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Make an informed decision about surgery or alternative care options.
Choose your specialist and your hospital.
Explore both private and public hospital options.
Confirm the treatments that are covered under your policy.
Know what to expect from your hospital stay.
Be fully informed of your out-of-pocket costs upfront, and any affordable care options available.
Is 'at home recovery' an option for you?
Learn how to stay healthy when you get home from hospital and beyond, and make sure your claims and care are organised.
Learn more about the most common procedures like knee replacements, colonoscopies, wisdom teeth removal and more.
Understand your out-of-pocket costs.
Avoid bill shock - understand the cost of your procedure and check your out-of-pocket costs.
How your hospital cover works to pay benefits towards some of the costs of your treatment.
Help on hand with 24/7 Medibank Nurse
Learn how Health Concierge could help you prepare for, and recover from a hospital stay.
Medibank at Home - bringing hospital care into our members' homes.
Medibank health support and services
As a Medibank member you get more than just health insurance. Through Hospital Assist, we can connect you with other services to support you during each stage of your hospital journey.
24/7 Medibank Nurse
With hospital cover you’re supported by Medibank nurses on our 24/7 Medibank Nurse phone service.~
Health Concierge provides personalised health support to help eligible Medibank hospital members prepare for, or recover from, a hospital stay or treatment.#
Medibank at Home
With your doctor's support, eligible members can choose whether a treatment is delivered in the hospital or home, with a range of services, such as rehabilitation and chemotherapy.*
Medibank has a wide range of health support and wellbeing programs for eligible members going to hospital, including a digital health concierge and hospital experience scores.
Got more questions? We've got answers
Going to hospital can be complex, so here is some extra information that might help. And if you still have questions, call us any time on 132 331. We're here to help.
Medibank's Hospital Assist makes going to hospital a little less stressful for Medibank members^, with personalised phone support before and after your stay, digital info packs, access to the 24/7 Medibank Nurse phone service, and hospital info and patient reviews.
Accident cover boost
If you have an Accident, you’ll get the benefits of our top level hospital cover, no matter what level of hospital cover you have#.
24/7 Medibank Nurse
Members with hospital cover can call our phone service to speak to a Medibank nurse about their health concerns at any time of the day or night.~
^ 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).
# For Accidents that occur after your cover starts and for which treatment is sought within 7 days. Excludes claims covered by third parties such as WorkCover and our Private Room Promise. Out of pockets may apply.
~ OSHC members should call the Student Health & Support Line on 1800 887 283.
If you’re an Australian resident with private health insurance, you can choose to be treated as a private patient at either a private or public hospital (provided the service is included in your cover), or a public patient at a public hospital.
Check out the government’s myHospitals website for information on public and private hospitals.
Your out-of-pocket expenses depend on things like the hospital you’re admitted to and what services are Included or Limited under your cover.
Here are three ways to help keep costs down, and avoid any unwelcome fees.
1. Choose specialists who will participate in GapCover for your treatment
GapCover is a scheme designed to help eliminate or reduce your out-of-pocket expenses for in-hospital charges. If your specialist decides to charge more than the MBS fee (the set government fee), you’ll be left with an out-of-pocket expense, commonly known as the ‘gap’. Learn more about GapCover on page 7 of the Going to Hospital brochure.
2. Find out where your specialist operates and opt for a Members' Choice hospital
We have arrangements with most private hospitals and day surgeries in Australia, so you generally get better value if you go to one of these providers.
If you’re treated in a non-Members’ Choice hospital, the amount we pay is generally lower than for a Members’ Choice hospital so you could be left with significant out-of-pocket expenses.
Find your nearest Members' Choice hospital.
3. Ask for a full breakdown of costs
It’s your right to know the full cost of your in-hospital treatment and how much your out-of-pocket expenses could be. Knowing about potential costs not only saves you worrying - it can also save you money.
Before going to hospital, ask each of your specialists for a breakdown of all the costs in writing. This is known as Informed Financial Consent. It should list the fees for each specialist involved in your treatment – your surgeon, assistant surgeon, and anaesthetist – and any other related costs.
Tell your specialists if you’re worried about cost — there may be ways to cut down on expenses without compromising your care.
A rehabilitation program is sometimes required after you have undergone joint replacement surgery. To give you greater choice and flexibility after total hip or knee replacement surgery, Medibank offers a program that allows you to complete your rehabilitation at home. This can involve regular visits from a physiotherapist, occupational therapist, nurse, and/or personal carer.
If you hold Medibank hospital insurance that includes hip and knee replacements, you could be eligible for this program. We will also consult your treating doctor to determine whether it’s safe and appropriate for you. Call us on 1800 065 769, email firstname.lastname@example.org to find out more or download this brochure.
Hospital cover can pay towards services you receive when you’re admitted to hospital and treated as a private patient. It can’t pay towards any services when you’re not admitted to hospital (e.g. seeing your GP or specialist).
Before booking your treatment as a private patient, call us on 132 331 to find out what services we will pay towards, and any out-of-pocket expenses you might incur.
Ask your specialist for the MBS (Medicare Benefits Schedule) item number/s for your treatment and call us on 132 331 to check if it’s an Included, Limited (Restricted) or Excluded service under your cover.
We’ll also let you know if you need to complete any relevant waiting periods.
Things you need to know
* Must have eligible hospital cover, all relevant waiting periods must have been served and treating doctor must consider it appropriate. Out of pocket expenses may apply. Chemotherapy, palliative and dialysis program not available in all areas.
~ OSHC members should call the Student Health and Support Line on 1800 887 283.
# 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).
Δ The information provided does not reflect clinical experience or competency or represent a score against minimum standards or accepted industry benchmarks. This tool does not provide clinical, medical or other professional advice.
While we hope you find this information helpful, please note that it is general in nature. It is not health advice, and is not tailored to meet your individual health needs. You should always consult a trusted health professional before making decisions about your health care. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).
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