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, a 24/7 Health Advice Line 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
Accidental Injury Benefit
We know that accidents happen. And when they do, recovery should be a top priority. It’s why we’ve made sure that regardless of their level of Hospital cover, our members receive the benefits of our top level of Hospital cover in the event of an Accident*.
24/7 Health advice line
We know that it’s important to access healthcare anywhere, anytime. That’s why members with Hospital cover can always speak with a Medibank nurse on our 24/7 Health Advice Line - 1800 644 325.
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.
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
Your new premium payment will apply to your next payment from 1 April 2019. Don't forget that you can choose how often we pay your premium - fortnightly, monthly, quarterly, every six months, or every year. To change your premium payment frequency please log in to medibank.com.au/members.
Australian private health insurance is based on a principle called 'Community Rating' which ensures everyone has fair access to private health cover and isn't limited by their claiming history or other factors such as gender or age.
We want you to make the most of your health cover so did you know you can access services like:
- linking your Medibank membership to your flybuys account for even better rewards
- chat online with one of our team about your policy, 24/7
- special offers from some of your favourite brands, including Fitbit®, Palace Cinemas and Sunglass Hut
- gym visits for as little as $8.50 with GymBetter®
- member discounts on Pet Insurance and Travel Insurance.
And depending on what's included with your policy, (check your cover summary to find out more) you may also be able to:
- talk to Medibank nurses anytime, through our 24/7 Health Advice Line (with Hospital cover).
- get 100% back on up to two dental check ups every year at a Members' Choice Advantage dentist#. A 2 month waiting period applies.
- get 100% back on optical items like frames, prescription glasses, contacts and more at recognised providers, up to your annual limits. Waiting periods apply and some lens coatings are excluded.
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.
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.
- Developing a number of community programs that help Aussies get healthy and stay healthy like Free + Active.
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.
We want you to make the most of your health cover, so have you registered for My Medibank yet? My Medibank allows you to easily submit claims, check your cover and limits, and make payments when it suits you. Once you sign up, you can also choose to receive health and wellbeing articles, recipes, exclusive member offers and more via email.
Download the Medibank Mobile App on the Apple App Store or Google Play. Or simply register online:
- Visit medibank.com.au/members to log in or register.
- Follow the prompts and switch your contact preferences to email and SMS.
- Be sure to opt in to marketing communication to receive exclusive member offers and discounts.
Healthcare costs are rising at a higher rate than inflation. Several factors contribute to this: the increasing use and cost of healthcare services, our ageing population, new medical technologies, and a rise in the incidence of chronic conditions. Medibank’s premiums need to keep pace with these rising costs to maintain the quality of cover and to meet our members' healthcare needs.
No, we’ve paid dividends for many years. The difference now is that instead having of one shareholder, the Australian Government, we now have many shareholders.
We know how important affordable health cover is to you. So we regularly review the way we work to see where we can be more efficient, progressive, and competitive with other health funds.
The industry average is calculated using figures from every health insurer, in every state. It's just a standardised figure. There are several factors that influence your premium, like which state you live in, the kind of cover you have, the excess you've chosen, and the general claiming pattern of members. Your premium could also be impacted by the Australian Government Rebate on private health insurance and the Lifetime Health Cover loading.
This really depends on a number of factors including the state of the Australian healthcare system and the general health of Australians at any given time. So, we can't say that premiums won't go up in the future, but we're working hard to both keep premiums down as much as we can, and deliver more value back to our members.
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 join date. 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.