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Medibank Health Insurance Review

Australia’s biggest health insurer doesn’t get by on reputation — we found Medibank to be one of the cheapest hospital providers across all tiers.

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Medibank Health Insurance
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Gary Hunter
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Medibank has been for-profit since 2009 and became privately owned in 2014. Despite its change, it still offers competitively priced policies across all its health insurance tiers.

Our Verdict

  1. At $88* per month (with a $500 excess) Medibank has the cheapest bronze hospital policy available on Finder and joint cheapest gold policy ($175). Its basic and silver policies aren't the lowest-priced, but at around $10 more a month, they're close.
  2. Despite being Australia's largest health insurer by market share, Medibank did not have the largest number of complaints (119) between 1 October and 31 December 2020 — HCF (230) and Bupa (174) had more, according to the Private Health Insurance Ombudsman report.
  3. It's not great if you just want a cheap basic extras policy. Medibank's lowest-priced option, Healthy Start Extras, is actually quite comprehensive compared to others, covering you for the basics plus psychology and major dental.

Review by our insurance writer Gary Hunter

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Compare Medibank health insurance options for you

*Prices based on a single male living in Sydney
Top 3 features
  1. Good for people who want a wide variety of hospital policy choices.
  2. Good for people who like discounts and rewards.
  3. Beware if you get flustered by too many choices.

Who is Medibank?

Medibank is one of Australia's oldest health insurers and it's the largest health insurer in Australia. It was originally a government-owned business but was privatised in 2014.

Medibank has a network of more than 160 member hospitals where you can save on some out-of-pocket expenses usually associated with private care.

The insurer also offers a number of perks and rewards opportunities including:

  • The ability to earn triple flybuys points on fruit (fresh only) and vegetables (fresh or frozen) when you shop at Coles. You can also link up an eligible fitness tracker to your Medibank account to earn an additional 10 points for every 10,000 steps.
  • A 10% discount on Medibank's range of travel, life, income protection, funeral and pet insurance if you also hold health insurance.
  • Discounts of up to 25% on a wide range of other products and services, including Fitbits, Palace Cinema tickets, Sunglass Hut, Philips Avent infant-feeding products, Motherworld and more.

What health insurance options are available?

All of Medibank's hospital policies fit into the new tier structure developed by the Australian government. However, they haven't updated their extras policies in the same way. They have until April 2020 to do so.

All of Medibank's hospital policies include the minimum requirements of providing restricted cover for rehabilitation, psychiatry and palliative care.

They also offer full cover for accidents and ambulance rides, plus transport and accommodation support if your round trip for hospital admission is more than 200km.

Basic Accident and Ambulance

This is the most bare bones policy, adhering to the government's minimum requirement for a Basic policy. It offers restricted cover for:

  • Rehabilitation
  • Hospital Psychiatric Services
  • Palliative care

You can choose an excess of $500 or $750.

Basic Plus Healthy Start

This covers everything Basic Accident and Ambulance does plus a little bit more, including:

  • Hernia and appendix
  • Joint reconstructions
  • Dental surgery

The only excess option available is $750.

Bronze Everyday

This sticks to the government's minimum requirement for a Bronze policy, with cover for 19 clinical categories including

  • Bone, joint and muscle treatments
  • Gynaecology
  • Pain management
  • Diabetes management (excluding insulin pumps)

You can choose an excess of $250, $500 or $750.

Bronze Plus Progress

This covers everything Bronze Everyday does plus a little bit more, including:

  • Sleep studies
  • Insulin pumps
  • Implantation of hearing devices
  • Dental surgery

It also offers full instead of restricted cover for palliative care.

You can choose an excess of $250, $500 or $750.

Silver Everyday

This sticks to the government's minimum requirement for a Silver policy, with cover for 27 clinical categories including:

  • Heart and vascular system treatments
  • Implantation of hearing devices
  • Plastic and reconstructive surgery (medically necessary)

You can choose an excess of $250, $500 or $750.

Silver Plus Assured

This covers everything Silver Everyday does plus a little bit more, including:

  • Insulin pumps
  • Sleep studies

It also offers full instead of restricted cover for rehabilitation and palliative care.

You can choose an excess of $250, $500 or $750.

Silver Plus Security

This covers everything Silver Plus Assured does plus a little bit more, including:

  • Cataracts
  • Dialysis for chronic kidney failure
  • Joint replacements

You can choose an excess of $250, $500 or $750.

Medibank Gold Complete

This covers all clinical categories defined by the Australian government. You'll get everything above plus:

  • Pregnancy and birth
  • Assisted reproductive services (like IVF)
  • Weight loss surgery
  • Pain management with device

These are Medibank's extras policies.

  • Top Extras. This could be a good option if you are seeking the highest benefits for services such as major dental (including orthodontics), optical and physical therapies with no combined limits. You can choose from 90%, 75% or 60% back on claims.
  • Growing Family Extras Only. A policy that provides generous benefits for extras services families use regularly, such as dental and optical. The major dental benefit also increases over time, and you can select from 70% or 60% back on claims.
  • Essential Extras. Get 75% back on the cost of common out of hospital services including general dental, optical, physical therapy, acupuncture and exercise physiology.
  • Healthy Start Extras. Affordable cover that pays 60% of the cost of general and major dental, physical therapy, optical and more.
Medibank also offers standalone ambulance cover, with a one-day waiting period, from around $65 per year. This standalone ambulance cover is identical to what you get with Medibank's health insurance policies.
What is covered

You are covered for emergency and medically necessary ambulance services with Medibank policies. This is only when the nature of your medical condition means another type of transport is not viable. You are covered in the following situations:

  • When you need to be transported to a hospital or other approved facility in order to receive immediate professional attention.
  • When, as an admitted patient, you are transferred to another hospital and can only be safely transported by ambulance. Benefits are only payable for transfers between private hospitals or between a public and private hospital. You are not covered for transfers between public hospital facilities as an admitted patient.
  • When an ambulance is called to attend to you with immediate professional attention, but transport is not subsequently required.
  • Air ambulance services with pre-approval from Medibank.
What's not covered

You are not covered for any ambulance services that do not meet the above criteria. This includes the following situations:

  • Ambulance services where immediate professional attention is not required, such as general patient transportation.
  • Inter-hospital transfers between public hospitals, as an admitted patient.
  • Any ambulance services that are used when another method of transport is a reasonable alternative.

In addition, no benefits are payable for ambulance services that are covered in another way, such as by a state scheme or another third party.

Other features of Medibank private

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4 Responses

    Default Gravatar
    BillySeptember 3, 2019

    What can I use my package bonus?

    Thanks.

    Reply
      Avatarfinder Customer Care
      JeniSeptember 4, 2019Staff

      Hi Billy,

      Thank you for getting in touch with Finder.

      Rebates can be claimed as part of the Medibank Private “bonus package”. For more info on what you can do with your bonus package with Medibank Health Insurance, please contact them directly.

      I hope this helps.

      Thank you and have a wonderful day!

      Cheers,
      Jeni

      Reply
    Default Gravatar
    FayAugust 15, 2019

    I want to know if Medibank Private, which I belong to, and have for many years, covers anything in the way of a single dental implant. I got a plate recently on that tooth, but it hurts and makes my tongue very painful and I can’t wear it. I have diabetes and am 85 y/o, so does that make any difference regarding a claim from you or perhaps the government?

    Reply
      Default Gravatar
      NikkiAugust 16, 2019

      Hi Fay,

      Thanks for reaching out to Finder.

      Finding cover for dental implants is not easy but it is possible. Here are two ways you can find cover for implants:

      1. Hospital cover: Some policies will cover dental implants as part of their hospital cover, but this would require that you are admitted to a hospital as an inpatient. Most implants are done in an outpatient setting, so in order to be covered on a policy like this, you would have to have special anesthetic needs or extensive bone grafting.
      2. Extras cover: Implants are categorised into an area of major dentistry called periodontics, having to do with the gums. If your policy covers periodontics and doesn’t specifically exclude implants, you may be covered. You’ll have to check with your insurer to be certain and be ready to pay out-of-pocket because your benefit almost certainly won’t cover the whole amount. If you can get a quote that lists your treatment item numbers – that will really help you work out final costs with your health fund.

      According to our dental implants guide, Medibank covers dental implants while on a Black 60 policy. When you visit the page, click the ‘Go to site’ button to be brought to Medibank’s site immediately. It is best to reach out to Medibank directly.

      Hope this helps!

      Best,
      Nikki

      Reply
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