on the Australian Government Prostheses List for benefits to be payable.

Surgery to replace a joint with a prosthesis by replacing all or part of the joint or joint resurface. It includes joint replacement surgery after fracture as well as revision of previous replacement surgery. Any prosthesis provided must be on the Australian Government Prostheses List for benefits to be payable.

Treatment to assist or replace the function of the kidneys by ensuring the appropriate balance of chemicals in the blood. It can include both haemodialysis (circulating the blood through a machine) and peritoneal dialysis (infusing and draining a sterile solution into the abdomen).

Surgery of arteries and removal of varicose veins.

Insertion of a device or injection to manage severe movement disorders or chronic pain.