What is Medibank’s No Gap Joint Replacement program?
Thanks to partnerships with select surgeons and hospitals, Medibank’s No Gap Joint Replacement program offers eligible members with hospital cover+ a more affordable care option for hip and knee replacement surgery.
Eligible members could pay no out-of-pocket costs* for included treatments and services as part of a hospital admission1 for elective hip or knee replacement surgery, when treated at a participating hospital with a participating surgeon.#
Step 1
Check your cover eligibility. Your cover must include Joint Replacement benefits and, if required, Rehabilitation benefits. Call us to confirm your cover and any waiting periods.
Step 2
Chat to your GP about a referral to a participating surgeon from the list below. There may be out-of-pocket costs for your GP consultation, which is not included in the No Gap Replacement program.
Step 3
Contact a participating surgeon to book an initial outpatient consultation. This appointment may incur out-of-pocket costs and is not included in the No Gap Replacement program.
Step 4
The surgeon will assess you to determine the next steps. It's important to note that, in some cases, surgery is not the most appropriate action and therefore the surgeon may recommend alternatives to surgery.
Step 5
If surgery is the next step, the surgeon will then discuss the No Gap Joint Replacement program and if you are a clinically appropriate candidate. The surgeon will have the final say if you are appropriate for the program or not.
Step 6
If clinically appropriate, the surgeon's rooms will organise the surgery booking with the hospital, which will also include scheduling pre-operative patient education.
What costs are included in the No Gap Joint Replacement program?
Usually, there are several out-of-pocket costs associated with an elective hip or knee replacement surgery: surgeon fees, bills for scans and blood tests, the anaesthetist’s bill and more - it adds up.
That’s why we’ve partnered with participating surgeons at participating hospitals to offer no out-of-pocket costs* for included treatments and services for knee and hip joint replacement surgeries under this program, including:
Pre-admission joint school
Hip or knee replacement surgery, including your prosthesis (artificial joint)
Anaesthetist costs
Assistant surgeon costs
Hospital accommodation, including all theatre costs
Diagnostic tests (scans and blood tests)
Crutches provided by the hospital prior to discharge
If required, rehabilitation provided in the comfort of your own home or where your participating surgeon deems most suitable for you
Out-of-pocket costs may still be payable for non-included treatments and services.
Call our Customer Health Support Team on 1300 733 388 to find out more.
How Medibank's No Gap Joint Replacement program supports members
Bronwyn and Robert share their experiences with Medibank's No Gap Joint Replacement program.
Dr Scott Tulloch and Dr Cameron Cooke share how Medibank offers No Gap Joint Replacement procedures, more affordable care options, shorter hospital stays, and personalised support before and after surgery.
How we can offer no gap procedures for our eligible members
You may spend less time in hospital but with the same quality of care
Receive personalised support before and after surgery
Extra support at no additional cost
Hospital Assist
To help you prepare for and assist in your recovery from a hospital admission, eligible members can access support over the phone from our Health Concierge clinicians, or visit the online hub for helpful tips and tools. 2 3
24/7 Medibank Nurse Support
Medibank health insurance members can chat to a registered nurse over the phone or online and get guidance on what they can do next, at no extra cost.4 Chat online or call 1800 644 325 anytime of the day or night, 7 days a week.
24/7 Medibank Mental Health Support
Medibank health insurance members can chat to a mental health professional over the phone or online about how they feel and get guidance on what they can do next, at no extra cost.4 Chat online or call 1800 644 325 anytime of the day or night, 7 days a week.
Hip or knee replacement surgery and recovery
Did you know hip or knee are the most common joint replacement surgeries in Australia and fall under the category of major surgeries? If you need a hip or knee replacement surgery, it's understandable you may have questions about the process. What is the recovery time? What do I do after surgery? Read on below for helpful resources to support you before and after surgery and help you feel more prepared.
Questions to ask your health professionals
These questions have been developed as a guide to help you feel better informed, prepared and confident with your health care options.
Recover from hip or knee surgery at home
After surgery or a hospital stay, Medibank members may be eligible to recover from hip or knee replacement surgery at home with the Rehab at Home program offering where your treating doctor considers it clinically appropriate.5
A guide to joint replacement surgery
Here, we share an overview of the types of hip and knee replacement surgery, how to prepare for a joint replacement and tips for recovering from surgery.
How much does joint replacement surgery cost in Australia?
We list the main types of joint surgery, including hip and knee replacements, and how much each typically costs in Australia.
Help & Support
Need more information or want to check if you're eligible?
Call us on 1300 733 338 or request a call from our Customer Health Support Team.
Frequently asked questions
Things you should know
+ Must have hospital cover that includes joint replacement surgery. Waiting periods apply.
* An excess or co-payment may still be payable, depending on the product a member has chosen and whether they are claiming under their hospital cover for the first time in a calendar year. The Medibank Member Guide and Fund Rules sets out hospital benefit exclusions, which apply to all hospital admissions for Medibank members. There may be out-of-pocket expenses associated with outpatient appointments, such as your initial visit with a participating surgeon in their consulting rooms.
1 Excludes joint replacements resulting from an emergency admission.
# Providers listed are orthopaedic surgeons who are participating in the no gap joint replacement program at participating hospitals. The surgeon and hospital will work with you to decide if the program is right for you and your health needs. However, if the surgeon refers you to a non-participating hospital and/or the program is not otherwise right for your health needs, any such procedure will not be part of the no gap joint replacement program and you may incur out-of-pocket costs.
2 Health Concierge is available to all eligible Medibank members who hold hospital cover. Excludes Overseas Visitor Health Cover, Working Visa Health Cover and Overseas Student Health Cover (OSHC). Some referred services may involve out of pocket costs.
3 OSHC members should call the Student Health and Support Line on 1800 887 283.
4 Some referred services may involve out of pocket costs and waiting periods may apply.
5 For resident hospital members with Joint Replacement benefits and Rehabilitation benefits who have served waiting periods. Treating doctor must consider it appropriate. Services are subject to provider availability. Providers are not located in all areas and may change without notice. Additional treatment may incur out-of-pocket costs.
The listing of a provider does not comprise any sort of representation or recommendation by Medibank regarding the provider. To the fullest extent allowed by law, such reference should not be construed as:
an endorsement by Medibank; or
commendation for the status of the provider’s registration with their registration bodies like the Australian Health Practitioner Regulation Agency (AHPRA); or
a recommendation or warranty by Medibank of, for or in relation to the provider’s services.
Accordingly, Medibank neither takes nor assumes any responsibility for the services provided. Members should rely on their own enquiries and seek any assurance or warranties directly from the provider in relation to the service or with the registration bodies (e.g. AHPRA) regarding any conditions or restrictions to the provider’s registration.
Information presented is refreshed regularly. Information is accurate at time of publishing.