Frequently asked questions

Pet insurance may help provide assurance against unexpected vet expenses for your cat or dog. Medibank Pet Insurance provides cover for eligible vet expenses to treat specified accidental injuries and illnesses, subject to the policy terms and conditions.^Ω The amount pet insurance can cover, and the types of illness or injuries it will cover depends on the cover you select. 

You can visit any vet, other than yourself, who is licensed in and currently registered in Australia (with the exception of a vet, other than yourself, who is licensed in and currently registered in New Zealand for the purposes of the Travelling in New Zealand additional benefits). ^¥

To make a claim using GapOnly®^~, you will need to check whether it is available at your vet clinic. If you’d like to find a GapOnly® enabled vet, use the handy vet finder.

Pet insurance can help you with unexpected eligible veterinary costs for illnesses and/or specified accidental injuries suffered by your pet.

Medibank Pet Insurance requires you pay a premium each year, which provides cover up to an annual limit of $10,000, $25,000 or $30,000 depending on your level of cover.^ꭥ  The premium can be paid on a fortnightly, monthly or annual basis. It also requires you to pay upfront vet expenses before submitting a claim, unless GapOnly® is used, and veterinary expenses that are above the accepted claim amount. Your policy allows you or your vet to claim veterinary expenses by submitting a claim. You can claim 70%, 80% or 90% of the vet’s invoice depending on your level of cover,^ꭥ after the commencement date of the first policy period and after any applicable waiting periods.

An excess of $0, $100, $250 or $500 (depending on your level of cover) is due per condition, per policy period. You can submit a claim online or by post, by paying the vet invoice(s) in full, and submitting a claim for reimbursement. Or you can claim via a GapOnly® enabled vet, who can do it on your behalf, which means you only pay the gap between the vet’s invoice and the amount covered by your policy.^~

Your policy is issued for a fixed contract term of 12-months. We will automatically renew your policy each year (unless you opt out of automatic renewals or tell us that you don’t want to renew your policy) for as long as we continue to provide the product and subject to the applicable terms and conditions of your policy. We will send your offer of renewal notice at least 14-days before your policy is due to expire to remind you that you can opt out of the automatic renewal process, to check the information we have on your certificate of insurance is correct and to check your insurance cover is still right for you. We’ll change the premium and may change the terms and conditions of the policy at the time of renewal, based on a combination of factors, including the risk associated with insuring pets like yours. You can opt-out of the automatic renewal process by contacting us. If you have chosen for your policy not to automatically renew, you will need to contact us each year to renew your cover. See PDS for more information.

Medibank Pet Insurance offers three different levels of cover to choose from:

• Medibank Pet Protect Pet Insurance: Provides up to 70% back on eligible vet bills, with an annual benefit limit of $10,000.^ꭥ Routine Care (non-insurance benefit) and/or Extra Care ^† can be selected as optional benefits.
• Medibank Pet Plus Pet Insurance: Provides up to 80% back on eligible vet bills, with an annual benefit limit of $25,000.^ꭥ Routine Care (non-insurance benefit) and/or Extra Care ^† can be selected as optional benefits.
• Medibank Pet Max Pet Insurance: Provides up to 90% back on eligible vet bills, with an annual benefit limit of $30,000.^ꭥ Extra Care is an included benefit with an extra care limit of $2,000, which is additional to the annual benefit limit. ^† Routine Care (non-insurance benefit) can be selected as an optional benefit.

More information about Medibank Pet Insurance plans is available in our Product Disclosure Statement and you can compare our three different levels of cover in our comparison table.

An excess is an out-of-pocket amount you contribute towards the cost of your claim(s), as shown on your certificate of insurance. The excess is calculated on a ‘per condition, per policy period’ basis. The excess will be deducted from your calculated claim benefits after we apply any benefit limit, sub-limit (if any), extra care limit (where applicable) and the benefit percentage to your claimed amount.

Please note, unless your vet uses GapOnly®,  you will need to pay the full amount for treatment upfront to the vet before seeking claims reimbursement for the eligible expenses. Additionally, you can only claim up to the annual benefit limit of your policy.^ꭥ  Vet expenses incurred over one year that exceed the annual limit of your policy will need to be paid in full. Please see your Product Disclosure Statement for more information.

Medibank offers three levels of cover, each with a different annual benefit limit.

Subject to your policy terms and conditions, you can claim up to $10,000 per year with Pet Protect Cover, $25,000 per year with Pet Plus Cover and $30,000 per year with Pet Max Cover.^ꭥ  When claiming, your claim benefit (or reimbursement amount) will be subject to the annual benefit limit, the benefit percentage, sub-limits (if any), and excess (if any).

Please see your Product Disclosure Statement for more information.

Medibank Pet Insurance does not cover or pay benefits to any pre-existing conditions, unless they meet the requirements of a temporary condition, which can be found in the PDS.

A pre-existing condition is:

• A condition that existed or occurred prior to the commencement date of your first policy period or within any applicable waiting period; and

• A condition that you or your vet were aware of, or a reasonable person in your circumstances would have been aware of irrespective of whether the underlying or causative condition has been diagnosed.

A pre-existing condition also includes a related condition or bilateral condition of a pre-existing condition.

You can apply to have pre-existing conditions reviewed. 

If, after any applicable waiting period, your pet has a pre-existing condition that is a temporary condition which hasn't existed, occurred or shown noticeable signs, symptoms or an abnormality in the 18-month period immediately prior to your claim treatment date, it won't be excluded from cover as a pre-existing condition.

This is a summary only. Read the Product Disclosure Statement for more information and examples of pre-existing conditions.

You can apply to have a pre-existing condition reviewed by completing the Pre-Existing Conditions Review form or contact us for assistance.

Your vet will need to certify and provide veterinary records as set out in the Pre-Existing Conditions Review form.

This is a summary only. Read the PDS for more information about pre-existing conditions.

You may find the PDS, TMD and policy forms on the Useful Documents page.

This is a common problem, especially if you have adopted a pet. If you truly have no idea, ask your vet who should be able to estimate your pet's age based on an examination of certain physical characteristics.

Each pet has its own policy with its own cover and excess option. If you insure more than one pet, a multi-pet discount of 5% on your premium will apply to each additional pet.^> If you are purchasing cover for multiple pets at the same time, the discount will be applied in the order in which the policies are selected. If you wish to insure an additional pet but not at the same time, contact us on 132 331.

No, you are not required to submit veterinary records when you apply for Medibank Pet Insurance.

However, when making a claim, you will need to submit any veterinary consultation notes. In some instances, we may require more information to process your claim such as medical history or pathology/laboratory results. We'll contact you or your vet(s) if this information is required. Read the PDS for more information. For adopted pets, veterinary history is only required from when you took ownership. You’ll also need to provide us with proof of adoption or transfer of ownership papers.

Medibank Pet Insurance only covers dogs and cats that are 8 weeks or older, and younger than 9 years at the time of your first policy commencement date.

Breeds that have been listed by your state or territory as dangerous, prohibited or restricted are not eligible for Medibank Pet Insurance. We are unable to provide cover for some breeds (and their cross breeds) banned by the Australian government, for example, the Presa Canario, Dogo Argentino, Fila Brasileiro and the Japanese Tosa.

Cats and dogs are more than just a pet, they’re a member of the family! And they help us in so many ways. Pet insurance is one way you can help look after them by focusing on their health, and less on the cost of treatment when it comes to eligible vet bills.

Pet owners can never predict when something might happen to their cat or dog. Pet insurance can help assist with unexpected eligible vet expenses, so you can help protect them when they need it most.

It’s important that you read the Product Disclosure Statement (PDS) and before you make a decision to buy or continue to hold this product. The PDS contains details about Medibank Pet Insurance, you can get a copy by calling 132331 or visiting the Useful Documents page.

Yes, you will receive a 10% discount off your Medibank Pet Insurance premium each year when you provide your accurate membership details at point of purchase or at renewal of your policy.^#

You can start your pet dog or cat’s cover when they are 8 weeks or older and before its 9th birthday. Cover is available for the life of your pet as long as we continue to provide the product, and you renew your policy each year without any break, lapse or change in in the level of cover. Cover and renewal is subject to the applicable terms and conditions of the policy for each policy period. See details in your Product Disclosure Statement.

For new policies

We calculate your premium based on several factors. Some are pre-set and don’t vary, e.g. amounts we consider for some internal expenses. Others can affect the premium amount depending on whether we believe it increases or decreases the risk to us. For example, the type of cover and options you have selected.

We’ll also take into account risk factors associated with you and your pet such as your pet’s breed and age. For instance, as your pet gets older the risk of your pet requiring treatment will increase and so the premium increases.

There are also commercial factors that affect your premium, including costs associated with operating our business and our commercial arrangements.

Your premium calculation may also include discounts or promotional offers that we provide. If you qualify for two or more discounts, we apply a specific order to our calculation of your final premium.

Also, any discounts and/or your premium may be rounded up or down and some may only apply in the first year of coverage.

For renewals and changes to your policy

For renewals, we also factor in the claim history for your pet and the average cost of care for pets like yours, as well as the claims experience across all our insured pets. Because of all of these factors and the changes to your pet’s risk profile, your premium will increase from year to year. When calculating your premium on renewal, we also consider how much your premium was previously, including any discounts that may have been applied. This means that we may limit movements up or down.

These same factors and others are also used to calculate your premium if you amend your coverage.

For more information refer to your PDS.

Yes, your premium will increase from year to year.

For renewals, we also factor in the claim history for your pet and the average cost of care for pets like yours, as well as the claims experience across all our insured pets. Because of all of these factors and the changes to your pet’s risk profile, your premium will increase from year to year.

When calculating your premium on renewal, we also consider how much your premium was previously, including any discounts that may have been applied. This means that we may limit movements up or down. These same factors and others are also used to calculate your premium if you amend your coverage.

Please see ‘How do you calculate my premium’ for more information about calculation of premiums.

We review the cost of everyone’s insurance every year, taking around of a range of factors. This includes the claims experience across all our insured pets. That means, for example, if the costs of claims increase, or due to an increased take-up of those services, it will likely lead to an increase in everyone’s premiums.

We also factor in  the average cost of care for pets like yours. For example, a pet parent with a three-year-old French Bulldog will be affected by the trends we see in our data from the other three-year-old French Bulldogs we insure. We also factor in the claim history for your own pet.

No. Pet insurance does not work like health insurance.

You can claim for diagnostic expenses in relation to conditions covered by your policy. However, elective, or routine tests aren’t covered. This is a summary. Read the PDS for more information.

You can claim for consultations in relation to conditions covered by your policy. ^ꭥ

• For Medibank Pet Protect, this is subject to the annual benefit limit, consultations sub-limit, benefit percentage and excess (if any).
• For Medibank Pet Plus and Medibank Pet Max, this is subject to your applicable annual benefit limit, benefit percentage and excess (if any).

Please see your Product Disclosure Statement for more information regarding your cover.

Medibank Pet Insurance policies do not include cover for Third Party Liability.

Yes, hereditary and congenital conditions are eligible for cover if they have not shown noticeable signs, symptoms or an abnormality at any time before the start date of the first policy period or during any applicable waiting period. You can read more about hereditary conditions and congenital conditions in the Product Disclosure Statement.

No, the purpose of Medibank Pet Insurance is to help assist pet owners with the cost of unexpected veterinary treatment for their pet. Mortality insurance, life insurance or liability insurance are not offered.

Like most insurance policies, there are certain situations where you will not be covered. This is a summary only. Read the FAQ ‘Does pet insurance cover pre-existing conditions?’ and the PDS for more information.

There are some general exclusions, such as:

• Pre-existing conditions which first existed or occurred prior to commencement of your first policy period or during any applicable waiting period. Read the PDS for more information.
• Routine or preventive treatments, unless you purchase the Routine Care non-insurance benefit, which provides a contribution up to the Routine Care limits for selected routine care items.
• Some elective treatments and procedures.
• Breeding and obstetrics.
• Anything that is not a specified accidental injury as listed in the PDS.
• Anything listed as a general exclusion in the PDS.

There may also be specific exclusions which may apply to specific levels of cover.

This is a summary only. Read the PDS for a comprehensive list and full explanation of policy exclusions.

You can visit any vet, other than yourself, who is licensed in and currently registered in Australia (with the exception of a vet, other than yourself, who is licensed in and currently registered in New Zealand for the purposes of the Travelling in New Zealand additional benefits). See PDS for more information.

If you have the Routine Care (non-insurance optional benefit), we will provide a contribution towards the cost(s) of any of the specified Routine care items, which includes desexing, up to the Routine care limits. Routine Care (non-insurance optional benefit) also provides contribution towards the cost of other specified Routine Care items, such as microchipping, heartworm preventative, teeth cleaning, dew claw removal, council registration fees, prescription diets, cremation/burial, vaccination or health checks and others. More detail about Routine Care is available here.

If you have the Routine Care (non-insurance optional benefit), we will provide a contribution towards the cost(s) of any of the specified Routine Care items, which includes vaccinations, up to the Routine Care limits. Routine Care (non-insurance optional benefit) also provides contribution towards the cost other specified Routine Care items, such as microchipping, heartworm preventive, teeth cleaning, dew claw removal, council registration fees, prescription diets, cremation/burial, vaccination or health checks and others.  More detail about Routine Care is available here.

When you make a claim, you’ll be asked to attach any veterinary consultation notes relevant to your claim.

If your cat or dog was adopted, veterinary history is only required from when you took ownership. You will also need to provide a copy of the proof of adoption or transfer of ownership papers for verification.

There is no time limit to submitting a claim for your pet.

There is no waiting period for specified accidental injuries (like a motor vehicle accident, ingestion of a foreign object or poisoning) which means you can submit a claim from your policy commencement date. For illnesses, there is a 30-day waiting period. A 6-month waiting period applies for cruciate ligament conditions. If you have Extra Care,^† there is a 30-day waiting period for specialised therapies, and a 6-month waiting period for specified dental conditions. See our product comparison page for more detail.

Medibank’s Extra Care, provides benefits for both specialised therapies and specified dental conditions. Extra Care included with Pet Max, and an optional benefit for Pet Protect and Pet Plus.^†  The Extra Care annual benefit limit is $2,000 and is in addition to your policy annual benefit limit.

The Extra Care limit is the maximum amount payable across both specified dental conditions and specialised therapies combined.

Specified dental conditions

Cover for specified dental conditions under the Extra Care benefit, includes eligible vet expenses incurred for scaling, polishing, dental x-rays and tooth removal of the following specified dental conditions: gingivitis, abscesses, odontoclastic resorptive lesions, and removal of teeth where medically necessary due to dental disease arising from infection, retained deciduous teeth, cavities or fractured teeth due to dental disease.

Medibank offers three levels of cover, each with a different annual benefit limit.

Subject to your policy terms and conditions, you can claim up to $10,000 per year with Pet Protect Cover, $25,000 per year with Pet Plus Cover and $30,000 per year with Pet Max Cover.^ꭥ  When claiming, your claim benefit (or reimbursement amount) will be subject to the annual benefit limit, the benefit percentage, sub-limits (if any), and excess (if any).

Please see your Product Disclosure Statement for more information.

There are many ways to make a claim:

GapOnly® ^~

GapOnly® is a service that enables same day, in-clinic claims processing. That means you can claim on the spot and only pay the ‘gap’ (the difference between the vet’s invoice and the eligible claim benefit calculated, if any, under your pet insurance policy). It helps keep the focus on the health of the pet (not the cost of treatment), with the added convenience of less paperwork and same day processing. Head to the vet finder to find your closest GapOnly® vet clinic.

eClaim

Alternatively, your vet may be able to submit your claim for you in-clinic electronically once you’ve paid your invoice (sometimes referred to as an eClaim). Once lodged you can check your claim’s status online via the Pet Portal.

Pet Portal

You can submit an online claim through Pet Portal. Simply upload an itemised tax invoice (a paid invoice that includes individual treatment items and costs adding up to the total amount paid) and payment receipts; and vet consultation notes, if you have them (these are the veterinarian's medical notes from examinations findings).

We may also contact you for additional documentation if needed. Not registered? Register now.

Paper Claim by Post

You can also submit a paper claim to us by post. If you do this, please post a completed Medibank Pet Insurance Claim Form and ensure you include itemised tax invoice (a paid invoice that includes individual treatment items and costs adding up to the total amount paid) and payment receipts; and vet consultation notes, if you have them (these are the veterinarian's medical notes from examinations findings).

All claim documentation must be original for postal claims, and the Medibank Pet Insurance Claim Form must be signed by you and your vet. You can get a copy of this form on the Useful Documents section of the website or can contact us by calling 132 331.

In some instances, we may require more information to process your claim such as medical history or pathology/laboratory results. We'll contact you or your vet(s) if this information is required.

Pre-approval

You can seek pre-approval for the expected costs of vet treatment(s). Pre-approvals aren’t mandatory, but they can provide you with reassurance as to whether you’ll be covered and if so, what benefits will be provided for an upcoming treatment. You will need to provide to us the itemised estimate of costs from your vet, along with the treatment required and relevant clinical records and/or veterinary history, and we will respond to you in writing with the outcome. For more information on how this works, please refer to the claims page.

If we agree to a pre-approval but the treatment provided by your vet differs from the treatment request in the pre-approval, then our assessment of the amount we cover under your claim may vary from the notified pre-approval amount. A variation in the amount we cover may also occur if you have reached your benefit limit, sub-limit (if applicable), Extra Care limit (if applicable), or routine care limits (if applicable) on the claim.

GapOnly® is a pet insurance payment service that enables same day, in-clinic claims processing. That means you can claim on the spot at participating vet clinics and only pay the ‘gap’ (the difference between the  vet’s invoice and the eligible claim benefit calculated, if any, under your pet insurance policy).^~ It helps keep the focus on the health of the pet, not the cost of treatment, with the added convenience of less paperwork and same day processing.^~

You can check if your vet is GapOnly® via the vet finder.

GapOnly® is currently available for Medibank Pet Insurance policyholders. It’s available at participating vets during the following hours:

Monday – Friday 8:00am – 10:00pm
Saturday 8:00am – 5:00pm
(Available AEST or AEDT as applicable, excluding NSW public holidays)

Your vet may be able to submit an electronic pet insurance claim - sometimes referred to as an eClaim -  outside of these hours.

Great! First, we suggest that you check whether your vet is GapOnly® enabled by visiting the GapOnly® Vet Finder. If they are, simply let your vet know that you would like to submit a GapOnly® claim the next time you have an appointment, or better still, at the time of booking your appointment. It’s best to let your vet know that you intend to use GapOnly® for your pet insurance claim as early as possible so they can prepare your claim ahead of time to help minimise any possible delays.

A GapOnly® claim will take around 10 minutes to process, while you’re still at the clinic. If the claims team think it will take a little longer, they will let the vet clinic staff know as soon as possible so you can decide whether you would like to wait, or if available, submit an electronic pet insurance claim instead. To help speed up this process, please let your vet know as early as possible that you would like to use GapOnly® for your pet insurance claim, either when you first book the appointment, or when you first arrive at the clinic. This will help minimise any possible delays.

You can use GapOnly® for eligible vet invoices covered by your Medibank Pet Insurance policy, provided your vet is GapOnly® enabled.^~ Find your nearest GapOnly® -enabled vet using the vet finder.

Yes, you can ask your vet to submit a GapOnly® claim on your behalf so you don’t have to wait for your claim to be processed when you pick up your pet. Simply let your vet know when you drop off your pet that you’d like to submit a GapOnly® claim  and, if available, they can arrange organise this on your behalf. If you forget to let your vet know don’t worry, you can always request to claim on-the-spot with GapOnly® in-clinic when you pick up your pet.

If your pet has an upcoming vet procedure or treatment surgery or scheduled hospital visit and you’d like to know whether your Medibank Pet Insurance policy will provide cover for the procedure, prior to treatment you can request a pre-approval via your vet. Simply ask your vet to organise one for you on your behalf through Medibank Pet Insurance when you first book your pet’s appointment, or after your pet’s consultation. Once the pre-approval process has been completed, you’ll hear from Medibank Pet Insurance in writing to confirm.

The Pet Portal can help manage your Pet Insurance policy. For more information on how to login or register for your Pet Portal, please click here.

There you can:

• Update your contact information and notification preferences.
• Update your payment details.
• Make and manage a Pet Insurance claim.
• Access your key Pet Insurance policy documents.

If you need to make other changes to your policy, please call our Customer Care Team during operating hours on 132 331.