Accident Override > Accidental Injury Benefit

Accidental Injury Benefit means that any Excluded or Limited Service will be treated as if it is an Included Service, where you require hospital treatment as a result of injuries sustained in an Accident. There are conditions associated with this benefit.

Restricted Service > Limited Service

A Limited Service is a service where we pay the minimum benefit set by the government towards hospital accommodation.

If you’re treated in a private hospital for a Limited Service, you are likely to incur substantial out-of-pocket expenses because this minimum benefit will not be enough to cover all hospital costs.

For Limited services as a private patient in a public hospital we will pay minimum shared room benefits.

Fixed Benefit > Fixed Amount

This is the amount we’ll pay towards the cost of an Extras service or item if you visit a non-Members’ Choice provider. It will generally be lower than the amount you would receive when you visit a Members’ Choice provider. The amount of the Fixed Amount depends on the cover you hold and the type of service or item you receive.

Co-Payment > Per-Day Payment

A Per-Day Payment is a daily amount that you contribute towards your accommodation costs when admitted to hospital, and is separate to any applicable excess. The amount payable is determined by the cover held and is payable directly to the hospital.

Gap > Out-of-Pocket Expense

An Out-of-Pocket Expense (previously known as the ‘gap’) is a difference between the fee charged by a provider, (a surgeon, dentist, or physiotherapist etc.) and the benefit Medibank will pay for the service. The term ‘gap’ will continue to be used for our GapCover scheme.

We’re always working to make things simpler for our customers, and are continuing to update our language. Have any questions you’d like answered? Chat to us online 24/7, or call our team on 132 331.