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Non Members' Choice
Medibank pays benefits to eligible members when they attend Recognised Providers. Recognised Providers are health care providers approved by Medibank for the purposes of paying benefits. Recognised Providers include those providers not participating in Members' Choice.
Medibank has entered into arrangements with many Recognised Providers from the Dental, Optical, Physiotherapy, Chiropractic/Osteopathy, Acupuncture and Naturopathy fields. The Members' Choice Agreement is an arrangement where providers agree to provide their services to Medibank eligible members for no more than Maximum Agreed Prices. These relationships form the Medibank Members' Choice network.
An eligible member is one of our members who has cover under one of our Extras covers which provide benefits towards goods and services of the kind provided by the Members' Choice provider.
Maximum Agreed Prices are the maximum a Members' Choice provider can charge a Medibank member for specified goods and services. The main considerations used when determining agreed price levels are market-based reviews and consultation with providers. Maximum Agreed Prices do not apply to all optical items but to selected optical items only. Agreed discounts apply to other optical items.
Both the provider and Medibank sign a document setting out the Terms and Conditions of the Members' Choice arrangement. This is designed to formalise the parties' obligations and secure our members' access to no or known out-of-pocket expenses. The providers' clinical independence is not affected in any way.
The names of Members' Choice providers are sent to our members on request, are available through the members enquiries phone number, listed on this website and distributed through Medibank Retail Centres and agencies. The choice of provider, whether non-Members' Choice or Members' Choice, rests solely with the member. Medibank does not recommend any particular provider.
Included in Members' Choice:
- Dental Prosthetist
- Remedial Massage.
The Members Choice Provider Help Desk phone number is 1300 720 165. Hours of Operation Monday to Friday 9.00am to 5.30pm EST except for National Public Holidays. A messagebank service operates Monday to Friday 5.30pm to 8.00pm
End to end handling of enquiries and assistance with matters including:
- Member eligibility
- Waiting periods
- Claims handling
- Members' Choice arrangements
- Limits and sublimits
- Restrictions and exemptions (dental)
- Maximum Agreed Prices
- PackagePlus PackageBonus
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