Using Your Cover

Making the most of your health cover

Here are a few tips to help you get the most out of your Medibank membership.

Written by Medibank
Kids enjoying with father on trampoline.

Your health cover isn’t just for those times when you’re sick – there are a number of ways you could use it to help keep you healthy and happy.

Here are a few tips to help you get the most out of your Medibank membership.

TIP #1 – Getting the most out of hospital cover

Personalised support with Medibank Hospital Assist

Beyond just helping to pay towards hospital bills, we're looking at ways to make going to the hospital easier. Hospital Assist brings together a range of new and existing services, including a personalised Health Concierge phone service, a targeted Digital Concierge service supporting members with online information, and the 24/7 Medibank Nurse phone service to help with general health questions and concerns. Additionally, members can access Patient Reported Experience Surveys to learn about other patients' hospital experiences and make more informed decisions before going to hospital^.

24/7 Medibank Nurse phone service

We know that it's important to access health advice anywhere, anytime. That's why members with Hospital cover have access to the 24/7 Medibank Nurse phone service. Whether it's a question about how to manage symptoms or when you should see a doctor, day or night, our nurses are available on 1800 644 325 for round-the-clock advice. Members with Overseas Student Health Cover should contact the Student Health and Support Line on 1800 887 283.

Common hospital procedures for someone like you and procedure cost estimator

If you’re wondering about what you might want cover for down the track, take a look at our interactive tool that reveals the common procedures our members are going to hospital for, what you might pay out-of-pocket, and how Hospital cover could help manage the costs. The results are based on our past claims data based on age and gender – and they might surprise you!

TIP #2 – Using extras to your advantage

Extras cover can be a great thing to have when things go wrong, but some services can actually be used to help prevent injury and illness in the first place. Here are some ways to get the most value from your extras.

Take the guesswork out of extras claims

Most members can now get an estimate of out-of-pocket expenses for select extras services, before visiting an extras provider. Simply log in to the My Medibank app and tap on 'Estimate a claim' to get started.

100% back on up to two dental check-ups every year at any Members' Choice Advantage dentist

Eligible Medibank members with Extras cover for two months or more can get 100% back on up to two dental check-ups every year, including bitewing x-rays (where required), at any Members’ Choice Advantage dentist~.

Get 100% back on optical

Everyone deserves to see the world clearly. That’s why when you join Medibank extras for 6 months or more you get 100% back on optical# at all recognised providers up to your annual limits and subject to waiting periods.

Know when your annual limits reset

Most extras annual limits reset annually on 1 January. Unused limits don’t carry over, so you should try to use up as much as you can before the end of the year. Most members can log in to My Medibank or download the My Medibank app to check their remaining limits. Some claims, like paper-based, may take longer to update.

TIP #3 – Ways to save $$$

Nominate your Australian Government Rebate tier

The Australian Government Rebate (AGR) on private health insurance helps make health insurance more affordable by giving you a rebate on your premiums. Your eligibility for the rebate depends on your age and income. If you nominate your AGR tier ahead of tax time, you may reduce your premium.

See what the income tiers are and see what rebate you’re entitled to.

Check on your excess

An excess is the amount you contribute towards your hospital admission (same-day or overnight), as a private patient, before we pay any benefits. Policies with a higher excess often have lower premiums. You could think about how much you are willing to pay up front if you were to need hospital treatment in order to reduce your premium. You can check your excess by logging into My Medibank.

Avoid paying the Medicare Levy Surcharge

The Medicare Levy Surcharge (MLS) applies to Australian taxpayers who don’t hold an appropriate level of private hospital cover and earn over a certain amount for the full tax year. The surcharge can be as much as 1.5% of your annual income* (for MLS purposes) – that’s a lot of dollars!

Here’s some more info about Medicare Levy Surcharge.

Avoid paying for Lifetime Health Cover loading

Lifetime Health Cover (LHC) loading is an Australian Government scheme designed to encourage people to take out Hospital cover. If you don’t have Hospital cover by 1 July after your 31st birthday, you may have to pay a 2% LHC loading for each year you haven’t held Hospital cover, once you do take it out. The maximum loading is 70%. So it could work in your favour to get Hospital cover (and keep it) early in life.

Read more about Lifetime Health Cover here.

TIP #4 – Get better value by choosing Members' Choice

Members' Choice Hospitals

Medibank has arrangements with most private hospitals and day surgeries in Australia, so members can generally get better value for included treatments than if they were to go to a non-Members' Choice hospital.

Members' Choice Extras Providers

Whether you're looking to have your annual dental check-up, to get a new pair of glasses, or get in a physio session, using a provider from our Members' Choice extras network means that you'll generally pay less out-of-pocket expenses than you would if you used a provider outside our network. This is because we've negotiated capped prices for a wide range of extras services at these providers, so you can find out how much you might have to pay upfront.

Find your nearest Members' Choice provider here.

Tip #5 – Enjoy the perks of your membership 

If you have eligible hospital or extras cover, you can now earn rewards with the Medibank Live Better app. Earn points to redeem on rewards, like reducing your premium or your hospital excess, or by getting more from your extras cover like a remedial massage or physio service simply by looking after your health.**

^ 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.

~ Limited to two dental check-ups on all extras annually. Maximum two bitewing x-rays per check-up, where clinically needed. Not available in all areas.

# Excludes some items. Excludes lens coatings.

* A MLS of 1.5% applies if your annual income for MLS purposes is greater than $140,000 for singles or $280,000 for families (including single parents and couples). For families with children, the thresholds are increased by $1,500 for each dependant child after the first.

** Must be 18 years or over and have a valid Australian residential address to register for Medibank Live Better. Must be a Medibank member with hospital cover, extras cover, or hospital and extras cover, be up-to-date with premium payments and have signed up to Medibank Live Better with ‘My Medibank’ or have linked their MyMedibank account with their Live Better account to redeem rewards. Excludes Overseas Visitor health cover, Working Visa health cover, Overseas Student Health Cover (OSHC), Ambulance only cover, ahm covers and other selected covers. Read full Medibank Live Better terms here.

Written by Medibank

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