Hospital insurance

Excess
An excess is the amount you pay before Medibank contributes to your hospital costs.
Benefits
  • Heart-related services
  • Joint Replacement surgery
  • Major eye surgery
  • Don’t pay for pregnancy & IVF
Excess An excess is the amount you pay before Medibank contributes to your hospital costs.

Choosing a higher excess will lower your premium. An excess will apply to each adult member admitted to hospital per calendar year. No hospital excess applies to children on family memberships.

Hospital inclusions
Included Treatments & Features Waiting periods Waiting periods explained Waiting periods are a length of time you need to wait after taking out your cover before you can claim or receive benefits covered by your policy. Waiting periods apply to new members or for new services, including if you're changing to a higher level of cover. If you're switching, we'll recognise waiting periods you've already served, so you'll only need to serve any balance with us before you can claim. A 12 month waiting period applies for all pre-existing conditions. Pre-existing condition A pre-existing condition is an ailment, illness or condition where 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. A 12-month waiting period applies for all pre-existing conditions. Call 134 190 to find out more.

Ambulance services

100% cover for immediate professional attention. Includes ambulance transportation to hospital when your medical condition means you can't be transported in any other way. Tasmania and Queensland have State schemes that cover ambulance services for residents of those States.

2 months

Shoulder and knee reconstruction surgery & investigations

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

2 months (12 months for pre-existing)

Appendicitis treatment

Hospitalisation for appendicitis

2 months (12 months for pre-existing)

Removal of appendix

The surgical removal of your appendix

2 months (12 months for pre-existing)

Removal of tonsils & adenoids

Surgery to remove tonsils and/or adenoids

2 months (12 months for pre-existing)

Surgical removal of wisdom teeth (for hospital charges only)

Accommodation and theatre charges for wisdom tooth removal in hospital (does not include doctor/dentist fees)

2 months (12 months for pre-existing)

Colonoscopies

Procedure to examine the large bowel

2 months (12 months for pre-existing)

Palliative care

Health care that provides support to people with a life-limiting illness

2 months

Spinal Fusion

Surgery to join two vertebrae

2 months (12 months for pre-existing)

Weight Loss Surgery (e.g Bariatrics)

Includes surgeries such as Gastric banding, Gastrectomy and Gastric bypass

2 months (12 months for pre-existing)

Restricted We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits.

Psychiatric treatment

Including diagnosed disorders or addiction requiring immediate hospital-based intervention

2 months

Rehabilitation treatment

Approved physical therapy and exercise programs, generally following an inpatient admission

2 months

Heart-related medical and surgical admissions

Including open heart and bypass surgery, and invasive cardiac investigations and procedures, such as angiograms, angioplasties and stent insertions.

2 months (12 months for pre-existing)

Plastic & reconstructive surgery

Surgery to repair deformity or improve function e.g. after cancer or tumour removal, repair of lacerations, burns or scars, to treat congenital abnormalities or following traumatic injuries.

2 months (12 months for pre-existing)

Major eye surgery - including cataract & lens-related services

Surgical procedures to treat vision loss caused by cataract and other eye-related admissions

2 months (12 months for pre-existing)

Hip & knee joint replacement surgery

Replacement surgery for hips and knees

2 months (12 months for pre-existing)

Other joint replacement surgery

Replacement surgery for shoulders, elbows and ankles

2 months (12 months for pre-existing)

Renal dialysis

Dialysis treatment in hospital for kidney failure.

2 months (12 months for pre-existing)

All other in-hospital services where a Medicare benefit is payable.

The Medicare Benefits Schedule defines what are considered appropriate interventions or treatment in Australia.

2 months (12 months for pre-existing)

Cover For Accidents

Covers which have services that are normally Restricted 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. Refer Cover Summary for full details.

nil

Access to GymBetter and Mi Health support services.

Support services include Medibank nurse 24/7, Online Health Hub and Mobile Health Apps.

nil

More details

Extras insurance

Benefits
  • 70% back on extras such as dental, physio, podiatry & chiro at Members' Choice providers
  • 100% back on a yearly check-up at a Members' Choice dentist (excludes x-rays). And this doesn't count towards annual limits
  • 100% back on optical at all optical providers up to annual limits
  • Increasing annual limits on some services
  • Includes a Membership Bonus
70% Claim Back Guaranteed percentage back on specified services provided by Medibank Members' Choice providers only up to annual limits. Services available through our Members' Choice provider network are indicated in the table with a #. Claim 70% back on the costs of included treatments at Medibank Members' Choice providers, up to annual limits. We've negotiated a capped price with Members' Choice providers, so you won't be charged more than the agreed price. If your provider is not part of our Members' Choice network, we still pay benefits up to a fixed benefit. This may be less than the provider charges, as we haven't negotiated a price with them. Generally, the higher the level of cover you choose, the higher the fixed benefit which will help reduce your out-of-pocket expenses.

Guaranteed percentage back on specified services provided by Medibank Members' Choice providers only up to annual limits. Services available through our Members' Choice provider network are indicated in the table with a #.

Extras inclusions
Included Treatments Annual limits per person An annual limit is the maximum amount of benefits Medibank will pay for particular treatments each calendar year. Generally, the more comprehensive your cover, the higher the annual limits. If you are switching, benefits that have been paid under your previous cover will be taken into account in determining the benefits payable under your Medibank cover. Waiting periods Waiting periods explained Waiting periods are the length of time you need to wait after taking out your cover before you can claim or receive benefits covered by your policy. Waiting periods apply to new members or for new services, including if you're changing to a higher level of cover. If you're switching, we'll recognise waiting periods you've already served, so you'll only need to serve any balance with us before you can claim.

Ambulance services

100% cover for immediate professional attention. Includes ambulance transportation when your medical condition means you can't be transported in any other way. Tasmania and Queensland have State schemes that cover ambulance services for residents of those States.

N/A

2 months

General dental#~

Includes examinations, preventative treatment, scale and clean, extractions, fillings and x-rays and surgical removal of wisdom teeth

No annual limit

2 months (12 months for surgical dental procedures)

Major dental#~

Includes services such as endodontic services (e.g. root canal); periodontics (e.g. treatment of gum disease); crowns, dentures and bridges; and major restorative fillings (e.g. veneers)

$1000

(increases by $50 per year up to $1250)
12 months

Optical items#

100% back up to annual limits. Includes frames, prescription lenses and repairs.

$250

6 months

Remedial Massage#

Benefits towards remedial massage treatments

$200

2 months

Physiotherapy#

Includes one-on-one and group consultations, Clinical Pilates, antenatal and hydrotherapy sessions

$900

(increases by $50 per year up to $1150)
2 months

Chiropractic# & Osteopathy

Benefits towards consultations with an osteopath or chiropractor

$900

(increases by $50 per year up to $1150)
2 months

Podiatry#

Benefits towards consultations, biomechanical assessments and custom orthotics

$900

(increases by $50 per year up to $1150)
2 months

Natural therapies

Consultations for naturopathy# and acupuncture#.
Consultations for reflexology, kinesiology, Chinese & Western herbalism, exercise physiology, shiatsu, aromatherapy, homeopathy, Bowen therapy, Alexander technique & Feldenkrais.

$200

combined limit
2 months

Dietetics

Benefits towards dietitian and nutritionist consultations

$200

combined limit
2 months

Breathing appliances~

Peak flow meters, nebulisers & spacing devices

$800

Combined limit
12 months

Blood glucose monitors & blood pressure monitors~

100% back up to your annual limit

$800

Combined limit
24 months

Speech Therapy

Benefits are paid towards consultations with a speech therapist

$800

Combined limit
2 months

Clinical psychology

Cover for consultations only

$800

Combined limit
2 months

Health appliances & external prostheses~

Including insulin delivery pens

$800

Combined limit
2 months

Health subscriptions

Benefits are paid towards membership of some health bodies and associations. Includes Arthritis Association and Coeliac Society subscriptions, Diabete Australia membership, and others.

$100

2 months

Hearing aids

Benefits are paid towards the cost of hearing aids and hearing aid repairs

Incl with Clinical psychology limit

36 months

Membership Bonus

To pay towards extras, hospital excess and other approved membership related services

$50

per single /$100 per couple membership (increasing to maximum $500 single/ $1000 couple)
6 months
More details

# 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.

from $95.65

Minimum pay frequency is fortnightly ($191.30)

Prices vary from state to state, and depending on your age, income and if you've held hospital cover previously. Prices are based on couples cover in NSW assuming 26.791% Australian Government Rebate and no Lifetime Health Cover loading.  Minimum payment frequency is fortnightly. Waiting periods and annual limits may apply.

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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).

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