Medibank Health Insurance Review

Published: July 19, 2017

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 benefits

  • Choice of hospital
  • List of providers
  • Gym memberships

Cover options

  • Single cover
  • Couples cover
  • Family cover

Need to know

  • Cost of cover
  • Waiting periods
  • FAQs

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:

  1. Better choices, with assistance and guidance on how to make positive health decisions.
  2. Better confidence in receiving quality cover.
  3. 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.

Members Choice Hospitals

Members get better value for covered treatments than if they were to go to a non-Member’s Choice hospital. Medibank ensures its members of the arrangement it has with most private hospitals and day surgeries in Australia, capping prices, so there are no surprises on your bill.

Medibank Providers

Medibank’s Members’ Choice Providers is an extra network of various medical service providers, including hospitals and day surgeries, giving members more options and generally offering lower for out-of-pocket costs than what non-members would have to pay.

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.

Medibank Livebetter (“Flybuys”)

Existing and new members of the flybuys reward program can enjoy rewards for leading a healthy and active lifestyle. You can accumulate flybuy points by linking your Medibank and flybuys memberships:

  • Triple points are earned on fresh fruit and frozen veg from Coles Supermarkets, including Bi-Lo and Coles Online.
  • Flybuys Points are earned for being active with an eligible Activity Tracking Device e.g. 10 points can be collected every day that you reach 10 000 recorded steps.

Gymbetter

Gymbetter is Medibank’s ground-breaking new initiative which aims to make gyms more accessible and affordable for all Australians. The Gymbetter network has over 170 different facilities within their network, which includes YMCA for young people aged 16 – 18 years, the female-only gym Fernwood and other gyms such as Anytime Fitness and Goodlife Health Clubs.

Participants can register for Gymbetter through their Apple and Android devices. Members have access to the wide network of gyms around Australia; all offered on a pay-as-you-go basis with no lock-in contracts. Over and above that, members with hospital and Medibank extras receive a 25% discount on passes.

Medibank Nurse 24/7 Hotline

As a Medibank member with hospital cover, you have 24/7 access to an experienced Medibank nurse for any health-related questions.  All Medibank nurses are able to complement the care given by your GP and other health professionals.

Discounts on Medibank Life Travel and Pet Insurance

Medibank Life Insurance offers cover of up to $1.5 million, and no medical or blood tests are needed on application. Best of all, renewal for life is guaranteed.

Medibank Travel Insurance also provides you with leading hospital, accident and medical evacuation cover while you’re travelling. Their Comprehensive plans even aim to cover you for minor mishaps like lost luggage, cancelled bookings and rental car insurance.

Medibank Health Cover members save 10% on their pet, travel and life insurance. You can claim up to 80% back on bills for vet consultations, emergency treatment, surgery and medicines.

Sport Events

Medibank’s social media pages regularly offer ticket giveaways and registration discounts for members, which include:

  • Australian Open Tennis Tournaments.
  • Parkrun Australia, weekly timed 5km runs.
  • Medibank Melbourne Marathon Fun Runs.
  • Medibank Feel Good Program free outdoor fitness classes in Brisbane.

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Need help? Call us on 1300 786 328

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 coveredDescription
Ambulance & Accident Cover100% cover for immediate professional attention
Hospital cover
  • Hospital Essentials: from $16.44 per week
  • Core: from $17.86 per week
  • Standard: from $24.05 per week
  • Top Essentials: from $30.46 per week
  • Complete hospital: from$31.32 per week
Dental100% back on annual check-ups and standard procedures at a Member’s Choice dentist. Excludes x-rays
Optical100% back at all recognised providers up to annual limits, including frames, prescription lenses and repairs.
Remedial massageAssessment and treatment of muscles, tendons, ligaments and connective tissues of the body to assist in rehabilitation, pain and injury management.
PhysiotherapyRehabilitation, injury prevention and fitness promotion.
Chiropractic & OsteopathyManipulation of the spine and skull to restore proper alignment.
Natural therapiesServices such as homoeopathy, naturopathy, reflexology, etc.
DieteticsAll 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 coveredDescription
Healthy start extras60% claim back
Basic extras70% claim back
Growing family extras only100% claim back for kids
Top Extras100% 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 coveredDescription
Core Hospital and Basic ExtrasWhen 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 Core100% claim back for kids
Standard Hospital & Basic Extras55% 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 ExtrasNo excess for kids. Members may choose between 55%, 70% or 85% on claim back.
Settled Families EssentialsRestricted Palliative Care, Rehabilitation and Psychiatric treatment.
Growing Families Essentials100% claim back for kids.
Standard Hospital and Top ExtrasRestricted psychiatric treatment and obstetrics-related services. Your choice of excess.
Top Hospital Essentials & Basic ExtrasRestricted psychiatric treatment. Your choice of excess.
Growing Family Complete100% claim back for kids and includes kids’ obstetrics. Your choice of excess.
Settled Families Comprehensive70% claim back at Members’ Choice. Your choice of excess.
Top Hospital Essentials and Top ExtrasIncludes joint replacements. Your choice of excess.
Complete Hospital & Top Extras55% claim back at Members’ Choice. Includes obstetrics.
Ultra Hospital CoverNo 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.

How much does Medibank private health insurance cost?

Medibank Health Insurance premium costs have increased by an average of 4.60% for 2017, which is lower than the national average, which is around 5%. Combined cover for a single person starts at around $22.01 a week, and growing families can expect core cover from $27.00 weekly.

It is important that you should know and understand what your health cover costs. This is the best way to avoid surprises and get the best value treatment for your money. Bear in mind that your hospital fee will include charges from all specialists involved, plus cover charges from the hospital for your accommodation and other services.

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:

ServicesWaiting period
All services (excluding accidents)2 months
Optical items6 months
Pre-existing conditions. However, this waiting period does not apply to hospital or hospital substitute treatment for psychiatric treatment, rehabilitation treatment or palliative care12 months
Blood glucose monitors24 months
Hearing aids and laser eye surgery36 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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Need help? Call us on 1300 786 328

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14 Comments

  • Bandana |

    Is treating varicose veins covered by Medibank Private “Top Hospital Essentials $500 excess with Top Extras 55”? The treatment may include sclerotherapy and surgery.

    • SPECIALIST
      Anneke Van Aswegen |

      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.

  • Shirley White |

    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.

    • SPECIALIST
      Anneke Van Aswegen |

      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.

  • Vishal |

    I plan to get Invisalign treatment for my teeth. Would that be covered in the Medibank health insurance?

    • SPECIALIST
      Anneke Van Aswegen |

      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.

  • Seiichi |

    Does Medibank cover ENT Surgery, and radiation therapy and what does such cover cost? What about hearing aids?

    • SPECIALIST
      Anneke Van Aswegen |

      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.

  • Adam |

    Do you have insurance coverage for liver disease?
    Thanks.

    • SPECIALIST
      Anneke Van Aswegen |

      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.

  • Dylan von Bratt |

    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.

  • W.D. Watson |

    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****.

    • SPECIALIST
      Anneke Van Aswegen |

      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.