Making the most of your cover

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.

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.

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. 

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. 

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

• 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.