Hospital cover designed to meet the needs of the young and healthy combined plus cover for some of the more-commonly used Extras.
For joins completed online, cover payments must be fortnightly at a minimum. We'll update the selected pricing for this cover from weekly to fortnightly.
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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.
If you have an Accident, you’ll get the benefits of our gold level hospital cover, no matter what level of hospital cover you have2.
Health concerns keeping you up at night? Members with health insurance are supported by registered nurses with 24/7 Medibank Nurse Support at no extra cost¥¥.
Members with health insurance can chat with a mental health professional over the phone or online in relation to any mental health or emotional concern, 24 hours a day 7 days a week at no extra cost¥¥.
Online or via the app – My Medibank is your personal health insurance hub to help you use and manage your cover wherever and whenever it suits you.
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). |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. For ambulance attendance or transportation to a hospital where immediate professional attention is required and your medical condition is such that you couldn't be transported any other way. Waiting period
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1 day |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Covers which have services that are normally Restricted or Excluded will be treated as an Included service where treatment is required for injuries sustained in an Accident that occurs after joining this cover, provided that the treatment is on the Medicare Benefits Schedule. Refer Cover Summary for full details.
Waiting period
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Nil |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Hospital treatment for the treatment and care of patients with psychiatric, mental, addiction or behavioural disorders. For example: psychoses such as schizophrenia, mood disorders such as depression, eating disorders and addiction therapy.
Waiting period
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2 months |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Hospital treatment for care where the intent is primarily providing quality of life for a patient with a terminal illness, including treatment to alleviate and manage pain. Waiting period
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2 months |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Hospital treatment for physical rehabilitation for a patient related to surgery or illness. For example: inpatient and admitted day patient rehabilitation, stroke recovery, cardiac rehabilitation.
Waiting period
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2 months |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Hospital treatment for the investigation and treatment of a hernia or appendicitis. Digestive conditions are listed separately under Digestive system.
Waiting period
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2 months
(12 months for pre-existing) |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Hospital treatment for surgery for joint reconstructions. For example: torn tendons, rotator cuff tears and damaged ligaments.
Joint replacements are listed separately under Joint replacements.
Waiting period
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2 months
(12 months for pre-existing) |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. Hospital treatment for surgery to the teeth and gums. For example: surgery to remove wisdom teeth and dental implant surgery.
Waiting period
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2 months
(12 months for pre-existing) |
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We pay limited benefits for restricted services. This means that if you choose to be treated in a private hospital the benefits we pay will not cover all hospital costs and are likely to result in significant out-of-pocket expenses. For restricted services in a Public hospital we will pay minimum shared room benefits. If your round trip for a hospital admission is more than 200km we will pay benefits towards costs associated with the travel and accommodation. Refer to your Cover Summary for full details.
Waiting period
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Nil |
| Exclusions |
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Hospital treatment for the investigation and treatment of diseases, disorders and injuries of the musculoskeletal system. For example: carpal tunnel, fractures, hand surgery, joint fusion, bone spurs, osteomyelitis and bone cancer.
Chest surgery is listed separately under Lung and chest.
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Hospital treatment for the investigation and treatment of the brain, brain-related conditions, spinal cord and peripheral nervous system. For example: stroke, brain or spinal cord tumours, head injuries, epilepsy and Parkinson’s disease.
Treatment of spinal column (back bone) conditions is listed separately under Back, neck and spine.
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Hospital treatment for the investigation and treatment of breast disorders and associated lymph nodes, and reconstruction and/or reduction following breast surgery or a preventative mastectomy. For example: breast lesions, breast tumours, asymmetry due to breast cancer surgery, and gynecomastia.
This clinical category does not require benefits to be paid for cosmetic breast surgery that is not medically necessary.
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Hospital treatment for chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours. Surgical treatment of cancer is listed separately under each body system.
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Hospital treatment for the investigation and management of diabetes. For example: stabilisation of hypo- or hyper- glycaemia, contour problems due to insulin injections.
Treatment for diabetes-related conditions is listed separately under each body system affected. For example, treatment for diabetes-related eye conditions is listed separately under Eye.
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Hospital treatment for the investigation and treatment of the digestive system, including the oesophagus, stomach, gall bladder, pancreas, spleen, liver and bowel.
For example: oesophageal cancer, irritable bowel syndrome, gall stones and haemorrhoids. Endoscopy is listed separately under Gastrointestinal endoscopy.
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Hospital treatment for the investigation and treatment of the ear, nose, throat, middle ear, thyroid, parathyroid, larynx, lymph nodes and related areas of the head and neck. For example: damaged ear drum, sinus surgery, removal of foreign bodies, stapedectomy and throat cancer.
Tonsils, adenoids and grommets are listed separately under Tonsils, adenoids and grommets.
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Hospital treatment for the investigation and treatment of the eye and the contents of the eye socket. For example: retinal detachment, tear duct conditions, eye infections and medically managed trauma to the eye.
Cataract procedures are listed separately under Cataracts.
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Hospital treatment for the diagnosis, investigation and treatment of the internal parts of the gastrointestinal system using an endoscope. For example: colonoscopy, gastroscopy, endoscopic retrograde cholangiopancreatography (ERCP).
Non-endoscopic procedures for the digestive system are listed separately under Digestive system.
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Hospital treatment for the investigation and treatment of the female reproductive system. For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.
Fertility treatments are listed separately under Assisted reproductive services.
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Hospital treatment for the investigation and treatment of the kidney, adrenal gland and bladder. For example: kidney stones, adrenal gland tumour and incontinence.
Dialysis is listed separately under Dialysis for chronic kidney failure.
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Hospital treatment for the investigation and treatment of the male reproductive system including the prostate. For example: male sterilisation, circumcision and prostate cancer.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
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Hospital treatment for the investigation and treatment of a miscarriage or for termination of pregnancy. |
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Hospital treatment for pain management that does not require the insertion or surgical management of a device. For example: treatment of nerve pain and chest pain due to cancer by injection of a nerve block.
Pain management using a device (for example an infusion pump or neurostimulator) is listed separately under Pain management with device.
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Hospital treatment for the investigation and treatment of skin, skin-related conditions and nails. The removal of foreign bodies is also included. Plastic surgery that is medically necessary and relating to the treatment of a skin-related condition is also included. For example: melanoma, minor wound repair and abscesses.
Removal of excess skin due to weight loss is listed separately under Weight loss surgery.
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Hospital treatment of the tonsils, adenoids and insertion or removal of grommets. |
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Hospital treatment for the investigation and treatment of the lungs, lung-related conditions, mediastinum and chest. For example: lung cancer, respiratory disorders such as asthma, pneumonia, and treatment of trauma to the chest.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
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Hospital treatment for the investigation and treatment of conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to benefits towards:
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
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Hospital treatment for the investigation and treatment of the back, neck and spinal column, including spinal fusion. For example: sciatica, prolapsed or herniated disc, spinal disc replacement and spine curvature disorders such as scoliosis, kyphosis and lordosis. Joint fusions are listed separately under Bone, joint and muscle. Spinal cord conditions are listed separately under Brain and nervous system. Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device. Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer. |
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Hospital treatment for the investigation and treatment of blood and blood-related conditions. For example: blood clotting disorders and bone marrow transplants.
Treatment for cancers of the blood is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
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Hospital treatment for the investigation and treatment of the heart, heart-related conditions and vascular system. For example: heart failure and heart attack, monitoring of heart conditions, varicose veins and removal of plaque from arterial walls.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
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Hospital treatment to correct hearing loss, including implantation of a prosthetic hearing device. Stapedectomy is listed separately under Ear, nose and throat.
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Hospital treatment which is medically necessary for the investigation and treatment of any physical deformity, whether acquired as a result of illness or accident, or congenital. For example: burns requiring a graft, cleft palate, club foot and angioma.
Plastic surgery that is medically necessary relating to the treatment of a skin-related condition is listed separately under Skin.
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Hospital treatment for fertility treatments or procedures. For example: retrieval of eggs or sperm, In vitro Fertilisation (IVF), and Gamete Intra-fallopian Transfer (GIFT).
Treatment of the female reproductive system is listed separately under Gynaecology.
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Hospital treatment for surgery to remove a cataract and replace with an artificial lens. |
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Hospital treatment for the implantation, replacement or other surgical management of a device required for the treatment of pain. For example: treatment of nerve pain, back pain, and pain caused by coronary heart disease with a device (for example an infusion pump or neurostimulator).
Treatment of pain that does not require a device is listed separately under Pain management.
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Hospital treatment for the provision and replacement of insulin pumps for treatment of diabetes. |
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Hospital treatment for dialysis treatment for chronic kidney failure. For example: peritoneal dialysis and haemodialysis.
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Hospital treatment for surgery for joint replacements, including revisions, resurfacing, partial replacements and removal of prostheses. For example: replacement of shoulder, wrist, finger, hip, knee, ankle, or toe joint. Joint fusions are listed separately under Bone, joint and muscle. |
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Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth. Female reproductive conditions are listed separately under Gynaecology.
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Hospital treatment for the investigation of sleep patterns and anomalies. For example: sleep apnoea and snoring.
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Hospital treatment for surgery that is designed to reduce a person’s weight, remove excess skin due to weight loss and reversal of a bariatric procedure. For example: gastric banding, gastric bypass and sleeve gastrectomy.
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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:
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.
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.
| Inclusions | Annual limits per person | Waiting period | |
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| Claim back percentage: | 60% | 75% | |
| Claim back percentage: | |||
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100% cover for immediate professional attention. Includes ambulance transportation when your medical condition means you can not be transported in any other way. Annual limits per person : N/A N/A Waiting period : 1 day |
N/A | N/A | 1 day |
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Members on this product may be eligible for 100% back on a dental check up at a Members' Choice Advantage dentist each calendar year. Check your cover summary to see if your product has any additional dental check ups, or other dental offerings. Annual limits per person : N/A N/A Waiting period : 2 months |
N/A | N/A | 2 months |
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Includes examinations, preventative treatment, scale and clean, extractions, fillings, x-rays, and surgery to remove wisdom teeth (excludes hospital charges).
Annual limits per person : $400 $750 Waiting period : 2 months |
$400 | $750 | 2 months |
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100% back on eligible items up to annual limits at all recognised providers. Includes prescription glasses and contact lenses. Some items, such as lens coatings, are excluded.
Annual limits per person : $150 $200 Waiting period : 6 months |
$150 | $200 | 6 months |
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Benefits paid towards remedial massage treatments.
Annual limits per person : $100 combined limit $100 combined limit Waiting period : 2 months |
$100 combined limit | $100 combined limit | 2 months |
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Includes one-on-one and group consultations, clinical pilates, antenatal and hydrotherapy sessions.
Annual limits per person : $300 combined limit $450 combined limit Waiting period : 2 months |
$300 combined limit | $450 combined limit | 2 months |
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Benefits paid towards consultations with a chiropractor or osteopath.
Annual limits per person : Included With Physiotherapy# Included WithPhysiotherapy# Waiting period : 2 months |
2 months | ||
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Consultations for Acupuncture#, Chinese medicine and Exercise Physiology. Annual limits per person : Combined limit Combined limit Waiting period : 2 months |
Combined limit | Combined limit | 2 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 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.
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.
We're proud to deliver award-winning health insurance products, but don't just take our word for it. Canstar have awarded Medibank an outstanding value award for health insurance in Australia for the 17th year in a row.
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
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.
2 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.
^ 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.
+ Covers with Restricted or Excluded services will be treated as Included services where treatment is required for injuries sustained in an Accident that occurs after joining this cover. Treatment must be sought within 7 days of the Accident. Excludes claims covered by third parties such as Workcover and our Private Room Promise. Out of pockets may apply. Refer to your Cover Summary. For Gold hospital covers, Accidental Injury Benefit is not required because all clinical categories are Included, regardless of whether or not the treatment is required as a result of an Accident.
¥¥ Some referred services may involve out of pocket costs and waiting periods may apply.
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/
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.
We'll have someone call you soon to help with any questions you have.
Complete this form to express your interest in one of our programs. If you're eligible, a member of our team will call you within 2-3 business days.
What program are you interested in?
Sorry, only members with current Hospital cover are eligible to participate in these programs
Eligible Medibank members with Extras cover are able to access a range of telehealth services included on their cover - you can find out more here. Alternatively, if you would like to talk to one of our team about your cover, we're here on 132 331.
Please provide your details so we can know how to contact you.
By clicking Submit, I understand that Medibank or its subsidiaries may contact me to discuss my eligibility for the Covid-19 Heath Assist program(s), and will disclose my personal information within the Medibank Group of companies and to third party service providers. Please see Medibank’s privacy policy for further information about how Medibank will handle my personal information, and how to contact Medibank: https://www.medibank.com.au/privacy/
If you are eligible, one of our health professionals will call you in 2-3 business days to discuss your situation and help to enrol you in the relevant program.
There is no cost to participate, however some referred services may incur an out of pocket cost.