= 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.
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.
Your cover also includes
Your cover also includes
Hospital cover
- Rest assured you'll receive the benefits of our gold level of Hospital cover in the event of an Accident⁺
- Cover for a wide range of hospital procedures and investigations
- Better value for families with no hospital excess for kids on a family membership
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 | |
| Nil | |
| 2 months | |
| 2 months | |
| 2 months | |
| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
|
| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
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| 2 months
(12 months for pre-existing) |
|
| Nil |
| Exclusions |
|---|
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 132 331 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
- You choose the cover to suit your budget and lifestyle - 60% or 75% back from Members' Choice Providers.
- Cover to help you look after your day-to-day health and wellbeing, plus a range of extras services to help your body move better.
- 100% back for kids at Members' Choice providers, up to annual limits.##
- 100% back on annual flu vaccinations up to annual limits.^^
| Inclusions | Annual limits per person | Waiting period | |
|---|---|---|---|
| Claim back percentage: | 60% | 75% | |
| Claim back percentage: | |||
| N/A | N/A | 1 day | |
| 2 months | |||
| $400 | $750 | 2 months | |
| $350 | $450 | 12 months | |
| $150 combined limit | $200 combined limit | 6 months | |
| 2 months | |||
| $200 combined limit | $400 combined limit | Nil | |
| 2 months | |||
| 2 months | |||
| $300 combined limit | $400 combined limit | 2 months | |
| 2 months | |||
| 2 months | |||
| 2 months | |||
| $150 | $200 | 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 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.
Awarded Outstanding Value Health Insurance 17 years running
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.
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
Medibank Live Better
Medibank cares about the health and wellbeing for all Australians. That’s why we’ve created Live Better, to help you towards a better, healthier life, and reward eligible members for their loyalty.≈
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.
Waiting periods and annual limits may apply.
^Tasmania and Queensland have State schemes that cover ambulance services for residents of those States.
+ 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.
# 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.
## Waiting periods apply, including 12 months for some dental services. Applies to Child and Student Dependants only, up to annual limits. Members' Choice providers not available in all areas.
^^ Waiting period applies.
± 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.
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.
≈ Must be 16 years or over to register for Medibank Live Better rewards in the My Medibank app. Some program partners and earning activities require a person to be at least 18 years of age to be eligible to earn and/or redeem a reward. Must be a Medibank member with hospital cover, extras cover, or hospital and extras cover, and be up-to-date with premium payments. Excludes Overseas Student Health Cover (OSHC), Ambulance only cover, ahm covers and other selected covers. Live Better Management Pty Ltd, ACN 003 457 289 has entered into commercial arrangements with Medibank Live Better program partners and may receive commissions. Please choose carefully as rewards will not be amended, cancelled, exchanged or refunded due to change of mind. Points earning activities and rewards are subject to change without prior notice and may be subject to availability. Additional terms and conditions may apply to points earning activities and rewards. See full Medibank Live Better rewards terms.
€€ Available each year and up to annual limits. Waiting periods apply. Subsequent consultations will have an out of pocket cost.
¥¥ Some referred services may involve out of pocket costs and waiting periods may apply.