Hospital insurance

Excess
An excess is the amount you pay before Medibank contributes to your hospital costs.
Benefits
  • Cover for accidents and ambulance
  • Treatment for heart-related services and more
  • Cover for obstetrics in a shared room in a public hospital as a private patient. Learn more in our article understanding your hospital birth options.
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.

Hospital inclusions
Services we pay benefits for 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 you will not need to re-serve waiting periods if you have already served your waiting periods and you change to a comparable or lower level of cover. If you change to a higher level of cover, we will recognise any waiting periods you have already served and pay benefits at your former lower level of cover until you serve the waiting periods for your higher level of cover. If you have only partially served your waiting periods on your former level of cover, you will need to serve the balance before you can claim at your former level of cover. 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.

No Excess for kids on a family membership

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

2 months
(12 months for pre-existing)

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)

Minor Gynaecological Surgery

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

2 months
(12 months for pre-existing)

Repair of Hernia

Surgical repair and treatment of a hernia

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 & endoscopies

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)

Restricted

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)

Restricted

Obstetrics-related services (eg. pregnancy)

Including regular and caesarean childbirth and in-patient diagnostic imaging

12 months

Major gynaecological surgery

Such as hysterectomy, prolapse and ovarian surgery.

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)

Other joint replacement surgery

Replacement surgery for shoulders, elbows and ankles

2 months
(12 months for pre-existing)

Nerve treatment

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

2 months
(12 months for pre-existing)

Vascular surgery

Surgery of arteries and removal of varicose veins.

2 months
(12 months for pre-existing)

All other in-hospital services where a Medicare benefit is payable unless they are Restricted or Excluded.

The Medicare Benefits Schedule sets out treatment and services which the Commonwealth Government subsidies via the Medicare system.

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, provided that the treatment is on the Medicare Benefits Schedule. Refer Cover Summary for full details.

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Services not covered by this product:

  • Fertility treatment (eg. IVF & GIFT programs)
  • Major eye surgery - including cataract & lens-related services
  • Hip & knee joint replacement surgery
  • Renal dialysis
  • Weight Loss Surgery (e.g Bariatrics)

Cover Summary

For further information on Standard Hospital, please see the cover summary.

Extras insurance

Benefits
  • Use your $500 limit toward the services that are the most important to you. Whether its physio, dental or chiro, you make the decision
  • 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 any recognised optical provider up to annual limits
60% Claim Back at Members' Choice

The information shown below is the Extras services you claim benefits for as well as any annual limits and waiting periods that may apply. If you use a Members' Choice provider you will be able to claim 60% back on the cost, up to annual limits, on the costs of services that are included in your cover. We've negotiated a capped price with Members' Choice providers, so you won't be charged more than the agreed price. Services available through our Members' Choice provider network are indicated in the table with a #.

If your provider is not part of our Members' Choice network, we still pay benefits up to a fixed benefit at any recognised provider. This benefit may be less than the provider charges.

Extras inclusions
Services we pay benefits for Treatments & Features 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 you will not need to re-serve waiting periods if you have already served your waiting periods and you change to a comparable or lower level of cover. If you change to a higher level of cover, we will recognise any waiting periods you have already served and pay benefits at your former lower level of cover until you serve the waiting periods for your higher level of cover. If you have only partially served your waiting periods on your former level of cover, you will need to serve the balance before you can claim at your former level of cover.

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.

No annual limit

2 months

General dental#~

Includes examinations, preventative treatment, scale and clean, extractions, fillings and x-rays and surgical removal of wisdom teeth (excluding hospital charges).

$500

combined limit for General dental, Major dental, Physiotherapy, Chiropractic & Osteopathy, Psychology, Dietetics, Non-PBS pharmaceuticals
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)

$500

combined limit for General dental, Major dental, Physiotherapy, Chiropractic & Osteopathy, Psychology, Dietetics, Non-PBS pharmaceuticals
12 months

Optical items#

100% back up to annual limits at any recognised provider. Includes frames, prescription lenses and repairs. Excludes some lens coatings.

$150

combined limit for Optical items, Remedial massage, Natural therapies
6 months

Remedial massage#

Benefits towards remedial massage treatments

Combined limit- see Optical items

2 months

Physiotherapy#

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

Combined limit- see General dental

2 months

Chiropractic# & Osteopathy

Benefits towards consultations with an osteopath or chiropractor

Combined limit- see General dental

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.

Combined limit- see Optical items

2 months

Dietetics

Benefits towards dietitian and nutritionist consultations

Combined limit- see General dental

2 months

Psychology

Cover for consultations only

Combined limit- see General dental

2 months

Prescription pharmaceuticals (non PBS)

For certain prescribed items not subsidised by the Government

Combined limit- see General dental

2 months

# 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.

Cover Summary

For further information on Healthy Start Extras 60, please see the cover summary.

icon-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).

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