Using Your Cover

Making the most of your health cover

Here are a few tips to help you get the most out of your Medibank health cover.

Written by Medibank

Your health cover isn’t just for those times when you’re sick – there are a number of ways you could use it to help keep you healthy and happy.

Here are a few tips to ensure you’re getting the most value out of your Medibank hospital and extras cover.

TIP #1 – Using extras to your advantage

Extras cover isn’t just for when things go wrong.  Some services may prevent injury and illness in the first place. Here’s how to get the most value from your extras.

Find a Members' Choice Advantage extras provider near you

Whether it’s an annual dental check-up, a new pair of glasses, or a physio session, you’ll generally pay less out-of-pocket expenses with a provider from our Member’s Choice extras network. How? We've negotiated capped prices for a wide range of extras services at these providers, so you can find out how much you might have to pay upfront.

Find your nearest Members' Choice provider here.

Get an estimate of how much you’ll pay and how much you could get back 

With the My Medibank app, you can get an estimate of how much you could pay, and how much you could get back before your next visit to an extras provider. Go to “Cover” followed by "Health Insurance" and tap on “Out of pocket estimator".  You can also view your annual limits. 

100% back on dental check-ups twice a year on eligible extras at any Members' Choice Advantage dentist~

Here’s something to smile about – Medibank members with eligible extras cover for two months or more get 100% back on up to two dental check-ups every year, including x-rays, at any Members’ Choice Advantage dentist.~

100% back on optical on eligible extras#

At Medibank we think you deserve to see the world clearly. That’s why when you join eligible Medibank extras you get 100% back on optical items at all recognised providers up to annual limits.#

And we've partnered with our Members' Choice Advantage optical provider, Specsavers, to offer added benefits to Medibank members with eligible extras cover. This includes 100% back on 2 pairs of single vision glasses (when you purchase from the $249 range).1 Additionally, you can earn 5 Live Better rewards points for every dollar you spend on prescription items from Specsavers. Offer available instore and online to eligible Medibank members with optical included in their extras cover, or in store only for eligible Medibank members with hospital cover or Healthy Living Extras cover.³±

Know when your annual limits reset

Most extras annual limits reset annually on 1 January. Make time to plan your healthcare visits for the year, and log in to My Medibank or download the My Medibank app to check your remaining limits. Some claims, like paper-based, may take longer to update.

TIP #2 – Getting the most out of hospital cover

Medibank members with hospital cover can access a whole range of health programs, services and support, at no extra cost.

Find a Members' Choice Hospital near you

Medibank has arrangements with most private hospitals and day surgeries in Australia, so members can generally get better value for Included treatments than if they were to go to a non-Members' Choice hospital. Find your closest Members' Choice Hospital here.

Access No Gap hospital treatments

Eligible members could have no out-of-pocket costs to pay on a wide range of services as part of hospital admission for a knee or hip joint replacement with participating surgeons and hospitals. See if you’re eligible here. Medibank is also supporting a pilot program in New South Wales, Victoria and Queensland to help eligible members avoid out-of-pocket medical costs when undergoing some endoscopy procedures with participating specialists and hospitals. Find out more here.

Get personalised hospital support

To help you prepare for, and recover from, hospital admission, eligible members can access support over the phone from our Health Concierge clinicians, or visit the online hub for helpful tips and tools.^

Use our Medibank at Home programs

When it comes to care, whether it is recovery or treatment, we believe that every person deserves to feel supported and have greater choice and flexibility.

Medibank at Home is a range of trials and programs that gives eligible members the choice of whether they receive care in a hospital or in the comfort of their own homes, when their doctor considers it clinically appropriate. Eligible members can receive, rehabilitation, chemotherapy, dialysis, infusions, cardiac rehabilitation and palliative care at home. Read more here.

24/7 Medibank Nurse or Mental Health Support

Members with health insurance can call 1800 644 325  or login to chat to a registered nurse at no extra cost.**

Members with health insurance can also call this number to chat to a mental health professional to discuss any mental health questions or issues and get guidance. That’s support that never sleeps, available 24 hours a day, 7 days a week.

TIP #3 – Enjoy the perks of your membership 

Sign up to our Live Better rewards program

If you are a Medibank member with an eligible hospital or extras cover, you can earn Live Better points for tracking your healthy actions with Live Better rewards in the My Medibank app! That's not all - you can also earn points when you shop with our partners or visit our Members Choice Advantage providers! You can use your Live Better points to redeem exciting rewards, like a premium reduction or a lower hospital excess, or by getting more from your extras cover like a remedial massage or physio service. You can also redeem gift cards from our partners like THE ICONIC, Apple, Brooks, Hellofresh and many more.* Find out more.

Download our Better Minds app

Medibank’s Better Minds app provides wellbeing checks, personalised skills training and one-on-one coaching with health professionals for members with hospital cover who may need extra support. And it’s all included with your hospital cover.

Tap into our Specsavers offers

We’ve partnered with Specsavers to offer added benefits to Medibank members with eligible extras cover. This includes 100% back on 2 pairs of single vision glasses (when you purchase from the $249 range)¹, 25% off tint and lens coating options and 25% off single frames (when you purchase from the $149 range or above).² Additionally, you can earn 5 Live Better rewards points for every dollar you spend on prescription items from Specsavers. Offer available instore and online to eligible Medibank members with optical included in their extras cover, or in store only for eligible Medibank members with hospital cover or Healthy Living Extras cover.³±

Live Better at Home

Keep your mind and body active with some fun and free activities that you can do in the comfort of your own home. Explore our delicious and healthy recipes, easy to follow exercise classes, and look after your wellbeing with guided meditations and mindfulness tips. Find out more here.

Discounts on our Travel & Pet insurance

No matter how well you plan, things can go wrong – whether it be overseas or at home with your pet. That’s why we offer Medibank members 15% off Medibank Travel Insurance and 10% off Medibank Pet Insurance.

Get up to 25% off your gym membership

As an eligible Live Better member,* you can get discounted selected membership fees at participating gyms with two of our fitness partners! That's not all, you can also earn 500 Live Better points every month just for going to the gym.≤ Find out more here.

Notice: As of 6th Dec 2024, the discount available to eligible Medibank Live Better rewards members signing up to, or renewing a Goodlife/Fitness First 12/18 month platinum memberships will change from 25% to 20%. Please note, any members that have already signed up with a 25% discount prior to 6 Dec 2024 will remain on this rate until they transfer or renew their membership. If you’ve got any questions, you can contact us here.

TIP #4 – Ways to help save your money

Nominate your Australian Government Rebate tier

The Australian Government Rebate (AGR) on private health insurance helps make health insurance more affordable by giving you a rebate on your premiums. Your eligibility for the rebate depends on your age and income. If you nominate your AGR tier ahead of tax time, you may reduce your premium.

See what the income tiers are and see what rebate you’re entitled to.

Check on your excess

An excess is the amount you contribute towards your first hospital admission each calendar year (same-day or overnight), as a private patient, before we pay any benefits. Policies with a higher excess often have lower premiums. You could think about how much you are willing to pay up front if you were to need hospital treatment in order to reduce your premium.

You can check your excess by logging into My Medibank and viewing your cover details.

Avoid paying the Medicare Levy Surcharge

The Medicare Levy Surcharge (MLS) applies to Australian taxpayers who don’t hold an appropriate level of private hospital cover and earn over a certain amount for the full tax year. The surcharge can be as much as 1.5% of your annual income¥ (for MLS purposes) – that’s a lot of dollars!

Here’s some more info about Medicare Levy Surcharge.

Avoid paying for Lifetime Health Cover loading

Lifetime Health Cover (LHC) loading is an Australian Government scheme designed to encourage people to take out Hospital cover. If you don’t have Hospital cover by 1 July after your 31st birthday, you may have to pay a 2% LHC loading for each year you haven’t held Hospital cover, once you do take it out. The maximum loading is 70%. So it could work in your favour to get Hospital cover (and keep it) early in life.

Read more about Lifetime Health Cover here.

 

Written by Medibank

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Things you should know

~ 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.

Waiting period applies. If your full annual optical limit (or more than $225 remaining of your limit) is not available at time of purchase, out of pocket costs may apply. Both pairs must be of the same prescription. Other lens options available at an extra cost.

³± Points cannot be earned on the cost of any services (including eye tests), on purchases paid for with a Specsavers gift card or on non-prescription goods such as non-prescription sunglasses, safety glasses, protective glasses or precision tinted lenses. All optical items offered are subject to availability and are subject to Specsavers Terms of Service and Returns & Warranty policies. For in-store purchases, you must use your Medibank membership card through HICAPS at the time of purchase to earn Live Better rewards points. This applies even if you have hospital only cover or have already reached your annual optical extras limit. If you have extras cover and any annual optical extras limit remaining, you will also be submitting a claim for benefits. For online purchases at https://www.specsavers.com.au/, you must submit an extras claim for prescription optical goods to earn Live Better rewards points. Members with hospital only cover, or Healthy Living Extras cover cannot earn points for online purchases. Points earned will be displayed in your Live Better rewards account within 5 business days, or once you have signed up to Medibank Live Better rewards with the My Medibank app within 6 months, from the date of your in-store purchase or making an extras claim for online purchases. A maximum of 10,000 Live Better rewards points can be earned per transaction. This offer may be withdrawn or changed at any time. Live Better rewards points earned from claims for children under 18 years of age will go to the policy holder’s account. A maximum of 10,000 Live Better rewards points can be earned per transaction. This offer may be withdrawn or changed at any time.

 Must have hospital cover that includes joint replacement surgery. There may be out-of-pocket expenses associated with outpatient appointments, such as your initial visit with a participating surgeon in their consulting rooms. An excess or per day payment may still be payable, depending on the product a member has chosen and whether they are claiming under their hospital cover for the first time in a calendar year.

^ Health Concierge is available to all eligible Medibank resident members who hold hospital cover. Excludes Overseas Visitor Health Cover, Working Visa Health Cover and Overseas Student Health Cover (OSHC). Some referred services may involve out of pocket costs.

 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.

** Some referred services may involve out-of-pocket costs.

 Not available for members with extras only cover, Overseas Student Health Cover or Overseas Workers or Visitors Health Cover.

² Does not apply to the 100% back on 2 pairs of single vision glasses from the $249 range bundle.

Fitness First 25% discount with Fitness First applies to new 12 & 18 month Platinum memberships purchased by eligible Medibank members with hospital or extras cover. To obtain the discount, simply present your photo ID, Medibank Membership Card and the partner offer page within the Live Better or My Medibank app when signing up at any participating gym. The name and email address used to sign up at the gym must exactly match the details attached to your Medibank account in order to earn Live Better points for attending the gym. After enrolling in the applicable gym membership discount offer, you will earn 500 Live Better points when you attend any participating gym 8 times within a calendar month, up to a total of 6000 points in any calendar year. Live Better points will be displayed in your Live Better account within 30 days of the end of the calendar month. You must be enrolled in the discounted gym membership offer before you can earn Live Better points. By signing up to this offer you permit Fitness & Lifestyle Group to share your personal information (including name, date of birth, contact details, gym location and gym attendance records) with Medibank and Live Better.  Medibank and Live Better will collect this information to assess your eligibility for Live Better points, award the Live Better points and to monitor uptake of the Live Better program. If you elect not to share this information you will not be eligible for the discounted gym membership or Live Better Points. Medibank's Privacy Policy (https://www.medibank.com.au/livebetter/rewards/terms/) contains information about how you can seek access to, and correction of, your personal information, or make a complaint about a breach of the Australian Privacy Principle. Full gym membership terms and conditions can be found at https://www.fitnessfirst.com.au/terms-and-conditions/. This offer may be withdrawn at any time.

Good Life Health Clubs 25% discount with Goodlife Health Clubs applies to new 12 & 18 month Platinum memberships purchased by eligible Medibank members with hospital or extras cover. To obtain the discount, simply present your photo ID, Medibank Membership Card and the partner offer page within the Live Better or My Medibank app when signing up at any participating gym. The name and email address used to sign up at the gym must exactly match the details attached to your Medibank account in order to earn Live Better points for attending the gym. After enrolling in the applicable gym membership discount offer, you will earn 500 Live Better points when you attend any participating gym 8 times within a calendar month, up to a total of 6000 points in any calendar year. Live Better points will be displayed in your Live Better account within 30 days of the end of the calendar month. You must be enrolled in the discounted gym membership offer before you can earn Live Better points. By signing up to this offer you permit Fitness & Lifestyle Group to share your personal information (including name, date of birth, contact details, gym location and gym attendance records) with Medibank and Live Better.  Medibank and Live Better will collect this information to assess your eligibility for Live Better points, award the Live Better points and to monitor uptake of the Live Better program. If you elect not to share this information you will not be eligible for the discounted gym membership or Live Better Points. Medibank's Privacy Policy (https://www.medibank.com.au/livebetter/rewards/terms/) contains information about how you can seek access to, and correction of, your personal information, or make a complaint about a breach of the Australian Privacy Principle. Full gym membership terms and conditions can be found at https://www.goodlife.com.au/terms-and-conditions/. This offer may be withdrawn at any time.

The maximum number of Live Better Points that each Medibank Live Better Member can earn from successfully completing any points-earning activity associated with any Live Better Points Promotion (including one or more Health and Wellbeing Challenges or Medibank Recommended Goals but excluding Partner Shopping), or any Onboarding Action, is 36,000 Live Better Points.  See full Medibank Live Better terms: https://www.medibank.com.au/livebetter/rewards/terms

¥ A MLS of 1.5% applies if your annual income for MLS purposes is greater than $140,000 for singles or $280,000 for families (including single parents and couples). For families with children, the thresholds are increased by $1,500 for each dependant child after the first.

* 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.