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Medibank Health Insurance

Medibank Health Insurance Review

Australia’s biggest health fund doesn’t rely on reputation. We found Medibank to be one of the cheapest hospital providers across all tiers.

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Gary Hunter

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Tim Bennett
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Pros

  • At $88.90 a month, Medibank has the joint cheapest Bronze hospital policies available on Finder.
  • Medibank's other hospital policies are also some of the cheapest in the market.
  • A smaller share of all Ombudsman complaints than its overall market share.

Cons

  • Medibank doesn't offer any very cheap extras policies – its cheapest option is around $32 a month.

Good value Medibank policies

These are some good value hospital policies from Medibank, one each from the Bronze, Silver and Gold tiers.


*Quotes are based on a single individual with less than $90,000 income, $500 excess and living in Sydney.

Medibank health insurance: Our verdict

Medibank is Australia's largest health fund by market share, but remains competitive on price.

Medibank is good if:

  • You want the joint cheapest bronze hospital policy available on Finder ($88.90 a month).
  • You want a competitively priced Basic, Silver or Gold hospital policy.
  • You're looking for a sign-up bonus or discount, as Medibank regularly offers these.

Medibank is not great if:

  • You get flustered by too many choices.
  • You're looking for a very cheap extras policy. Medibank's lowest-priced option, Healthy Start Extras, is actually quite comprehensive and priced accordingly.

Review by our insurance writer Gary Hunter

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Sign-up deals with Medibank Health Insurance for July 2022

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What types of health insurance does Medibank offer?

Hospital
Extras
Combined
Ambulance

Hospital icon

Hospital Coverage

All of Medibank's hospital policies include the minimum requirements of providing restricted cover for rehabilitation, psychiatry and palliative care. It also offers full cover for accidents and ambulance rides, plus transport and accommodation support if your round trip for hospital admission is more than 200km.

Basic and Bronze cover

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

This covers everything Basic Accident and Ambulance does plus a little bit more, including:
  • Hernia and appendix
  • Joint reconstructions
  • Dental surgery

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)

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.

This covers everything Bronze Plus Progress covers plus podiatric surgery. It's Medibank's most comprehensive Bronze policy.

Silver and Gold cover

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)

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.

This covers everything Silver Plus Assured does plus a little bit more, including:
  • Cataracts
  • Dialysis for chronic kidney failure
  • Joint replacements

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

Extras icon

Extras coverage

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 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. Cover that pays 60% of the cost of general and major dental, physical therapy, optical and more.

Clipboard icon

Combined coverage

With Medibank, you can mix and match hospital and extras policies or choose from one of its packages, most of which are tailored towards couples who plan to have children or growing families on different budgets:
  • Basic Everyday Starter.
  • Medibank Bronze Growing Family.
  • Medibank Bronze Plus Assured Growing Family.
  • Medibank Silver Plus Growing Family.
  • Medibank Gold Growing Family.
  • Medibank Gold Ultra Health.

Ambulance icon

Ambulance coverage

Medibank also offers standalone ambulance health insurance, with a 1-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.

Medibank health insurance complaints

We looked at the 2021 Ombudsman health insurance complaints. Because Medibank owns ahm, they're grouped together. Here's how they stacked up:

  • Medibank/ahm had fewer complaints than its market share. The number of complaints vs market share was also better than the previous year (0.68 vs 0.85).
  • Medibank/ahm had a better complaints score than other big health funds like Bupa and HCF.
  • Some smaller funds, including HBF, had a better complaints score.

This chart shows the weighted volume of complaints received by each health fund, according to the Commonwealth Ombudsman. The lower the number, the better. Only non-restricted funds with a national market share of at least 0.1% are included here. Medibank/ahm is seventh overall in this ranking. The weighting ensures that funds are compared fairly; larger funds serve more customers so can potentially get more complaints.

Medibank frequently asked questions

  1. Commonwealth Ombudsman - 2021 State of the Health Funds Report
  2. Commonwealth Ombudsman - 2020 State of the Health Funds Report
  3. Health Insurance Policy Data Source

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4 Responses

  1. 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
  2. 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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