Medibank Silver Plus Support and My Choice Extras Family
Combine selected Extras services that help you and your children thrive with Hospital cover that pays a benefit towards a wide range of services such as heart & vascular, rehabilitation and more. With added support from a Private Emergency Department Benefit>, so you may have more options during an accident or emergency.
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.
Here’s something to smile about – 100% back on up to two dental check-ups a year including bitewing x-rays where clinically required. Members’ Choice Advantage providers are not available in all areas. 2 month waiting period applies.1
Want more options during an emergency? With our Private Emergency Department Benefit we’ll pay towards the admission fee charged for attending an Emergency Department at a Private Hospital, up to your product's annual limit, per membership per year. Other fees may apply.>
Medibank health insurance members can speak to a registered nurse or mental health professional over the phone or online in relation to a general health or emotional concern at any time of the day or night at no extra cost.¥¥
Hospital cover
Everything included on Silver Plus Core with the addition of a $300 Private Emergency Department Benefit per membership each year> and benefits towards Insulin Pumps, Pain Management with a Device and Rehabilitation.
This cover can also support you with Unlimited Emergency Ambulance^, 24/7 Medibank Nurse Support¥¥ and no hospital excess for kids on a family membership.Ω
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).
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.
No matter what hospital excess you pay, the excess will not apply if kids on your membership are admitted to hospital
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.
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.
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.
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.
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.
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 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.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 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.
Eyelid procedures are listed separately under Plastic and reconstructive surgery.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 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.
The implantation of a hearing device is listed separately under Implantation of hearing devices.
Orthopaedic neck conditions are listed separately under Back, neck and spine.
Sleep studies are listed separately under Sleep studies.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 of the tonsils, adenoids and insertion or removal of grommets.
Waiting period
2 months(12 months for pre-existing)
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 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.
Spinal cord conditions are listed separately under Brain and nervous system.
Spinal column conditions are listed separately under Back, neck and spine.
Joint reconstructions are listed separately under Joint reconstructions.
Joint replacements are listed separately under Joint replacements.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
Management of back pain is listed separately under Pain management. Pain management that requires a device is listed separately under Pain management with device.
Waiting period
2 months(12 months for pre-existing)
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.
Bone fractures are listed separately under Bone, joint and muscle.
Procedures to the spinal column are listed separately under Back, neck and spine.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
Waiting period
2 months(12 months for pre-existing)
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 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.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 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.
Hernia and appendicectomy procedures are listed separately under Hernia and appendix.
Bariatric surgery is listed separately under Weight loss surgery.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 the female reproductive system.
For example: endometriosis, polycystic ovaries, female sterilisation and cervical cancer.
Fertility treatments are listed separately under Assisted reproductive services.
Pregnancy and birth-related conditions are listed separately under Pregnancy and birth.
Miscarriage or termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 miscarriage or for termination of pregnancy.
Waiting period
2 months(12 months for pre-existing)
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 chemotherapy, radiotherapy and immunotherapy for the treatment of cancer or benign tumours.
Surgical treatment of cancer is listed separately under each body system.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 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.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 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.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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 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.
Treatment for ulcers is listed separately under Skin.
Provision and replacement of insulin pumps is listed separately under Insulin pumps.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 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.
Chemotherapy and radiotherapy for cancer is listed separately under Chemotherapy, radiotherapy and immunotherapy for cancer.
Waiting period
2 months(12 months for pre-existing)
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
2 months(12 months for pre-existing)
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 conditions affecting the foot and/or ankle, provided by a registered podiatric surgeon, but limited to benefits towards:
• accommodation; and
• the cost of a prosthesis as listed in the prostheses list set out in the Private Health Insurance (Prostheses) Rules, as in force from time to time.
Note: Insurers are not required to pay for any other benefits for hospital treatment for this clinical category but may choose to do so.
Waiting period
2 months(12 months for pre-existing)
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 to correct hearing loss, including implantation of a prosthetic hearing device.
Stapedectomy is listed separately under Ear, nose and throat.
Waiting period
2 months(12 months for pre-existing)
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 provision and replacement of insulin pumps for treatment of diabetes.
Waiting period
2 months(12 months for pre-existing)
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 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.
Waiting period
2 months(12 months for pre-existing)
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 of sleep patterns and anomalies.
For example: sleep apnoea and snoring.
Waiting period
2 months(12 months for pre-existing)
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.
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.
We’ll pay towards the admission fee charged for attending an Emergency Department at a Private Hospital, up to your products annual limit, per membership per year. Other fees may apply.
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.
Spinal fusions are listed separately under Back, neck and spine.
Joint reconstructions are listed separately under Joint reconstructions.
Podiatric surgery performed by a registered podiatric surgeon is listed separately under Podiatric surgery (provided by a registered podiatric surgeon).
Hospital treatment for investigation and treatment of conditions associated with pregnancy and child birth.
Treatment for the baby is included under the clinical category relevant to their condition.
Female reproductive conditions are listed separately under Gynaecology.
Fertility treatments are listed separately under Assisted reproductive services.
Miscarriage and termination of pregnancy is listed separately under Miscarriage and termination of pregnancy.
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.
Pregnancy and birth-related services are listed separately under Pregnancy and birth.
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.
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.
Extras cover that includes the things to help you and your children thrive.
100% back on your first consultation at a Members' Choice provider for one of the following services - physiotherapy, chiropractic, remedial massage or acupuncture.**
100% back on annual flu vaccinations up to annual limits.^^
100% back for kids at Members' Choice providers, up to annual limits##
100% cover for immediate professional attention. Includes ambulance transportation when your medical condition means you can not be transported in any other way.
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.
Includes examinations, preventative treatment, scale and clean, extractions, fillings, x-rays, and surgery to remove wisdom teeth (excludes hospital charges).
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
:
$200 combined limit$225 combined limit
Study and treatment of vision problems due to defects in the eye muscles (such as a squint or a lazy eye) or harmful visual habits. Used to treat eye strain, vision-induced headaches, cross-eyes or double vision. Therapy involves eye exercises and treatment to correct the alignment of the eyes.
Benefits are paid towards consultations with a recognised orthoptist (eye therapist).
Includes most prescription-only items not subsidised by the Government. Benefits will be paid after a set charge has been deducted. It's important to note that we don't pay benefits for oral contraceptives or for pharmaceuticals prescribed for cosmetic purposes.
Exercise physiology is evidence based movement, physical activity, and exercise-based interventions aimed to facilitate and optimise health status, function, recovery, and independence for people across the full health spectrum.
Acupuncture is the insertion of fine, sterile, single use, disposable needles into specific acupuncture points balancing the body’s energy pathways (meridians) to maintain wellbeing.
Chinese medicine treatment can include Chinese herbal medicine and acupuncture. Chinese herbal medicine takes a holistic approach to disease and prophylactic care through the prescription of individualised Chinese herbal formulas.
Remedial massage is the systematic assessment and treatment of the muscles, tendons, ligaments and connective tissues of the body to assist in rehabilitation, pain and injury management. Myotherapy provides evidence-informed assessment, treatment and rehabilitation of pain associated with musculoskeletal conditions.
Includes consultations and birthing courses with a midwife, and lactation consultations with a midwife or a lactation consultant registered with Lactation Consultants of Australia and New Zealand (LCANZ). Providers must be working in private practice.
Annual limits per person
:
$400 combined limit$600 combined limit
Waiting period
:
2 months
$400 combined limit
$600 combined limit
2 months
Combined limit: Antenatal & Postnatal services, Pregnancy compression garments, TENS machine, Australian Breastfeeding Association Membership, Speech Therapy & Occupational Therapy
Combined limit: Antenatal & Postnatal services, Pregnancy compression garments, TENS machine, Australian Breastfeeding Association Membership, Speech Therapy & Occupational Therapy
Occupational therapy helps with the development or recovery of core physical, mental and developmental abilities. Benefits are paid towards consultations with a recognised occupational therapist.
Procedures to help with the correction & alignment of the teeth and jaw. We pay benefits towards braces.
Annual limits per person
:
$400$800
Waiting period
:
12 months
$400
$800
12 months
$400 opening balance. Top up of $200 each year, up to lifetime limit of $1,200
$800 opening balance. Top up of $400 each year, up to lifetime limit of $2,400
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
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).
Unlimited Emergency Ambulance
For ambulance attendance or transportation to a hospital or other approved facility where immediate medical attention is required and your condition is such that you couldn't be transported any other way. 1 day waiting period applies.^
Medibank Health Programs
Where clinically appropriate, eligible Medibank members can access a range of health programs designed to help them manage their health conditions and provide access to more affordable care options.††
Live Better rewards
With Live Better rewards, you can earn points by tracking healthy actions. And if you're an eligible Medibank member with hospital or extras, these points can go towards rewards from select partners, a $200 premium payment and more.≈
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.
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.
> Two month waiting period applies. We'll pay a benefit up to an annual limit per membership towards any admission fee ("facility fee") charged by the Private Hospital for patients attending a Private Accident and Emergency Department. The fee amount varies by Private Hospital and does not include medical and other charges (such as charges for diagnostic imaging or pathology), so out of pocket expenses may still apply. Only available at Private Hospitals with an Accident and Emergency Department. Members will need to submit a claim to receive the benefit and may have to pay upfront.
¥¥ Some referred services may involve out of pocket costs and waiting periods 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.
†† Must have eligible hospital cover and meet clinical eligibility criteria. All relevant waiting periods must have been served and treating doctor must consider it clinically appropriate. Out of pocket expenses may apply.
≈ 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.
+ 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.
Ω Other out–of–pocket expenses may apply.
# 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.
€€ Available each year and up to annual limits. Waiting periods apply. Subsequent consultations will have an out of pocket cost.
^^ Benefits are payable towards the influenza vaccine only and not payable towards any other fees, including administrative fees or GP consultations. Some individuals may be eligible for free influenza vaccines under a Commonwealth or State scheme, such as the National Immunisation Program, or similar schemes. Benefits are not payable where influenza vaccines are administered under such a scheme.
Request a call back
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insurance.
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COVID-19 Health Assist - Expression of interest
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.
Your membership details
Please provide your details so we can know how to contact you.
Your contact details
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/
Thank you for expressing your interest in one of our COVID-19
Health Assist programs.
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.
