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2023 Review of nib Health Insurance

Private Health Insurance gives policyholders the confidence that they will receive the coverage and assistance necessary for unforeseen incidents. Choosing the right Health Insurance Provider and Policy that matches your personal needs can be quite difficult and daunting.

Megan Fraser

Fact Checked

Updated: 21 May 2024

Nib is an Australian and New Zealand Health Insurance Provider that offers a wide range of Hospital and Extras cover to meet their policyholders’ personal requirements. Today we will have an in-depth look into nib Health Insurance, its policies, its coverage, how to make an online claim, and any other questions a potential policyholder may have.

Key facts

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Who is nib?

The nib  Group is a Health and medical insurance based in Australia and New Zealand established in 1952. In 2023, nib now assists 1,6 million Australian and New Zealand residents and more than 200,000 workers and international students in Australia. Nib is unique in many of its policies. One such policy is the ability to receive financial assurance and protection when travelling the world.

Nib states that its business aims to assist its members in leading healthier and better lives. They achieve this through not only their policies but also campaigns and community assistance programs. In 2022, nib announced a flood disaster relief package in which members in flood-affected areas could receive a 30-day waiver on their premiums and the option to choose to suspend their policy for three months.

Nib offers policies for singles, couples, and families. These policies come in the form of Hospital, Extras and Ambulance cover. The policies also provide members with a range of rewards, benefits, promotions, and programs.

Types Of Cover

Nib has designed and created policies to meet the individual needs of its many members. These members may lead vastly different lifestyles, and as such, need policies that match these lifestyles. As mentioned, nib offers singles, couples, and families cover. Nib offers three forms of cover. These coverage types are Hospital, Extras, and Combined. Let’s explore these different coverage types and what nib offers their policyholders for each.

Hospital Cover by nib

Hospital cover assists in providing coverage for treatment costs as a private patient in a private hospital or a private patient in a public hospital. Much like every insurance provider, nib offers several tiers with their hospital coverage. These tiers are:

Each tier is different and, as such, offers a different level of coverage. For example, the Basic Essential Hospital Plus Cover provides simple coverage for services such as Dental, Hernia, and Joint reconstruction. Still, the Gold Top Hospital policy offers a fully comprehensive package of hospital procedures and services.

To choose the right hospital coverage, it is important to look at not only the overall price but the coverage you will receive and the personal requirements that you may have. It is essential always to have a hospital policy that directly matches your personal health and financial needs.

Extras Cover by nib

The Extras Cover that nib offers is for claiming services outside of the hospital that Medicare doesn’t cover. This may include things such as dental, optical, and physio. 

Alongside nib’s Extras Cover, they provide members with freedom of choice, which means that policyholders can select their own healthcare facilities to partner with as long as the facility is recognised by nib and a part of the member’s policy. Nib also offers nib First Choice which grants policyholders additional discounts and rewards for visiting selected dental, optical, and physio healthcare facilities.

Combined Cover by nib

Nib allows members to choose a policy that combines both Hospital and Extras cover. These policies are designed to meet the personal requirements of members both in and out of the hospital. Combined cover is a great way to ensure that you receive the necessary coverage for your personal needs, whether in a hospital or with additional services such as dental, optical, and physio.

Member Complaints

Nib’s complaints process aims to assist members with any possible complaints that they may have concerning the service provided. This complaints process also aims to increase the quality of service nib provides its customers.

The complaints process starts with a member phoning in and filing a complaint. The nib complaints agent will then attempt to assist the customer while on the phone. If the issue is not resolved over the phone, the matter can be transferred to the Customer Resolutions Team, who will acknowledge the complaint within 2 working days.

The resolution process aims to deal with the problem within 5 working days of the case manager contacting a member and 15 working days after filing the complaint. If this does not resolve the issue, nib suggests that members contact the Private Health Insurance Ombudsman to assist further.

How much does it cost?

The cost of a policy will greatly vary based on several factors. These factors may include:

Compare nib Policies

Hospital Policy
Average Premium per Month
Extras Policy
Average Premium per Month
Basic Essential Hospital Plus
$122.04 – $129.99
Basic Essential Hospital Plus
$113.51 – $137.16
Bronze Hospital
$125.92 – $136.80
Value Extras
$19.00
Bronze Hospital Plus
$157.05 – $175.85
Core Extras
$47.40 – $70.06
Silver Hospital
$229.38 – $287.52
Advantage Extras
$102.24
Silver Advantage Hospital Plus
$320.97
Premium Extras
$130.36
Gold Top Hospital $750 Excess
$159.15
Top Extras
$159.15

Source: Privatehealth.gov.au (June 2023; Premium estimates for a single individual living in NSW)

Gap Cover by nib

A gap occurs when the policy and Medicare are not able to completely cover your costs. Out-of-pocket costs can often create exceptionally stressful situations. When your coverage does not completely assist in the costs of a service or procedure, it can become rather frustrating. Many Private Health Insurance Providers offer their members a ‘no-gap’ policy. This means that they assist in lowering the overall final amount that is due.

Nib offers their members with wonderful gap cover. This gap cover is referred to as nib’s Medigap policy. Medigap aims to lower or completely eliminate the out-of-pocket costs that a member may have. Specific specialists and healthcare providers that partner with the Medigap program agree to not charge a gap fee for their services. This means that members who use these services will not have any out-of-pocket costs.

A member can also ask their personal doctor, specialist, or healthcare provider if they are willing to partake in the Medigap program. Doctors often do this on a case-by-case basis and will decide whether patients can or cannot utilise the program.

Discounts and Rewards

Nib offers its members a lovely benefits and rewards program. The rewards program that nib provides is called nib Rewards. To be a part of this, members simply need to wait a month after signing up with nib and ensuring their premiums are paid. Once this time has elapsed, they can access the mobile app that grants them rewards with over 100 participating brands.

The benefits that nib offers its members include:

Ambulance Cover

Nib offers Emergency Ambulance Cover to assist if an Emergency Ambulance service is required. Since Medicare does not cover the cost of an emergency ambulance, nib will assist in lowering the out-of-pocket cost for this service. 

Nib ambulance cover offers some of the following:

Family Policies

Nib’s family policies allow student and non-student dependents to remain on the extended family policy until age 31. The optical and dental services offered by nib First Choice also apply to the dependants on the policy. The range of coverage that a family will receive is dependent on the policy tier that is chosen. The family policy cost will also vary based on the previously mentioned points of geographical location and policy type.

The available policy tiers are:

Online Claiming

When making a claim, there are three main avenues that nib offers its policyholders: With the nib card, online, or in-app. To make a claim using the nib card, check if the healthcare facility has a HICAPS card terminal. Scanning your card at this terminal will result in the claim being made. Your card can also be loaded onto your Apple or Android as a digital card.

To make a claim online or in-app, a member must log into their profile and navigate to the ‘make a claim’ section of the app or online website. Once there, the member must fill out the relevant documentation and await feedback on the claim. A claim made on a member account should take roughly 3-5 business days to process, but slight delays can still occur.

Frequently Asked Questions and Answers

Nib requires all complaints to first go through their phone channel. The complaints consultant will attempt to assist the member with the complaint while still on the line. The matter gets transferred to the Customer Resolutions Team if the complaint is not resolved. A case manager will then contact the member and attempt to solve the complaint within 5 days of first contact. If this does not resolve the complaint, nib recommends that members raise the issue further with the Private Health Insurance Ombudsman.
Nib provides gap cover to its members in the form of Medigap. Medigap is a program in which healthcare professionals partner with nib to eliminate the gap costs involved with procedures and treatments. It is important to ask your healthcare professional if they are a part of the Medigap program. Doctors also use this program on a case-by-case basis and can deny the program if they believe that Medigap cannot completely fund the procedure.
Some of the extras nib provides coverage for include optical, general dental, major dental, physiotherapy, Chiropractic / Osteopathy, Psychology, Natural Therapies, and Orthodontia.
Nib offers a rewards program that is directly partnered with over 100 brands. Members can receive rewards and benefits from these brands. Nib also discounts premiums to members who sign up for a policy and are below the age of 30. Members receive discounts on optical, dental, physio, and partnered healthcare facilities.
Nib offers emergency ambulance cover. This cover aims to assist members with emergency ambulance services. The entire fee is covered if the member receives on-site assistance and does not require transport to the hospital. If the transport is provided by a state or territory ambulance service, 100% of the fee will be covered. If it is medically necessary for a patient to be transferred between hospitals, nib’s ambulance cover will cover the costs.
Nib offers five policy tiers for potential members searching for family cover. Student and non-student dependents can remain on the extended family cover until age 31. All dependants on the member’s policy have access to the Medigap services provided by nib.
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Specialist

Megan has extensive experience writing about health and life insurance in Australia. Megan has a special interest in health and wellness. She relies on her background in counselling psychology to convey the latest findings in a manner that is most beneficial to ComparingExperts readers. In every article she writes, Megan aims to uphold the standards of the Private Health Insurance Intermediaries Association (PHIAA) which ComparingExpert is part of.

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