Changes for the better. Driven by you.
We understand that private health insurance can be a significant investment. We’ve been focusing hard at our end to deliver better value and support, by working closely with doctors, policy makers, and experts in medical technology. But perhaps most important of all, we’ve been listening to what our members have to say. Here are the recent changes we’ve made below, driven by you.
100% back on up to two dental check-ups
We know our members want greater everyday value when it comes to extras. That’s why you can now get 100% back on up to two dental check-ups every year, for everyone on your cover, at any Members’ Choice Advantage dentist, subject to waiting periods#.
Hospital Assist
Beyond just helping to pay towards hospital bills, we’re looking at ways to make going to hospital easier for eligible members with Hospital cover. The Hospital Assist program will include a Health Concierge phone serviceX, a Digital Concierge for online assistanceX, 24/7 Medibank Nurse¹ and Patient Reported Experience Measures surveys (PREMs).
Medibank at Home
You asked for healthcare on your terms, so we developed Medibank at Home. This trial program - which we’re hoping to roll out nationally - allows eligible members to receive treatment from the comfort of their own home for chemotherapy, dialysis, rehabilitation and palliative care^.
Reasons to keep your cover in 2019 and beyond
Accident cover boost
We know that accidents happen. And when they do, recovery should be a top priority. It’s why we’ve made sure that you'll receive the benefits of our gold level of hospital cover in the event of an Accident no matter what level of hospital cover you have.*
24/7 Medibank Nurse
We know that it's important to access healthcare anywhere, anytime. That's why 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 and night.1
100% back on Optical
Depending on your Extras cover, you could get 100% back on optical, up to your annual limit, at almost any provider in Australia. Waiting periods apply and some services, like lens coating, aren’t included.
You may get seen sooner
If you require elective surgery, wait times for procedures are generally shorter in a private hospital. In fact, in a private hospital, you'll be treated as soon as you and your specialist are ready.
Choose the private hospital and specialist that’s right for you
Have peace of mind knowing that as a private patient, where you’re treated and by which specialist is entirely up to you.
Don’t let hospital treatments cost you an arm and a leg
Private hospital bills can be expensive but with Hospital cover you can rest easy knowing you won't be shouldering the full costs of private treatment on your own. Out of pocket expenses apply. You can learn more about the potential costs of some common hospital procedures with our handy tool.
Getting better value from your cover
Getting better value from your cover can be as simple as understanding what's included. Log in to refresh your knowledge about your current cover.
My Medibank App.
We made it simpler for our members to stay on top of their cover with the MyMedibank App. Check your limits, make a claim for most Extras and find a Members’ Choice provider anywhere, anytime. And now, most members can estimate benefits and gaps for select Extras claims.
Download now: Google Play or Apple App Store.
Medibank Free + Active
We want Australians to get together and get moving. Our goal is to help build happier, healthier, more connected communities by supporting our favourite partners to bring you free and social activity and make it more accessible to more Australians.
Heading to hospital?
Below are some common hospital procedures for different life-stages and the potential
costs involved. You can also use our handy tool to learn more about common hospital procedures for someone like you.
Tooth Extraction
Removal of impacted teeth by a surgeon.
47% of the time there are no medical out-of-pocket expenses for this in-hospital procedure. But where there are, approximate costs look like the donut chart displayed.**
- Out-of-pockets for this procedure typically don’t exceed $460.
- Excess is based on your policy and varies from $0 - $500.
- Some policies may also have a per-day payment arrangement.
Childbirth (vaginal) - hospital admission only
An in-hospital procedure for the birth of a baby through the vagina.
69% of the time there are no additional medical out-of-pockets for the hospital admission. But where there are, approximate costs look like the donut chart displayed.**
- Out-of-pockets for this procedure typically don’t exceed $580.
- Excess is based on your policy and varies from $0 - $500.
- Some policies may also have a per-day payment arrangement.
Colonoscopy
A procedure to examine the bowel using a flexible tube containing a small camera and light.
74% of the time there are no medical out-of-pocket expenses for this in-hospital procedure. But where there are, approximate costs look like the donut chart displayed.**
- Out-of-pockets for this procedure typically don’t exceed $550.
- Excess is based on your policy and varies from $0 - $500.
- Some policies may also have a per-day payment arrangement.
Gastroscopy
A procedure to examine the oesophagus, stomach and small bowel using a flexible tube containing a small camera and light.
71% of the time there are no medical out-of-pocket expenses for this in-hospital procedure. But where there are, approximate costs look like the donut chart displayed.**
- Out-of-pockets for this procedure typically don’t exceed $455.
- Excess is based on your policy and varies from $0 - $500.
- Some policies may also have a per-day payment arrangement.
Cardiac Stents
A procedure to hold open blocked arteries to the heart by insertion of a tube-shaped device (or metal mesh tube).
6% of the time there are no medical out-of-pocket expenses for this in-hospital procedure. But where there are, approximate costs look like the donut chart displayed.**
- Out-of-pockets for this procedure typically don’t exceed $510.
- Excess is based on your policy and varies from $0 - $500.
- Some policies may also have a per-day payment arrangement.
**Out-of-pocket expenses:
The chart shows approximate costs based on claims data for this procedure at Medibank Members' Choice Hospitals. It doesn't include out-patient costs where you aren't admitted into hospital, or doctors' fees that aren't disclosed to us (eg. booking fees).
When a medical out-of-pocket expense occurs, it is typically due to the charges for: principal specialist/surgeon, anaesthetist, assistants, diagnostics (eg. lab tests, medical imaging) and other specialists.
Important information:
This is not a quote and should be used as a guide only. The chart above shows a median view of costs for procedures (according to MBS item numbers or Adjacent DRGs) undertaken at Members’ Choice hospitals, based on Medibank in-patient claims data received electronically (between 1/7/2017 and 30/06/2018) for Australian residents and excludes those claims where a medical out-of-pocket expense has not occurred. We recommend you contact us prior to any hospital admission to: check whether the procedure is an included, limited or excluded procedure under your policy; confirm whether you have served relevant waiting periods; and discuss any out-of-pocket expenses you may incur. You should also speak to your doctors and the hospital to discuss any out-of-pocket expenses you may incur. Benefits may not be available in the first 12 months of cover if the procedure relates to a pre-existing condition.
Why premiums are reviewed annually
Reviewing premiums is necessary to keep pace with both the rising cost of healthcare, and the increasing number of treatments sought by Australians. Here’s some of the reasons why premiums are changing.
Better quality healthcare
In Australia, we enjoy some of the best healthcare in the world. New and improving technologies mean better treatment, but they can come at a price. These technologies are often expensive to implement, and contribute to higher overall costs in the health sector.
A rise in chronic conditions
While we’re living longer, Australians are also being admitted to hospital in record numbers. Chronic conditions such as heart disease and diabetes are still increasing year by year.
Our ageing population
It’s great news that Australians, on the whole, are living longer. But the longer we live, the more healthcare we’re likely to need. Generally speaking, increasing life expectancy equals increasing premiums.
Decreasing government rebates
The Australian Government Rebate on private health insurance has been steadily decreasing each year.
Improving affordability
We believe ongoing industry-wide change is needed to address broader issues around the value of health insurance. And we’ve embraced several new initiatives to make a start; like the Youth Discount that applies from 1 April 2019, and provides a financial incentive, for Australians aged between 18 and 29, to take up and maintain eligible hospital cover.
Are you on the right cover?
Everyone benefits from a quick health check now and then. And the same goes with your health insurance.
We know that affordability will always be important for our members. If your circumstances have changed since we last spoke, it may be a good time to review your cover and check if a different cover option may be more suitable.
Answer a few quick questions to find out whether your cover is still right for you, and request a callback to chat about your options.
Frequently asked questions
We know how important affordable health cover is to you and have been working to provide better support and value for members. We’ve also worked hard to take costs out of our business – $40 million in the past two years and a further $50 million planned over the next three years.
We’ve worked hard to reduce costs as a deliberate strategy to provide our product at the best possible price for our customers. This year we’ve delivered:
- The Government’s industry-wide reforms, focused on making health insurance more accessible and simple to understand.
- Our members wanted more control over where and when to get treatment, so we developed Medibank at Home, a group of trial programs that bring hospital care right into the homes of our eligible members, where available, providing them with choice and flexibility over where they receive their treatment.
We're tackling increasing healthcare costs in a number of ways:
- Working closely with the government on policy reform to reduce costs in heath cover.
- Investing in primary care programs for eligible people with chronic conditions to help them stay out of hospital.
- Partnering with the healthcare sector to support better health outcomes for members.
- Launching the Live Better rewards programme to help Australians get healthy and stay healthy.
We can't charge you less for not using your cover or charge you more for using it. Private health insurance in Australia must meet the government's community rating requirements. This means everyone has access to the same insurance products at the same base price, regardless of their health or claiming behaviour.
The main reason for premium change is to keep pace with the rising cost of healthcare and the increasing need for healthcare. We're living longer, chronic conditions are on the rise and we enjoy some of the best healthcare in the world. Your specific premium change depends on several factors, such as the state you live in, the type of cover you're on, and the general claiming pattern of members.
We’ve been working hard to ensure our members can get better value
from their membership. Depending on what’s included in your policy, (check your cover summary to find out more) you may be able to:
- access our Mental Health Line 24/7 (on 1800 644 325)
- talk to a Medibank nurse anytime 24/7 (with Hospital cover)
- get 100% back on two dental check-ups a year at a Members’ Choice Advantage dentist.¹
- get 100% back on optical items like frames, prescription glasses, contacts and more at recognised providers, up to your annual limits. (some lens coatings are excluded).
- at Specsavers, get two prescription designer glasses, including standard single-vision lenses, with no gap. (Both pairs must be of the same prescription and adequate optical limits must be available at the time of purchase).2
- get member discounts on Medibank Pet, Travel and Life Insurance.
And with our Live Better rewards program, we’re rewarding you for looking after your health. You can:
- access free, active and social activities across the country (such as parkrun and outdoor fitness classes)
- access expert health information, recipe inspiration, exercise tips and online courses to support your health
- if you are an eligible Medibank member, earn Live Better reward points and use them towards a gift card, savings of $200 on your health cover or get more on your extras like a remedial massage or physio service - simply by taking a broad range of healthy actions.
The private hospital system gives you peace of mind and choice.
Shorter wait times: For in-hospital procedures that are considered non-life-threatening or elective, you’re likely to be treated sooner as a private patient in a private hospital. If it’s a condition that affects your ability to work or causes pain, this becomes really important.
Choice over your specialist: There’s a lot to be said for being able to choose your preferred specialist as a private patient in a private hospital; even more so if you’re embarking on a health journey like pregnancy, or if it’s a serious illness and your life is quite literally in their hands.
A private room: You are much more likely to get the calm and comfort of a private room whilst in a private hospital (provided one is available and is appropriate for your clinical needs).
Extras
Your Medibank extras cover is there to help with your day-to-day health and could even prevent smaller issues from becoming bigger ones. But you do need to know what’s included under your cover to make the most of it. You can check this through the Medibank mobile app or by logging into My Medibank.
It’s also important to make sure you’re on the right type of cover for where you’re at in life; and that’s why we’re encouraging all our members to take another look at their cover. Give us a call on 132 331 and we’ll take you through a cover review.
Your new premium will apply to your next payment from 1 April 2020 and will be communicated to you as well as available for you to view online via My Medibank, from early February. Don't forget that you can choose how often you pay your premium - fortnightly, monthly, quarterly, every six months, or every year. To change your premium payment frequency please log in to My Medibank.
The Government reforms introduced in April this year have been designed to make the private health system simpler, easier to understand and more affordable for all Australians.
Medibank made the decision to adopt all the Government’s optional reforms because it was the right thing to do.
This includes giving customers the option to increase their excess to $750 to reduce their premium. It also means introducing a discount of up to 10% for young adults.
The cost of delivering healthcare costs in Australia continues to rise, largely driven by more frequent and more expensive hospital admissions and a population that is getting older.
No, we’ve paid dividends for many years. The difference is that instead having of one shareholder, the Australian Government, we now have many shareholders.
No, the main reason premiums are increasing is the rising cost of healthcare and an increase in the frequency of Australians seeking treatment. Medibank’s premiums need to keep pace with these costs to maintain the quality of cover and continue to meet our members' healthcare needs.
Things you should know
X Health Concierge and Digital Health Concierge are 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).
# Limited to two dental check-ups annually across all extras. Not available in all areas.
* 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.
^ 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.
Rehabilitation – Available nationally.
Palliative care – Current trials in limited areas in WA and in Sydney metro area.
Chemotherapy – Current trials in NSW, QLD, SA, VIC and WA in metro areas. Limited availability in regional areas.
Dialysis – Current trials in NSW, QLD and VIC.
~ Waiting period applies. For ambulance attendance or transportation to a hospital where immediate medical attention is required and your condition is such that you couldn’t be transported any other way. Tasmania and Queensland have State schemes providing ambulance services for residents.
1 OSHC members should call the Student Health & Support Line on 1800 887 283.