If you’re considering investing in health insurance and wondering if Medibank is a good option for you, this article will provide you will all the essential information you’re looking for.
Medibank Health Insurance Review
Published: July 19, 2017
Medibank is an affordable, non-profit health insurer, offering private healthcare. All members are covered by a versatile range of hospital benefits, with various options available
ComparingExpert does not currently have access to this provider. Visit www.medibank.com.au to request a quote and compare their price and benefits to the Australian private health insurance companies we have access to.
About Medibank private health insurance
Medibank’s philosophy centres on better health for all people. They view every interaction with a customer as an opportunity to build a relationship. Members are promised:
- Better choices, with assistance and guidance on how to make positive health decisions.
- Better confidence in receiving quality cover.
- Better outcomes, by promoting an improved health system that produces quality outcomes while containing health costs.
As one of Australia’s largest providers of private health and insurance solutions, Medibank has helped 3.8 million Australians to live fuller, healthier lives.
Benefits of being a Medibank member
Medibank offers a range of cover for people from all walks of life, including singles cover, couples cover, family cover, single parent cover, corporate health cover and working visa health cover. As a Medibank policy holder, you have:
- Control over your healthcare.
- Choice about the service you use.
- Your choice of doctor.
- Choice of appointment times.
- Better quality of care.
- The ability to avoid financial penalties such as the Medicare Levy Charge.
The Medibank Community Fund continually aims to keep premiums affordable through expanding its membership base. This enables Medibank to ease the pressure on premiums for all members and to continue helping communities to live in better health.
Who are Medibank Providers?
- Hearing Aid Providers.
- Dentists: Providing free dental check- up and cleanings every year at any Member’s Choice dentist, over and above your annual dental limit. This excludes x-rays and a two month waiting period applies.
- Dental Prosthesis.
- Optical retail outlets.
- Chiropractors.
- Physiotherapists.
- Podiatrists.
- Acupuncturists.
- Naturopaths
- Remedial massage therapists.
It is worth noting that Medibank’s agreements with their various Members Choice providers are subject to change without notice. It might be a good idea to confirm whether your preferred provider is part of their Members’ Choice network, before commencing with treatment.
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Medibank health insurance cover options according to your life stage
Medibank Health Insurance offers you a variety of options. The most important aspect is that your treatment both in and outside of hospital will be taken care of.
Singles Cover
| What’s covered | Description |
| Ambulance & Accident Cover | 100% cover for immediate professional attention |
| Hospital cover |
|
| Dental | 100% back on annual check-ups and standard procedures at a Member’s Choice dentist. Excludes x-rays |
| Optical | 100% back at all recognised providers up to annual limits, including frames, prescription lenses and repairs. |
| Remedial massage | Assessment and treatment of muscles, tendons, ligaments and connective tissues of the body to assist in rehabilitation, pain and injury management. |
| Physiotherapy | Rehabilitation, injury prevention and fitness promotion. |
| Chiropractic & Osteopathy | Manipulation of the spine and skull to restore proper alignment. |
| Natural therapies | Services such as homoeopathy, naturopathy, reflexology, etc. |
| Dietetics | All aspects pertaining to Nutrition. |
Couples Cover
Medibank Couples Cover has the same benefits as the Singles Cover Option but with the following added benefits:
| What’s covered | Description |
| Healthy start extras | 60% claim back |
| Basic extras | 70% claim back |
| Growing family extras only | 100% claim back for kids |
| Top Extras | 100% back on dental and optical at all recognised providers up to annual limits. |
Families Cover
If you’re adding a new-born to an existing Family Policy, Medibank needs to be notified within 2 months of their date of birth. This will help you avoid serving any waiting period.
| What’s covered | Description |
| Core Hospital and Basic Extras | When using a Member’s Choice provider, you can claim back 55% on the cost of services included in your cover. For providers who are not part of our Member’s Choice, Medibank still pays benefits up to a fixed benefit at any recognised provider. |
| Growing Family Core | 100% claim back for kids |
| Standard Hospital & Basic Extras | 55% Claim Back at Members’ Choice, 100% back on a yearly check-up at a Members’ Choice dentist and optical providers up to annual limits. |
| Core Hospital & Top Extras | No excess for kids. Members may choose between 55%, 70% or 85% on claim back. |
| Settled Families Essentials | Restricted Palliative Care, Rehabilitation and Psychiatric treatment. |
| Growing Families Essentials | 100% claim back for kids. |
| Standard Hospital and Top Extras | Restricted psychiatric treatment and obstetrics-related services. Your choice of excess. |
| Top Hospital Essentials & Basic Extras | Restricted psychiatric treatment. Your choice of excess. |
| Growing Family Complete | 100% claim back for kids and includes kids’ obstetrics. Your choice of excess. |
| Settled Families Comprehensive | 70% claim back at Members’ Choice. Your choice of excess. |
| Top Hospital Essentials and Top Extras | Includes joint replacements. Your choice of excess. |
| Complete Hospital & Top Extras | 55% claim back at Members’ Choice. Includes obstetrics. |
| Ultra Hospital Cover | No excess: 100% claim back on extras. |
Singles & Couples cover vs Family cover
*R = Restrictive| What’s covered? | Singles & Couples (No dependants) | Family Cover | ||
|---|---|---|---|---|
| Standard Hospital | Top Hospital Essentials | Standard Hospital | Top Hospital Essentials | |
| 100% Ambulance Services | ||||
| Shoulder and knee reconstruction | ||||
| Minor& Major gynaecological Surgery | ||||
| Repair of a hernia | ||||
| Appendicitis treatment or removal | ||||
| Removal of tonsils and adenoids | ||||
| Surgical removal of wisdom teeth | ||||
| Colonoscopies & endoscopies | ||||
| Palliative care | ||||
| Spinal Fusion | ||||
| Psychiatric Treatment | R | R | R | R |
| Rehabilitation Treatment | ||||
| Heart-related medical & surgical admissions | ||||
| Obstetrics-related services (e.g. pregnancy) | R | R | ||
| Plastics & Reconstructive Surgery | ||||
| Other joint replacement surgery | ||||
| Nerve treatment | ||||
| Cover for accidents | ||||
| All other in-hospital services | ||||
| Hip and knee joint replacement surgery | ||||
| Renal dialysis | ||||
| Weight Loss Surgery | ||||
| Fertility Treatment (including IVF and GIFT programmes) | ||||
| Cancer Treatment | ||||
Sometimes a waiting period may apply. This includes a 12 month period for pre-existing conditions and some dental services. A waiting period is the period of time you need to wait before being able to receive benefits for services or items covered. You will not be able to receive benefits for anything you might have obtained while serving a waiting period before joining Medibank.
Corporate health cover
With this option, your employer does the hard work for you, leaving you with the Flexi 80 option. Flexi 80 allows you to use your Flexible Extras at any recognised provider, in the way you choose to, with an 80% back. Flexi 80 offers 100% back on optical items.
Working Visa health cover
Each option includes unlimited emergency ambulance cover.
- Working Visa Basic Insurance helps towards hospital accommodation costs as well as all fees incurred by medical expert practitioners.
- Working Visa Hospital Insurance helps if your country has a Reciprocal Health Care Agreement (RHCA), in which case you might receive some Medicare benefits.
What factors influence the cost of Medibank Health Insurance?
- The cover option product you have chosen.
- Your level of cover: Basic, essentials, top ups and complete cover.
- Whether your specialists chose to participate in GapCover and treat you at a Members’ Choice Hospital, in which case your extra costs will be reduced and sometimes even eliminated.
- The excess you choose to pay in the event of a claim.
- Private Health Insurance Government Rebate, which is determined by your family status and income.
- The number of people covered by your insurance policy.
Medibank private health insurance waiting periods
Waiting periods refer to those periods of time you will have to wait before being able to receive benefits for services or items offered by Medibank. This applies when you are changing cover, or joining as a new member. However, if you have an accident after joining Medibank or changing cover and you require treatment, the 2 month waiting period indicated below, will be waived.
Medibank Waiting periods:
| Services | Waiting period |
| All services (excluding accidents) | 2 months |
| Optical items | 6 months |
| Pre-existing conditions. However, this waiting period does not apply to hospital or hospital substitute treatment for psychiatric treatment, rehabilitation treatment or palliative care | 12 months |
| Blood glucose monitors | 24 months |
| Hearing aids and laser eye surgery | 36 months |
Frequently asked questions about Medibank
What is Medibank Mihealth?
Medibank Mihealth includes a variety of health support services aimed to give you all the health resources and information you need to lead a healthier life.
If you have Medibank hospital cover, you are automatically given access to Medibank MiHealth. Here you have entrance to a range of health support services that are there to help you make informed decisions about health and lifestyle, including
- Medibank Nurse 24/7: A call centre offering you medical support by experienced nurses.
- Hospital support: Personal advice and support for during your hospital stay.
- Online Health Hub: Online information about conditions or treatments, weight management, assessing your risk factors, making better food choices, giving up smoking and planning a better lifestyle for you and your family.
- Mobile Health Apps: Access to a wide range of health information and resources on the move. This is a free app for your smartphone.
Does Medibank have a cooling off period?
Yes. You can cancel your membership within 30 days of joining and receive a full refund, provided you haven’t already made a claim.
What if I have a pre-existing condition?
If you have a pre-existing condition and have not had private hospital cover before, or if your cover has lapsed, you will need to wait 12 months before you can claim for treatment. If you have upgraded to one of Medibank’s higher levels of hospital covers, you will need to wait 12 months to receive the higher benefits.
Medibank regards any ailment, illness or condition as being pre-existing where the signs and symptoms were present up to six months before joining or changing cover.
How can I switch from my current Health Insurance to Medibank?
You can easily switch from your current health insurance to Medibank by simply contacting Medibank and requesting your policy with them start when your old cover is cancelled. Medibank will waive the waiting periods you’ve already served with your prior health fund when you join Medibank within 2 months of leaving your old fund. Otherwise a waiting period will apply.
Any loyalty bonus or other similar entitlements built up with your former fund (e.g. orthodontic entitlement) will not transfer to Medibank.
We trust that you have found this information about Medibank’s private health insurance coverage useful and informative. If you would like to update your existing cover or are looking for new cover, it might be worth comparing quotes from a variety of companies to find your perfect fit.
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16 Comments
Is treating varicose veins covered by Medibank Private “Top Hospital Essentials $500 excess with Top Extras 55”? The treatment may include sclerotherapy and surgery.
Hi Bandana,
Yes, Medibank’s Top Hospital Essentials with Top Extras do cover surgery of arteries and removal of varicose veins. However, there is a 12 months waiting period if you had varicose veins that require surgery before taking out the policy, this is considered a pre-existing medical condition.
I am the Grandmother of a 4-year-old and a 5-year-old who live in NSW. Their parents are both in the Navy and are covered for Ambulance cover. I would like a quote to cover them for Ambulance cover only, please.
Hello Shirley,
Ambulance Only cover is available from select health insurance providers. As your comment is made on our Medibank page, you can review their Ambulance cover here.
Be sure to inquire whether both emergency and non-emergency ambulance services are provided, and which ambulance transportation types are covered, i.e. land, air and by sea.
If you would like us to help you in comparing ambulance only cover types from other health funds, give us a call on 1300 786 328.
I plan to get Invisalign treatment for my teeth. Would that be covered in the Medibank health insurance?
Hi Vishal,
Whether orthodontics is covered in your Medibank policy depends on the type and level of cover you purchase. You’ll usually want Extras cover that offers dental insurance, including orthodontic coverage. For example, Medibank’s Growing Family Extras and Top Extras.
Does Medibank cover ENT Surgery, and radiation therapy and what does such cover cost? What about hearing aids?
Hello Seiichi.
Most hospital options from Medibank include the removal of tonsils and top Extras generally include hearing aids. However, you’ll need to provide specifics regarding the type of ENT surgery you’re wanting cover for, as it can include a wide range of diseases of the neck, ear, nose and throat.
Radiation oncology services, including radiation therapy, are supported through the Medicare Benefit Schedule (MBS).
You might want to complete the quote form above, so a specialist can assist you.
Do you have insurance coverage for liver disease?
Thanks.
Hi Adam,
Let me start by saying that you’ll generally have to wait up to 12 months before claiming health insurance benefits associated with pre-existing conditions, for example, liver disease.
You might be able to claim medications not covered by Medicare or listed on the Pharmaceutical Benefit Scheme (PBS) from your health fund’s Extras Cover. However, medications covered vary from insurer to insurer and usually depends on the type and level of cover you choose.
Please give us a call on 1300 786 328 so a specialist may assist you in finding the right cover for your situation.
Good day,
We are moving to Australia in February next year on a working permit for 4 years.
if we get private medical cover when we arrive ( Feb ) will my pregnant wife be covered for the birth of our child? (birth date June)
thank you.
Hi Dylan,
Generally, private health insurers will require a 12 month waiting period from when your policy starts before you can claim any pregnancy or birth-related services.
I am renewing my 410 Visitors Visa for another 10 years and I will need a quote for single coverage Top Hospital Essentials. My date of arrival in Australia will depend on the sale of my home here in Canada.
Can you provide me with a letter that will satisfy the Requirements of the 410 Visa so that I will be able to show the Visa section what coverage I am getting when I arrive in Australia? I had coverage in Australia for 11 years with Medibank and my member number was 2827****.
Hey,
To satisfy Visa requirements, you’ll first have to purchase a policy and have a health insurance company provide you with documented proof. You can generally decide on your starting date, i.e. when you want to start paying premiums and have the cover kick in.
ComparingExpert is a comparative website, not a private health fund. If you’d like to compare policies and then purchase one suited to your requirements, please fill in the quote form above or call 1300 786 328 for immediate assistance.
Hi. Is breast reconstruction surgery after Mastectomy because of breast cancer covered by Medibank?
If yes, then which type of coverage is it and can I apply for my surgery during the 12 months waiting period so I can do the surgery straightaway without wasting more time?
Thanks
Hi Bisher, thanks for reaching out.
Please note, breast reconstruction surgery is generally paid for through the public health system if you are eligible for Medicare. It’s very important that you first talk to your breast surgeon about this possibility and ask them for a written quote before committing to surgery.
Regarding private health insurance, breast reconstruction surgery generally falls under high-cost medical services and as such will usually be covered by Gold Hospital policies. After starting your policy, you’ll typically have to wait 12 months before you can claim for this benefit. Please also have a read of our Prostheses List guide.
It’s best to contact Medicare directly to receive a full breakdown of the policies covering this surgery and how much out-of-pocket costs you could expect.
Best of luck
Anneke