About Medibank recognised ancillary providers

With Medibank, you have access to one of the largest Members' Choice networks of ancillary healthcare providers in Australia. We also recognise many other ancillary healthcare providers outside our Members' Choice network. From time to time, our list of recognised providers changes.

So, here's some information to help you understand more about our relationships with ancillary healthcare providers and how changes to our provider relationships may impact you.

What does it mean to be a 'recognised provider'?

A recognised ancillary healthcare provider is someone who provides health services that members can claim for using their Medibank extras cover.

Our recognition criteria require ancillary healthcare providers to:

  • Be registered, or hold a licence to provide treatment in their profession; for example, physiotherapy, optical, podiatry or dental.
  • Are professionally qualified or are members of a professional body recognised by Medibank.
  • Maintain thorough and accurate patient records in English.
  • Follow appropriate billing practices.
  • Offer services in an independent private practice that is appropriate for the health and wellbeing of Medibank members.
  • Follow other standards which Medibank believes are appropriate.

Why do relationships with providers change?

Our relationships with healthcare providers can change for a number of reasons. Providers could retire, cease to practise or move overseas. Or, Medibank might decide to suspend or cease recognising a provider that we believe does not meet our recognition criteria.

Will Medibank tell me if it suspends or ceases to recognise a healthcare provider?

We'll notify our customers if we suspend or de-recognise a provider whom they have used in the past 12 months.

Will my provider tell me if they are no longer a recognised provider of Medibank?

Healthcare providers should give you information about the fees and charges involved in your treatment before you receive their services, including whether they are recognised by your health fund. You can also call us on 132 331 to find out if a provider is recognised, or visit our website to find a Members' Choice provider.

Can I still claim benefits for services if the provider I've been seeing is no longer recognised?

You can still claim benefits for services provided before the effective date of the change, but services provided after the effective date of suspension or de-recognition are not covered. We encourage you to call us on 132 331 if you are unsure whether your provider is recognised by Medibank.

What if I need ongoing treatment from a provider who is no longer recognised by Medibank?

Our first priority is to help you get the care you need. If you need ongoing treatment, please call us on 132 331, so we can find an alternative solution for you.

How do I find a Medibank Members' Choice recognised provider?

You can visit our website to find a Members' Choice provider.

My provider is not a Members' Choice provider. Can I still claim benefits for services using my Medibank extras cover?

Yes, if they are a recognised provider of Medibank.

I have chosen a new provider. How can I be sure that I can claim benefits for the new provider?

You can find a Members' Choice provider online or call us on 132 331 to find out if your provider is a Members' Choice provider or recognised by Medibank. Please note, some providers may have requested to be excluded from the online search.

How can I avoid surprise out-of-pocket charges?

Our best advice is to contact us before you visit your healthcare provider. This way, we can provide details of what is and isn't covered by your policy and help you understand what questions you should be asking your health service providers about out-of-pocket expenses.

How can I find out more?

We have a dedicated team that are here to help. You can contact one of our experienced team members on 132 331 from 8am-8pm, Monday to Friday, or visit us in store for a chat.