This is the amount you pay towards your hospital treatment before we pay any benefits. It's paid once per person, per calendar year. It does not apply to children on a family policy. Choosing the higher excess reduces the premiums you pay.
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Hospital cover
Helps towards the accommodation costs and doctors, specialists, surgeons and anaesthetists fees for the Included services below.
What is a waiting period?
A set period of time you need to wait before you can receive benefits for services or items included in your cover. You can’t receive benefits for any items or services you obtained while you’re serving a waiting period. This means you will have to pay the full cost of the service.
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? A set period of time you need to wait before you can receive benefits for services or items included in your cover. You can’t receive benefits for any items or services you obtained while you’re serving a waiting period. This means you will have to pay the full cost of the service. 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 | |
| Nil | |
| 2 months | |
| 2 months | |
| 2 months | |
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| 12 months | |
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
|
| Nil
(12 months for pre-existing conditions) |
Please note: Medibank does not pay any benefits towards the cost of cosmetic surgery/procedures e.g. surgery that isn’t clinically necessary and which an MBS item is not billable.
Hospital cover explained
For the services listed as Inclusions in the table above, we pay benefits towards:
- Doctors' fees for Included in-hospital medical services (as set out in Medical benefits below).
- Surgically implanted prostheses (such as an artificial body part like a limb) and other items on the Federal Government's Prostheses List^^.
- Pharmaceutical Benefits Scheme (PBS)** listed medication given to you as part of your admitted treatment for most medical conditions, including medication prescribed for after you leave hospital.
- Overnight accommodation in a private or shared room
- Same-day admissions
- Intensive care
Other benefits as set out in 'Hospital benefits' below.
- Overnight accommodation in a private or shared room
- Same-day admissions
- Intensive care
- Operating theatre fees
- Outpatient and emergency department charges
Hospital benefits
Members’ Choice hospitals
Medibank has agreements with most private hospitals and day surgeries in Australia. We call this our Members’ Choice network. When you visit a Members’ Choice hospital you will generally get better value for money compared to a non-Members’ Choice private hospital, provided the service is included under our agreement with the hospital and not Excluded under your cover.
To find your nearest Members’ Choice hospital, visit medibank.com.au/memberschoice. Members’ Choice hospitals are subject to change from time to time and are not available in all areas.
Hospital excess
With Overseas Workers Premium Hospital, Medical and Extras you can choose from a $0, $250 or $500 excess.
This is the amount you pay towards your hospital treatment before we pay any benefits. It's payable once per member, per calendar year if admitted to hospital. If you choose a higher excess you will pay a lower premium, but will need to pay more to your own accommodation costs.
For example:
You choose an excess of $500. You'd need to pay $500 towards your accomodation costs before Medibank we'll pay any benefits.
If you choose an excess, it does not apply for any children on a family membership.
Medical benefits
Overseas Workers Premium Hospital, Medical and Extras includes benefits towards medical services provided by a doctor, that are listed in the government’s Medicare Benefits Schedule (MBS). The MBS is a list of medical services and corresponding fees.
Overseas Workers Premium Hospital, Medical and Extras pays 200% of the MBS fee for:
- general practitioner (GP) consultations
- other medical services provided out-of-hospital (for example specialists, pathology and x-rays)
- in-hospital medical services provided as part of an Included service (for example surgeon and anaesthetist fees)
- allied health services billed with an MBS item number (for example eye checks and services related to chronic disease and mental health management plans).
If your doctor chooses to charge above the amount we pay you will have to pay an out-of-pocket expense to cover the difference.
Extras cover
- Help pay towards a wide range of services, including more costly ones, like major dental, orthodontics and hearing aids
- 100% back on up to two dental check-ups every year (including x-rays) at any Members’ Choice Advantage dentist1, OR
- 100% back on an annual dental check-up & clean at any Members' Choice dentist, on top of your annual limit (excludes x-rays)2
| Inclusions | Annual Limit | Waiting Period |
|---|---|---|
| Claim back percentage: | 85% | |
| Claim back percentage: | ||
| No annual limit | 2 months | |
| $1,200 | 12 months | |
| $1,000 | 12 months | |
| $250 | 6 months | |
| $400 combined limit | 2 months | |
| $700 | 2 months | |
| $500 | 2 months | |
| $500 | Nil | |
| $500 | 2 months | |
| - see Remedial massage | 2 months | |
| $500 | 2 months | |
| $250 combined limit | 12 months | |
| 24 months | ||
| $500 | 2 months | |
| $500 | 2 months | |
| $1,200 | 36 months | |
| $600 | 2 months | |
| $500 | 2 months | |
| $500 | 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.
# Medibank Members' Choice providers are available for these services. This means you'll receive 85% back when you visit one (subject to your annual limit). Members' Choice providers are not available in all areas. Excludes Optical which pays 100% back (subject to your annual limit) at all recognised providers. ~ 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.
Further benefits
- 24/7 Medibank Nurse Support
Medibank health insurance members are supported round the clock by a registered nurse at no extra cost#. Chat online or call 1800 644 325 24 hours a day, 7 days a week.
- Repatriation
If you or any person on Overseas Worker Premium Hospital, Medical and Extras sustains a substantial life-altering disability or a serious medical condition, as determined by us, and needs to return to their home country, we may arrange and pay the reasonable cost of travel with the appropriate medical supervision.
In the unfortunate event of death, we’ll pay the reasonable cost for the repatriation of mortal remains of you or anyone else on your membership to their home country.
The provision of any repatriation benefit is at our discretion. Conditions apply, including waiting periods. Contact us or refer to the Overseas Workers Member Guide for more information.
If your situation changes
If at any time you gain access to full Medicare entitlements or your visa status changes (e.g. you are granted permanent residency), Overseas Worker Premium Hospital, Medical and Extras may no longer be suitable. In these instances, you should notify us of the change in your circumstances. Medibank can still remain an important part of your private health insurance plans as we offer a large range of other covers.
Supporting documents
Things worth knowing
Find out more about things like waiting periods and pre-existing conditions or check our list of definitions if you don't know the meaning of a word or phrase
^^If you need to be hospitalised for a procedure requiring a surgically implanted prosthesis (for example: a pacemaker or cardiac stent), we’ll pay the minimum benefit for the thousands of items set out in the Australian Government’s Prostheses List.
**The PBS provides subsidised prescription drugs to residents of Australia, as well as certain foreign visitors covered by a Reciprocal Health Care Agreement.
1 Members can claim a maximum of two 100% back dental check-ups per member, per year—either two check-ups at a Members’ Choice Advantage dentist (including up to two bitewing x-rays per check-up where required), or a first check-up at a Members’ Choice dentist (excluding x-rays) and a second check-up at a Members’ Choice Advantage dentist. These check-ups do not count towards annual limits. Waiting periods apply. Not available in all areas.
2 Limited to two dental check-ups on all extras annually. Maximum two bitewing x-rays per check-up, where clinically needed. Waiting periods apply. Not available in all areas.
#Some referred services may involve out of pocket costs and waiting periods may apply.