Frequently asked questions

No, we have postponed premium increases for six months for all members. This will be applied automatically to all policies so there is no need to contact us to arrange this.

No, premium increases will be postponed automatically to all policies so there is nothing you need to do.

If you have an automatic payment coming out this week, we may not be able to adjust it in time. If that happens, don;t worry, we'll correct it on your next payment and credit your policy.

If you had an automatic payment coming out this week, we may not have been able to adjust it in time. If that happened, don’t worry, we'll correct it on your next payment and credit your policy.

Yes, we will continue to stay in touch on any changes to your premium.

No, postponed premium increases are for private health insurance policies only.

If you were being moved to a new extras product , yes, this change will still take place and you’ll get the additional 5% claim-back value as of 1 April at Members’ Choice providers.  You will receive the benefit of the premium increase postponement in respect of your new product.

If you were moved to a new hospital product as a result of the private health insurance industry reforms, yes, this change will still take place on 1 April.   You will receive the benefit of the premium increase postponement in respect of your new product.

We’ll let your payroll department know that they need to hold off on applying any increase to your premium. We also encourage you to follow this up with your payroll department if you notice any discrepancies.

Medibank is looking into making other services available, such as Physiotherapy, over the coming weeks. This means customers will still be able to get value from their cover during this time.

For the most up-to-date information and advice, please visit the Department of Health and relevant state and territory health department websites.

The Australian Government's Coronavirus app is also a great resource to stay up to date with official information and advice about the situation. You can check your symptoms and get notified when urgent information and updates are published.

Medibank’s Chief Medical Officer, Dr Linda Swan, will also provide regular health information updates on this webpage that will best assist our members through this difficult period, including:

• New information on groups that may be at high risk of infection
• What to do if you’re feeling unwell
• Preventative advice to protect yourself and loved ones
• Information on self-isolation requirements
• Links and contact details of relevant health services
• Helpful advice and tips to help you cope during this time

We are very mindful that the current situation with COVID-19 may place some customers under financial pressure, which is why we're introducing an intial support package.

Regardless of your level of existing hospital cover, Medibank will pay benefits towards chest, heart, lung and kidney hospital admissions, including those related to the coronavirus (COVID-19) until the crisis passes.

We have also introduced a financial hardship policy, which includes suspension to customers’ policies.

We would encourage people who are suffering financial hardship to contact us so we can review your cover options.

Yes, Medibank and ahm will pay benefits towards one-on-one psychology consultations via telehealth from 30 March 2020 through to 30 September 2020.

This is available for members with extras cover that includes psychology and who are:

• undergoing an existing course of treatment, and have seen the psychologist providing the teleconsultation over the past six months, or;
• new patients and have had telepsychology services recommended by their GP (members will not be required to provide proof of their general practitioner’s recommendation), and · not receiving a benefit from Medicare for the consultation

The benefits will be the same as a face-to-face consultation, and are subject to waiting periods and annual limits

We’re still updating things on our end, so when claiming via My Medibank online or with the My Medibank app please select ‘add service item screen’ and select either:

• Medibank item 100 if your receipt lists item 701
• Medibank item 200 if your receipt lists item 801

The most recent advice from the Australian Government is that health services like dentists, physiotherapists can remain open at this time.

This may change at any time, so please contact your health service provider directly to confirm their availability.

It's also worth asking what additional measures they have in place to ensure everyone's safety.

If you are admitted to hospital and treated as a private patient, you may have some out-of-pocket expenses. 

For treatments included under your policy, Medicare and Medibank will jointly cover the cost of each MBS-listed item that was provided in your treatment, up to the MBS fee (the set government fee). 

However, if your treating doctors choose to charge more than the MBS fee, you may have to pay the gap amount as an out-of-pocket cost. Read more about how Medibank’s GapCover scheme can help reduce some of these out-of-pocket costs. 

Also, keep in mind that some private hospitals charge an emergency department facility fee. Because this is generally a fee that the hospital charges an outpatient, it isn’t usually covered by private health hospital insurance. 

And if your policy includes an excess, then this is also payable by you. 

Regardless of a members’ level of existing hospital cover, Medibank will pay benefits towards chest, heart, lung and kidney hospital admissions, including those related to the coronavirus (COVID-19) until the crisis passes. 

Regardless of your level of existing hospital cover, Medibank will pay benefits towards chest, heart, lung and kidney hospital admissions, including those related to the coronavirus (COVID-19) until the crisis passes (standard waiting periods apply. This includes customers with Basic and Bronze levels of cover where currently excluded. If you are admitted to a public hospital and treated as a public patient, your treatment is fully covered by Medicare and you don’t have to use your private health insurance. In fact, you may end up paying extra if you do use your private cover (for instance, if your policy includes an excess).

Please check with your hospital. If you’re 75 or older (with eligible hospital cover), our Hospital Assist service will support you, before and after your booked treatment.

During this time, it’s more important than ever that you feel supported in any decisions involving your health. So please don’t hesitate to call us on 1800 789 414. 

Put simply, good hygiene and social distancing.

Good hygiene

Practising good hygiene is one of the most effective ways to protect against infection and prevent the spread of coronavirus.  All of us have a role to play in maintaining high standards to protect our own health and the health of each other.  These measures include:

• covering your coughs and sneezes with your elbow or a tissue

• disposing of tissues properly

• washing your hands often with soap and water, including before and after eating and after going to the toilet

• using alcohol-based hand sanitisers

• cleaning and disinfecting surfaces

Social distancing

Another way to protect the community is social distancing, which is essentially reducing the contact you have with other people.  It includes:

• staying at home if you are unwell, and avoiding close contact with anyone who is unwell

• avoiding large public gatherings if they’re not essential

• keeping a distance of 1.5 metres between you and other people whenever possible

• minimising physical contact, especially with people at higher risk such as older people and people with existing health conditions 

Self-isolation

If you returned to Australia from overseas from midnight 15 March 2020, or have been in close contact with a confirmed case of coronavirus, you will be required to self-isolate.  The Australian Government has prepared some information around what this means and the advice you should follow.

The symptoms of coronavirus can include fever, coughing, sore throat, fatigue, and shortness of breath.

If you have these symptoms, please contact a health clinic or your doctor, and they will advise next steps, including if you need to be tested.

At this time testing is being prioritised for those that have had recent overseas travel or contact with a confirmed case, and also for health care workers.

Most importantly, if you have serious symptoms such as difficulty breathing, call 000 for urgent medical help.

As of 25 March 2020, all non-urgent elective surgeries in Public Hospitals are suspended, with Private Hospitals doing the same on 1 April 2020. If you're a patient with a pre-existing or complex condition, we recommend you check regularly with your doctor and hospital for the most up-to-date advice.

During this time, it’s vital that the most vulnerable members of our community receive the support they may need. If you are aged 75 or older, have eligible hospital cover and going to hospital, or have been in hospital , our Hospital Assist service is here for you, including calls to check in and see if you’re ok. Alternatively, if you have any concerns about your hospital stay, please don’t wait. Call us on 1800 789 414. 

As of midnight, on Wednesday 25 March 2020, all non-urgent elective surgeries in Public Hospitals are suspended, with Private Hospitals doing the same on 1 April 2020.  

Announced by the Prime Minister, this decision will ensure that all health services can focus their efforts and resources on assisting communities for any incoming coronavirus cases.    

Please note, emergency surgeries WILL NOT be affected by this announcement.  

You will likely hear from your specialist regarding these changes. However, if you have surgery booked this week, or any other concerns, we recommend calling your specialist or admitting hospital as soon as possible to see how this may affect you.  

During this time, it’s vital that the most vulnerable members of our community receive the support they may need. If you have eligible hospital cover and going to hospital, or have been in hospital, our Hospital Assist service is here for you. If you have any concerns about your hospital stay, please don’t wait, you can call us on 1800 789 414. 

It's likely wait times will be affected but this will depend on the hospital, and the state in which you'll be treated. As of 25 March 2020, elective surgeries are suspended, with Private Hospitals doing the same on 1 April 2020.  Which means there will be longer wait times for non-urgent procedures. If you are unsure of an upcoming procedure, please contact your hospital directly.  

Understandably, these are stressful and uncertain times. Even if you don't feel ill, you may still find it difficult to cope with things like social distancing and any potential financial pressures. 

You may find it worthwhile to visit Beyond Blue for some very helpful information to help look after your mental health.

Unfortunately, benefits will not be payable for face masks that are purchased to avoid contracting COVID-19 (or any other ailment) under any private health cover. 

To protect our people, customers and community from Coronavirus, our stores will be closing from close of business Tuesday, 31 March 2020, until further notice.  

Rest assured, we’re not reducing our levels of service, as our store staff will now join the phone & webchat teams to continue supporting you, until it’s safe to re-open stores.  

To ensure we can help you effectively, we’re encouraging all our members to: 

• claim online via My Medibank or the My Medibank app where possible  
• switch your communication preferences to electronic, rather than mail, so we can get in touch with you quickly  
  
• update your payment preferences with your bank account details, rather than cheque, so you can claim faster 
  
• change your payment preferences to direct debit, rather than cheque, for speedier transactions 

The most recent advice from the Australian Government is that health services like dentists, optical providers and physiotherapists can remain open at this time. 

We all hope COVID-19 is relatively short lived and we can go back to normal conditions later in the year. By keeping your extras cover, you can continue to access extras services such as dental, optical, physio and psychology, which continue to remain open for business. It also means you'll avoid re-serving waiting periods, which could range from 2 months to 2 years if you were to cancel your policy and then re-join.  

Keeping your Extras cover will also enable you to maintain any loyalty limits and/or life time limits you may have accrued.  

We all hope COVID-19 is relatively short lived and we can go back to normal conditions later in the year. With this in mind, it is important to understand that once a policy is terminated, you may be required to re-serve waiting periods already served. For example, if you have a pre-existing condition (PEC) and cancel your cover, you may need to serve a 12 month waiting period when you re-join. Or if you choose to downgrade your cover now and upgrade when the services is required, you may need to re-serve waiting periods for standard clinical categories not included in the lower cover.  

Whilst elective surgeries have been temporarily cancelled due to COVID-19, your private hospital insurance will still cover you for any urgent admissions, where the service is included or restricted on your policy and you have served any required waiting period. 

Category 1 and some category 2 elective surgeries are still being performed – and for some our customers they will need their cover for those surgeries. 

Determined by a Medibank-appointed Medical Practitioner, a Pre-Existing Condition (PEC) is an ailment, illness or condition where signs or symptoms existed any time during the six months before you either took out your new cover, or transferred to a higher level of cover.

With the Australian Government regularly updating their advice on travelling in and out of Australia, we are continuing to work through the implications for our Travel Insurance members.

We’ve prepared some answers to some of your commonly-asked questions which you can read here:

Important Information Regarding Coronavirus (COVID-19) and Travel Insurance

The hospital you're admitted to will submit their claim directly to Medibank.

As for your doctor's fees:

• If your doctor uses Medibank’s GapCover, they'll bill us directly.
• If your doctor doesn’t use Gap Cover, they will bill you directly. You will need to lodge the bill with Medicare using what is called a two-way claim form. This is the quickest and easiest way to claim from both Medicare and Medibank.

If you're a member on an Overseas Workers or Overseas Visitors Health Cover, your medical services can't be claimed online. Please mail your receipts directly to Medibank with a completed claim form.

Medibank Private Limited

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MELBOURNE VIC 3001

If you are admitted to hospital and treated as a private patient, Medicare and Medibank will pay benefits towards diagnostic services included in your policy (e.g. blood tests, x-rays, scans and ultrasounds) up to the MBS fee (the set government fee).

If you’re charged more than the MBS fee, you may have an out-of-pocket cost. GapCover doesn’t apply to diagnostics.

As always, if you require hospitalisation, then please call our Hospital Assist team on 1800 789 414 who can support you before and after treatment.