The amount you can claim back at Members’ Choice providers, up to annual limits. Fixed amounts apply at non-Members’ Choice providers, up to annual limits.
The amount you pay before Medibank contributes to your hospital costs.
Hospital & Extras offer - Want 6 weeks free and up to $500 in gift cards?
Join and maintain eligible Bronze hospital and extras cover or above and you could get 6 weeks free plus 50,000 Live Better points (couples and families) or 25,000 Live Better points (singles and single parents) to redeem on rewards like gift cards. We’ll also waive 2&6 month waiting periods on extras. Use promo code: 6WEEKSPLUS. Offer ends 21 November 2024. New members only.€
Hospital cover
- Our most extensive level of Hospital cover
- Earn an Ultra Bonus each year to cover eligible hospital out of pockets
- Unlimited emergency Ambulance Australia-wide^
What is a waiting period?
The time you need to wait before you can receive benefits for services or items listed in your cover.
When do they apply?
To new members, or when switching to a higher level of cover.
Switching funds?
If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served.
What is a pre-existing condition?
An ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by Medibank, the signs or symptoms existed at any time during the six months before you either took out your new cover, or transferred to a higher level of cover (12 month waiting period applies).
Inclusions | Waiting period
What is a waiting period? The time you need to wait before you can receive benefits for services or items listed in your cover. When do they apply? To new members, or when switching to a higher level of cover. Switching funds? If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served. What is a pre-existing condition? An ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by Medibank, the signs or symptoms existed at any time during the six months before you either took out your new cover, or transferred to a higher level of cover (12 month waiting period applies). |
---|---|
Nil | |
1 day | |
2 months | |
2 months | |
2 months | |
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
12 months | |
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
6 months | |
Nil | |
Nil |
Hospital costs explained
Hospital cover helps with the cost of treatments you receive in hospital as a private patient. Of course, everyone is different, and so our Hospital covers come in all shapes and sizes to suit different priorities and stages in life.
For services included under each of our Hospital covers, we’ll pay benefits towards:
- Eligible ambulance services
- In-hospital medical services
- Overnight accommodation in a private hospital, or a shared room in a public hospital as a private patient
- Same-day admission
- Intensive care
- Theatre fees
- The minimum benefit for medical devices and human tissue products as set out in the government's Prescribed List of Medical Devices and Human Tissue Products
Depending on your cover you may need to pay an excess or co-payment before we will pay any benefits towards your hospital admission. Other out-of-pocket expenses may apply.
- Services not included in your cover or for which you are serving waiting periods
- Some high-cost medications
- Services not covered by Medicare
- Medical devices and human tissue products in excess of approved benefits in the Government’s Prescribed List
- Cosmetic treatments
- Certain other items (e.g. streaming services and parking), depending on the hospital you're admitted to. The hospital should discuss any charges with you.
It's a good idea to call us on 1300 518 089 so we can take you through what we will pay benefits for, and let you know of any potential out-of-pockets you might expect for your procedure.
Extras cover
- Includes exclusive Ultra benefits, such as laser eye surgery
- Higher annual limits for more costly services, such as major dental, orthodontics and hearing aids
- Health screening test, bowel screening, bone density, retinal scans where not covered by Medicare
- 100% back on up to three dental check-ups every year (including bitewing x-rays) at any Members’ Choice or Members' Choice Advantage dentist1
Inclusions | Annual limits per person | Waiting period |
---|---|---|
Claim back percentage: | 100% | |
Claim back percentage: | ||
N/A | 1 day | |
N/A | 2 months | |
No annual limit | 2 months | |
$1600 | 12 months | |
$1500 | 12 months | |
$300 | 6 months | |
$500 combined limit | 2 months | |
$1000 | 2 months | |
$750 | 2 months | |
$600 | 2 months | |
Combined limit | 2 months | |
$600 | 2 months | |
$300 | 12 months | |
24 months | ||
$600 | 2 months | |
$600 | Nil | |
$600 | 2 months | |
$100 | 2 months | |
$200 | 2 months | |
$1600 | 36 months | |
$800 | 2 months | |
$600 | 2 months | |
$600 | 2 months | |
$250 | 2 months | |
$500 | 2 months | |
$3500 | 36 months |
What are annual limits?
The maximum amount of benefits payable towards services, items or groups of services and/or items in a calendar year.
Switching health funds?
Benefits paid under your previous cover will be taken into account in determining the benefits payable under your Medibank cover.
What is a waiting period?
The time you need to wait before you can receive benefits for services or items listed in your cover.
When do they apply?
To new members, or when switching to a higher level of cover.
Switching funds?
If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served.
Extras costs explained
Extras cover gives you money back for non-hospital services such as dental, physio, optical and more.
The amount of money you can claim back depends on the level of cover you have. Generally speaking, the higher the level of cover, the higher your annual limit and higher the percentage you can claim back. Which means more money back in your pocket.
- 100% back on at least one dental check-up and clean each year at a Members’ Choice or Members’ Choice Advantage provider.1
- 100% back on optical items at all recognised providers up to annual limits. Excludes Healthy Living Extras.±
- Access to Members’ Choice, one of the largest health provider networks in Australia, covering more than 12,000 providers. We’ve set maximum prices that these providers can charge, so you’ll avoid any surprises when the bill arrives
With a Members' Choice provider, you'll receive a fixed % back on services, up to your annual limits.
If your extras provider isn't part of our Members' Choice network don't worry. As long as they're a Medibank recognised provider, we'll still pay a fixed amount for each service or item, up to your annual limits.
Supporting documents
Why choose Medibank?
30 day cooling off period
If you're not completely happy with your cover in the first 30 days of joining, let us know and we'll transfer you to a more suitable cover or refund your premiums (as long as no claims have been made).
100% back on optical on eligible extras±
When you join eligible Medibank extras you get 100% back on optical items at all recognised providers up to annual limits.±
100% back on dental check-ups twice a year on eligible extras1
With eligible extras cover you get 100% back on up to two check-ups each year at a Members’ Choice Advantage Dentist (including bitewing x-rays where clinically required).1
Want to discuss your options?
Leave your details and a Medibank expert will be in touch to take you through your options. In providing your telephone number, you consent to Medibank contacting you about health insurance.
^ Tasmania and Queensland have state schemes that cover ambulance services for residents of those States.
= Eligible members on Medibank extras (excluding Healthy Living Extras and Gold Ultra Health) can claim a maximum of two 100% back dental check-ups per member, per year at a Members’ Choice Advantage provider (including bitewing x-rays where clinically required). For members on eligible extras, the first two check-ups do not count towards your annual limit. Members with Healthy Living Extras can get 100% back on one dental check-up each year at a Members’ Choice Advantage provider (including up to two bitewing x-rays, where clinically required) or at a Members’ Choice provider (excluding x-rays). Members with Gold Ultra Health can get 100% back on up to three dental check-ups at a Members’ Choice or Members’ Choice Advantage provider. Members’ Choice and Members’ Choice Advantage providers are not available in all areas. Two month waiting period applies. Some products may have other dental benefits, check your cover summary for details.
# Medibank has Members' Choice providers for these services. Not available in all areas.
~ Some items and services may require a Referral Letter and may have a benefit replacement period. Please see the Cover Summary or Member Guide for more information.
1 Eligible members on Medibank extras (excluding Healthy Living Extras and Gold Ultra Health) can claim a maximum of two 100% back dental check-ups per member, per year at a Members’ Choice Advantage provider (including bitewing x-rays where clinically required). For members on eligible extras, the first two check-ups do not count towards your annual limit. Members with Healthy Living Extras can get 100% back on one dental check-up each year at a Members’ Choice Advantage provider (including up to two bitewing x-rays, where clinically required) or at a Members’ Choice provider (excluding x-rays). Members with Gold Ultra Health can get 100% back on up to three dental check-ups at a Members’ Choice or Members’ Choice Advantage provider. Members’ Choice and Members’ Choice Advantage providers are not available in all areas. Two month waiting period applies.Some products may have other dental benefits, check your cover summary for details.
± Excludes Healthy Living Extras and select products that are no longer available for sale (for more information check your cover summary or check this page). Applies to prescription glasses and select contact lenses. Some glasses lens coatings and contact lenses are excluded. To find which specific items are included or excluded, call us on 132 331. 6 month waiting period applies.
€For new members on new memberships who join and start eligible combined Bronze hospital and extras cover or above from 18 September – 21 November 2024 and who have not held Medibank health cover in previous 60 days (unless they are dependents coming off their parent’s cover). Must quote promo code ‘6WEEKSPLUS’ and set up direct debit when joining. Excludes Basic cover, Corporate covers, Hospital only cover, Extras only cover, Accident Cover, Overseas Visitors Health Cover, Overseas Workers Health Cover, Overseas Students Health Cover (OSHC), Ambulance Cover, ahm covers, and other selected covers. Not available to Medibank employees. Not available with any other offer. Medibank reserves the right to amend these Terms and Conditions from time to time.
6 weeks free terms: Must maintain direct debit and hold eligible cover for 42 consecutive days from the policy start date to get next 6 weeks free. The 6 weeks free will not be issued if you change to an ineligible cover, terminate your cover or suspend your cover during this period.
2&6 month waits waived on extras terms: 2&6 month waiting periods on extras waived. Other waiting periods apply (including 12 months on some dental services). Annual limits apply. If you're switching from another fund and you’ve used any of your current limits (at that fund), that will count towards your annual limits with us. If you've reached your limits at your previous fund you may not be able to claim straight away on extras.
Live Better rewards points terms: Must maintain direct debit and hold eligible product for 42 consecutive days from the policy start date to receive Live Better rewards points. The points will not be issued if you change to an ineligible cover, terminate your cover or suspend your cover during this period. Policyholder will require access to a smartphone and will need to download the My Medibank app. Policyholder will need to have registered a My Medibank account, sign up to Live Better via the My Medibank app and track a Live Better activity within 42 consecutive days from the policy start date. Must be 16 years or over to register for Live Better. Live Better rewards points could take up to 10 weeks from the policy start date to be loaded to the policyholder’s Live Better account. Singles and single parents will receive 25,000 Live Better rewards points, and families and couples will receive 50,000 Live Better rewards points.
Live Better rewards terms: Must be a Medibank member with eligible hospital cover, extras cover, or hospital and extras cover, be up-to-date with premium payments and have signed up to Live Better via the My Medibank app to redeem rewards. Additional terms and conditions may apply to the redemption of a reward depending on the type of reward chosen. Read full Medibank Live Better terms here: https://www.medibank.com.au/livebetter/rewards/terms/