Frequently asked questions

We understand that sometimes your circumstances change. If you’re experiencing financial stress, we have a number of support options that may help you. Click here to learn more. 

Please note: this is not applicable to Overseas Health Cover policy holders.

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 an outpatient fee, it isn’t usually covered by private health hospital insurance. 

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

Any future claims for complications arising from COVID-19 will be assessed in line with the pre-existing condition rules, where a Medibank-appointed Medical Practitioner will make a determination as to whether there were any signs or symptoms of the condition that existed at any time in the six-month period ending on the day on which the member became insured under the policy or changed their cover. 

Every state and territory will have their own advice and regulations in place, so we recommend calling your health provider to check their COVID-safe practices before an appointment. There may even be a telehealth option for your consultation.

The Royal Australian College of General Practitioners have outlined some helpful information on how and when to book a telehealth consultation. 

Now is an important time to keep to our health checks and appointments with health professionals to help prevent and manage any ongoing health issues during this difficult and stressful time.

As we enter our third year of the pandemic, feelings of isolation and loneliness are shared by many. But it's important to know that you're not alone. 

Please visit the Medibank Better Minds website for helpful advice, guidance and support for your mental health needs. Our 24/7 Medibank Nurse Phone Service is also available around the clock for eligible members with hospital cover on 1800 644 325. 

You can also reach out to the following mental health services:

Lifeline:                  13 11 14

Beyond Blue:         1300 22 4535

Kids Helpline:        1800 55 1800

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). You can read more about the differences between public and private hospital systems here.

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

Please note: this is not applicable to Overseas Health Cover policy holders. If you have OSHC questions about hospital access during COVID, call 134 148.

• Get vaccinated - it’s one of the most important and effective ways to stop the spread of COVID-19, and protect our loved ones.

• Get tested if you feel unwell and self-isolate until you’re given the all-clear.

• Keep up good hygiene.

• Wear masks – in line with your state and territory public safety orders.

• If you do have COVID-19 or you’ve been identified as a close contact, make sure you isolate in your home and follow state or territory public health advice.

The symptoms of COVID-19 to look out for include:

• Fever
• Runny nose
• Sore throat 
• Coughing
• Chills or sweats
• Shortness of breath
• Loss in sense of taste or smell 

If you’re feeling any one of these symptoms, please make sure you get tested as soon as possible.

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

If you are experiencing symptoms of COVID-19, such as a runny nose, sore throat, coughing, fever, loss of taste or smell, please get tested as soon as possible.

If you have any questions about getting tested, call the National COVID-19 Helpline on 1800 020 080 or call your GP. Check the links below for the nearest COVID-19 testing clinic in your state or territory:

ACT — covid19.act.gov.au

QLD — covid19.qld.gov.au

NT — coronavirus.nt.gov.au

NSW — nsw.gov.au/covid-19

SA — covid-19.sa.gov.au

TAS — coronavirus.tas.gov.au

VIC — dhhs.vic.gov.au/coronavirus

WA — healthywa.wa.gov.au

Elective surgery restrictions will vary from state to state, so we recommend calling your treating specialist or hospital to check if your elective surgery is impacted, if they haven’t contacted you already.

If you have eligible hospital cover and are either going to hospital or you have recently been discharged, 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.

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. 

We recommend you contact your provider directly to find out if, and when, they will be offering this service. 

Benefits will only be paid towards dental and orthodontic treatments that are administered in person (not via phone or online), by a recognised provider.

There are a few ways you can claim. The easiest way is with My Medibank, either online or via app.  

To claim online, members with eligible extras need to register their details at members.medibank.com.au and follow the prompts. Or for the app, they need to search ‘My Medibank’ in the App Store of Google Play and follow the instructions.   

Eligible Medibank extras members have the choice of face-to-face or telehealth consultations - the benefits we'll pay towards either type of consultation will be the same.

Check your cover summary to see if these services are included on your extras cover and if any waiting periods or annual limits apply.   

Benefits will only be paid towards dental and orthodontic treatments that are administered in person (not via phone or online), by a recognised provider.

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

This form will enable Medibank to determine if you are eligible to receive assistance through our Member Support Package.

To process your financial hardship application, Medibank will collect certain information about you (including the information described above). Medibank will use this information to confirm your eligibility and contact you to discuss your application.  We may be unable to process your application without this information.

Our privacy policy (available at: https://www.medibank.com.au/privacy/) has further information about how we handle personal information, how you can seek to access to or correct your information, or how to contact us if you have any questions or concerns.

Accepted documentation to support your hardship claim can include:

• JobSeeker Payment - previously called NewStart
• Austudy / Abstudy
• Youth Allowance
• Sickness Allowance
• Parenting Payment
• Document from employer confirming Jobkeeper payment

The COVID-19 vaccine will help protect you and others from getting really sick or dying from COVID-19, and if we can achieve a high vaccination rate within the community it’s likely to reduce number of outbreaks, and the need to utilise border closures and travel restrictions as preventative public health measures.

It’s important to note that the vaccine won’t entirely eliminate the chance of getting COVID-19, but the severity of the infection may be reduced compared with not being vaccinated. 

The Federal Government has developed the COVID-19 Vaccine Eligibility Checker so you can find out when and where you can receive a COVID-19 vaccine.

While it is a potential side effect, there is a very low chance of developing a blood clot from a COVID-19 vaccine. 

Find out more about the risk of blood clots after a COVID-19 vaccination here

Please consult with your GP or health practitioner if you have any concerns.

COVID-19 is a highly infectious disease. Even if you’re fit and healthy, you can still get COVID-19 and spread it to others, which can be particularly dangerous to loved ones with pre-existing conditions and illnesses.

You may also experience long-term side effects from being unwell – this is called ‘Long COVID’ or ‘Long Haulers’. If this happens you might experience symptoms such as fatigue, breathlessness and chest pain.

Please refer to the joint statement here, from the Royal Australian and New Zealand College of Obstetricians and Gynaecologists and the Australian Technical Advisory Group on Immunisation.

The approved COVID-19 vaccines have undergone a thorough assessment in Australia.

Because of the severity of the COVID-19 pandemic, researchers and developers worldwide are prioritising the development of a vaccine.

The Therapeutic Goods Administration (TGA) were engaged much earlier with vaccine developers and pharmacy companies checking trials in real-time rather than at the end of clinical trial phases, which helped to accelerate the review process.

Find out more about the approval process at health.gov.au

You may experience some side effects after receiving a COVID-19 vaccination, like soreness or redness where you received your needle, mild fever or headache. Some people may experience more significant flu-like symptoms. Most side effects last no more than a couple of days.

Serious reactions such as allergic reactions are rare. They usually occur within 15 minutes of receiving a vaccine, which is why you are asked to wait for this time period after receiving your vaccination.

Use the COVID-19 vaccine side effects symptom checker if you have concerns about any symptoms after your vaccine. The checker is also available through the National Coronavirus Helpline, 1800 020 080, 24 hours a day.

You can also find out more information here.

Children aged 5 and older are recommended for vaccination to help reduce the risk of COVID-19 transmission in the community, and to help protect family members such as older grandparents and younger siblings who are too young to be vaccinated.  

Having your child vaccinated may also help them continue doing those things they enjoy, such as playing team sports, learning at school and catching up with friends.

COVID-19 vaccines have been thoroughly assessed for safety by the Therapeutic Goods Administration (TGA). And they will continue to monitor the vaccines after their approval.

Parents should seek the advice of their GP or local pharmacist for more information on vaccine doses. 

It is reported that most side effects for the vaccine tend to be mild such as headache, pain/redness/mild swelling at the needle site, as well as a mild fever. 

Side effects can be checked via the government’s side-effect checker or by speaking to your GP. Please only contact 000 in an emergency.

To book a vaccine appointment for your child, speak to your GP or pharmacist, check your state/territory government websites in case they offer appointments for state-run hubs, or you can try using the COVID-19 vaccine booking tool.

Currently, there are different intervals for vaccines doses across different ages in children – it may be worth finding out more information about this here.

Alternatively, please speak to your GP or pharmacist for more information about vaccine intervals.

The Australasian Society of Clinical Immunology and Allergy advises that the COVID-19 vaccines are considered safe for kids aged 5 years and older who have allergies. There are no food products found in the COVID-19 vaccines and they are not egg based. For more information, please speak to your child’s GP or their specialist treating team.

Here are a few tips that may help overcome any nervousness your child may have about the vaccine:

• Ask them what they know about the COVID-19 vaccine, needles and any previous vaccines they may have had. Acknowledge how they are feeling and listen to any concerns.
• To help them feel at ease on the day of vaccination, it may help to outline what they may expect during the appointment.
• If your child is afraid of needles, try to not rush them through the process and consider vaccinating them in a familiar setting, such as your family GP or small pharmacy, as this may be less overwhelming than a vaccination centre. 
• Distraction may also be a handy tool in these situations, so be sure to bring along their favourite items, be it a toy or a book to help keep them preoccupied.

For more helpful tips on how to speak to kids about the COVID-19 vaccine, the Australian government has prepared a fact sheet here that includes child-friendly responses to any questions children may have about the COVID-19 vaccine.    

Besides vaccination, there are simple measures we can all take to protect children against COVID-19. These include hand hygiene, wearing masks, social distancing and following your state/territory health advice.

For reliable, up-to-date information regarding the COVID-19 vaccine program, we recommend bookmarking the following links.

• For more information about the vaccine and the nationwide rollout, visit the Department of Health COVID-19 vaccine page
• Subscribe to the latest COVID-19 vaccine updates here
• Find your state or territory health departments here

You can also call the National Coronavirus & COVID-19 vaccine helpline on 1800 020 080.

Visit the Coronavirus (COVID-19) updates page on our website for helpful information about Australia's COVID-19 vaccine rollout and ways in which your Medibank membership can help you at this time.

Eligible Medibank members with hospital cover can also speak with a 24/7 Medibank nurse or 24/7 Mental Health Phone Support on 1800 644 325.

Medibank OSHC members can call the Student Health & Support Line on 1800 887 283.

COVID-19 booster doses are free for everyone in Australia, and you are eligible to receive one if you:

• are 16 years or older, and
• have had your second dose of COVID-19 vaccination at least 3 months ago.

Age requirements may change, so please check the latest eligibility criteria on the Department of Health's Booster vaccine website. 

If you're 18 years or older, you can choose either the Moderna or Pfizer vaccine, regardless of what your first two doses were.

If you're 16 or 17 years old, or turned 16 since your primary dose of COVID-19 vaccine, you can have the Pfizer vaccine as your booster dose.

For more information about booster dose brands available, please check this Department of Health page, or speak to your GP or pharmacist. 

If you have had COVID-19, it's recommended that you recover from acute COVID-19 illness before receiving your booster dose. Otherwise, there's no need to wait, so long as it's been at least 3 months since your primary COVID-19 vaccine dose.

If you have any further questions or concerns regarding your recovery from COVID-19 and getting your booster, please speak to your GP or vaccine provider.

According to the Department of Health, the side effects of a booster dose may be similar to those experienced after the first two COVID-19 vaccine doses. Most side effects are mild and go away in a couple of days.

For more information about booster shot vaccine side effects, click here. 

Due to the health risks of COVID-19 on babies and their mothers, it is recommended that pregnant women receive a booster dose 3 months after their primary dose.

The Royal Australian & New Zealand College of Obstetricians and Gynaecologists have issued the following statement regarding booster eligibility and pregnancy. You can read it here. 

To find your nearest vaccine booster location, visit the government's Vaccine Clinic Finder, or check with your GP or pharmacist. 

According to the Department of Health, whilst two doses of COVID-19 vaccine provides very good protection against severe disease, a third dose will ensure the protection provided by the previous dose is even stronger and longer lasting.

In doing so, a booster dose increases your protection against: 

• infection with the virus that causes COVID-19
• severe disease
• dying from COVID-19.

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