Health insurance for seniors

Things you should know

^ Waiting period applies. For ambulance attendance or transportation to a hospital where immediate medical attention is required and your condition is such that you couldn't be transported any other way. TAS and QLD have State schemes that provide ambulance services for residents of those States.

ᵟ Medibank has Members' Choice providers for these services. Not available in all areas.

ᵝ 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.

ᶲ A health support benefits approval form must be completed by a health practitioner and the service must be intended to manage an existing health condition prior to receiving any eligible benefits (excluding nicotine replacement therapy).

^> 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. Two month waiting period applies.

¹ Must have eligible hospital cover, all relevant waiting periods must have been served and treating doctor must consider it appropriate. Out of pocket expenses may apply. Chemotherapy, palliative, infusion and dialysis program not available in all areas.

² Medibank Live Better Challenges & Goals Earning Policy: The participant of a Medibank Live Better Challenge or Goal may not receive Live Better points or may have their already credited Live Better points reversed in accordance with the Medibank Live Better terms and conditions. To earn Live Better points, the participant needs to properly complete 100% of the eligible Challenge according to the instructions. The number of Live Better points available for Medibank Live Better Challenges and Goals is subject to change without prior notice. The maximum number of Live Better points that each Medibank Live Better member can earn from successfully completing health and wellbeing Challenges, Goals or any Onboarding action in a calendar year is 40,000 Live Better points. To the extent of any inconsistency between this Policy and the Medibank Live Better terms and conditions, the terms and conditions will take precedence.

³ 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.

⁴ Average fee for a GP standard (Level B) consultation (including Medicare rebate) from Health of the Nation report 2023 by The Royal Australian College of General Practitioners. Some referred services may involve out of pocket costs and waiting periods may apply.

Nurses may provide advice about health concerns, including when to see a doctor or other medical professional or go to an emergency department. Service should not be used in an emergency or life-threatening situation – call triple zero (000). This is general advice and not health advice tailored to meet your individual health needs. Always consult a trusted health professional before making decisions about your health care. We can’t guarantee that the information is accurate, complete or up-to-date. While we may mention goods or services provided by others, we aren’t endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).

⁵ 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 dentist (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.

⁶ Members’ Choice Advantage providers are not available in all areas. Waiting periods and annual limits apply.

⁷ Some referred services may involve out of pocket costs and waiting periods may apply.

⁸ For Accidents that occur in Australia after your cover starts. Must seek medical treatment within 7 days, and receive hospital treatment within 12 months of the Accident occurring. Excludes Private Emergency Department Benefit, hospital bonus, claims covered by third parties and our Private Room Promise. Out-of-pocket costs may apply.

¹⁰ You need to join Medibank within 2 months of leaving your old fund, or waiting periods apply again. Also, benefits that have been paid under your previous cover will be taken into account in determining the extras benefits payable under your Medibank cover.

¹¹ Members’ Choice providers are not available in all areas and may change without notice.

For new members on new memberships who join and start eligible combined Bronze hospital and extras cover or above and who have not held Medibank health cover in previous 60 days (unless they are dependents coming off their parent’s cover). Must set up direct debit and quote promo code ‘6WEEKSPLUS’ when joining.  Excludes Hospital only cover, Extras only cover, Basic covers, Corporate covers, Accident Cover, Ambulance Cover, Overseas Visitors Health Insurance, Overseas Students Health Cover (OSHC), Working Visa Health Insurance, ahm covers and other selected covers. Not available with any other offer. Medibank may end this offer or amend these offer terms and conditions at any time without notice. Medibank employees are not eligible for this offer.

6 weeks free terms: Must maintain direct debit and hold eligible cover for 28 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). 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 points terms: Must maintain direct debit and hold eligible product for 28 consecutive days from the policy start date to receive Live Better 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 any Live Better activity within 28 consecutive days from the policy start date.  Policyholder must also maintain direct debit and continue to hold an eligible product for 28 consecutive days from the policy start date to receive the Live Better Points. Must be 16 years or over to register for Live Better. Live Better rewards points could take up to 8 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 Medibank 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/