Compare Medibank Health Insurance from one of the biggest names in Australian health insurance
Established in 1975, Medibank today provides health insurance solutions to more than 3.8 million people across Australia and New Zealand. If you’re looking for private health insurance, Medibank Health Insurance offers a wide range of hospital and extras cover options for singles, couples, families and single parents.
Medibank Health Insurance options
Medibank Health Insurance offers a comprehensive range of cover options for Australians of all ages, budgets and family situations. You can choose from standalone hospital or extras cover, or mix and match hospital cover with extras cover to create a combined policy. You can also take out additional cover options like Accident Cover and Ambulance Cover.
Basic Hospital Cover provides protection for the cost of things like ambulance transportation, colonoscopies, knee and shoulder reconstructions, hernia surgery and more. In short, it offers a basic level of cover for a range of common procedures that young and healthy people might require.
Standard Hospital, Top Hospital Essentials and Top Hospital Cover all provide increasing levels of protection, including cover for things like accidents and heart surgery, until you reach the highest and most comprehensive level of cover available.
- Basic Hospital. Designed to provide essential cover at an affordable price, this policy includes cover for ambulance services, shoulder and knee reconstructions, appendicitis treatment, tonsil removal, wisdom tooth removal, and colonoscopies.
- Standard Hospital. Standard Hospital Cover is a little more expensive and provides cover for accidents and ambulance services. A range of common procedures (tonsil removal, appendicitis, wisdom teeth removal and knee reconstructions) are included in this cover. Other treatments covered include palliative care, rehabilitation treatment, heart-related services, reconstructive surgery, and other in-hospital services where a Medicare benefit is payable.
- Top Hospital Essentials. Top Hospital Essentials provides a higher level of cover for a selection of essential procedures, including everything from hip replacements and eye surgery to renal dialysis and a wide range of other services.
- Top Hospital. This is the highest level of Hospital Cover available from Medibank Health Insurance and it covers all the essential procedures listed above. It also provides cover for IVF and related services, major eye surgery, psychiatric treatment, obstetrics services and joint replacement surgery.
In terms of Extras Cover, the affordable Basic Extras option covers essential treatments like dental, optical and physio. But if you’re willing to pay more for Top Extras Cover you can also receive higher cover limits and included cover for things like orthodontics and podiatry.
- Basic Extras. Basic Extras Cover allows you to choose between 55-70% back on a range of general treatments including general dental, optical, physio, chiropractic and natural therapies.
- Top Extras. With Medibank’s Top Extras Cover, you can choose between receiving 55, 70 or 80% back on extras. As well as the treatments covered under a Basic Extras plan, Top Extras also covers major dental, podiatry, speech therapy, hearing aids, dietetics and clinical psychology.
- Accident Cover. Accident Only Cover from Medibank Health Insurance provides 100% cover for the cost of ambulance services, as well as restricted cover for palliative care and psychiatric services. Cover is also included for accidental injuries.
- Ambulance Cover. As the name suggests, this policy covers the expensive cost of ambulance transportation to hospital. It also covers air ambulance transport, transfer via ambulance between hospitals, and the cost when an ambulance is called to provide immediate medical attention, but no transport is needed.
Medibank Health exclusions
Your Medibank Health Insurance policy will not offer cover if your claim:
- Is for services provided when your premiums are in arrears or your membership is suspended
- Is for services rendered or products purchased from outside Australia
- Is for something for which you may be entitled to lodge a claim for damages or compensation
- Is for treatment provided by an unrecognised provider
- Is for pharmaceuticals that are available under the Pharmaceutical Benefits Scheme
- Is for oral contraceptives
- Form contains false or inaccurate information
- Is for services rendered in an aged care service
- Is for cosmetic surgery that is not medically necessary
- Is for medications prescribed for cosmetic purposes.
How much does Medibank cover cost?
Medibank Health Insurance offers policy options to suit people with a wide range of budgets. For example, basic hospital and extras cover for a single person can start from under $20 a week. However, there is a wide range of factors that can affect the cost of your insurance, including:
- What level of cover do you have? Top-level cover offers many more benefits than an entry-level policy, and as a result it costs a lot more.
- Do you have combined cover? Choosing just hospital cover will be cheaper than if you select combined hospital and extras cover.
- Do you have a tailored package? Medibank Health Insurance offers a range of tailored packages to suit singles, couples, families and single parents. Choosing to build your own cover instead of selecting one of these tailored policies could cost you more.
- When did you take out cover? A loading will apply to the cost of cover if you take out a policy when you are over the age of 31.
- How many people are on your policy? The number of people who are covered under your policy.
What is an excess?
Of Medibank’s wide range of hospital covers, some require you to pay an excess. This is the amount you will have to contribute towards your hospital treatment and will be deducted from the benefit amount you receive. Depending on the hospital, you may be required to pay this excess at the time of admission.
The amount of the excess that applies to your policy will be listed in your policy schedule.
How can I pay less for health insurance?
- Pay a higher excess. This will result in lower premiums.
- Choose a lower level of cover. The lower your level of cover, the less you will have to pay for it.
- Consider your need for extras cover. If you decide that you can do without extras cover, removing it from your policy can save you a significant amount of money.
- Discounts. If you’re a single parent, take advantage of the cheaper cover available to you.
How do I make a claim?
Making a health insurance claim with Medibank is easy. If on-the-spot claiming is offered by your health care provider, all you have to do is swipe your card for instant approval. However, if this option is not available you can quickly lodge a claim online and then receive any benefits directly into your bank account or by cheque. Claims can also be lodged by mail or in a Medibank Health Insurance store, while a fast and easy claiming option is also available on smartphones via the Medibank Mobile app.
Get the Medibank Mobile app
Is there an option for overseas visitors?
Medibank Health Insurance Overseas Visitors Health Cover allows visitors and working visa holders to reduce the cost of the health care and medical treatments they receive in Australia. Options include:
- Young Visitor Health Insurance. This covers ambulance costs and key procedures like tonsil removal and appendicitis, and is available for students.
- Working Visa Hospital Cover. Working Visa holders can enjoy basic cover for ambulance transportation, heart services, shoulder and knee reconstructions, 24-hour nurse services and more.
- Working Visa Hospital and Medical Cover. This mid-level option adds cover for obstetrics, reconstructive surgery, IVF, renal dialysis and more.
- Top 85 Working Visa Cover. Only available to people on certain types of working visas, this policy offers the highest level of cover for private hospital accommodation and public hospital accommodation as a private patient.
Are there any additional benefits?
Medibank Health Insurance members also receive access to MiHealth, a program that offers a wide range of health support services. This includes a 24/7 health advice line staffed by Medibank nurses, mobile health apps and a huge selection of online health resources and tools. With MiHealth, you can do everything from improve your family’s lifestyle to start training for a marathon.
What does Medibank pay for specific treatments?
Each condition and treatment you claim for with Medibank will have its own benefit payment assigned to it, generally increasing or decreasing with the seriousness of the illness and the complexity of the procedure or surgery required to treat it.
Below are listed 22 commonly claimed on medical services and the dollar amount that Medibank and Medicare (MBS) will pay on each. The data is drawn from the Australian Medical Association's annual report card on private health insurance providers:
|Basal Cell Carcinoma or Squamous Cell Carcinoma removal from nose, eyelid, lip, ear, digit or genitalia||$221.35||$303.15|
|Breast, benign lesion surgical biopsy of excision||$260.05||$355.30|
|Carpal Tunnel Release||$276.80||$404.90|
|Complicated Delivery (of baby)||$1,629.35||$2,198.50|
|Coronary Artery Bypass||$2,200.00||$3,265.15|
|Femoral on Inguinal Hernia||$464.50||$636.05|
|Overnight investigation for sleep apnoea||$588.00||$694.25|
|Tonsils or Tonsils and Adenoid||$295.70||$472.35|
|Uncomplicated Delivery (of baby)||$693.95||$1,886.95|
I recognise most of these funds except for the AHSA, what is that?
The funds represented by the ASHA are:
- ACA Health Benefits Fund
- Australian Unity Health Limited
- CBHS Health Fund Limited
- CUA Health Limited
- Defence Health
- GMF Health
- Budget Direct Health Insurance
- Frank Health Insurance
- GU Health
- HBF Health Ltd
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited
- Health Partners
- Navy Health
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Limited
- Reserve Bank Health Society Ltd
- rt health fund
- Teachers Health Fund > UniHealth Insurance
- Teachers Union Health
- The Doctors' Health Fund Pty Ltd
- Transport Health