nib Health Insurance
nib is one of Australia's largest health insurers, protecting more than 1 million Aussies.
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nib has been around since 1952 and has built itself into the 4th largest health insurer in Australia. Unlike some other insurers, nib hasn't branched out into many other areas of insurance and instead sticks to only health and life insurance.
Top 3 features
- Good for people who want a little bit more cover than what is usually at the standard Basic, Bronze and Silver hospital tiers.
- Good for people who like perks, like a wide network of member hospitals.
- Beware if you want a very basic extras policy - the lowest level from nib starts with more coverage than some other providers.
Who is nib?
nib is a private Australia-based insurer providing health insurance to more than 1 million Australians. As of 2018, it was the 4th largest health insurer in Australia by market share.
nib's network of 200 member hospitals (including day hospitals) is among the largest in Australia. By visiting one of these hospitals, members can save money on out-of-pocket expenses usually associated with private care.
You can save even more with nibs MediGap specialists program. If you're treated by one of nib's networked specialists who have agreed to bill nib directly, meaning you won't pay a thing for their in-hospital services.
Nib also offers an accidental injury benefit that temporarily increases your cover to nib's highest level of cover for the next 90 days following an accident, giving you full cover if you're readmitted during that time.
What health insurance options are available?
All of NIBs policies fit within the Australian government's tier structure with one at each tier and two at bronze. All of nib's policies except Gold are "plus" policies meaning they offer more than the minimum requirements set out by the government for each tier. Gold is as high as you can get, so there's no need for a "plus" version of that.
All policies offer the minimum restricted cover for rehabilitation, psychology and palliative care as mandated by the Australian government's 2019 health insurance reforms.
Basic Essentials Hospital Plus
nib's Basic Essentials Hospital goes beyond the government's minimum requirement for a Basic policy by offering full cover for 7 other clinical categories including:
- Tonsils, adenoids and grommets
It goes above and beyond that by offering , hernia and appendix, gastrointestinal endoscopy, gynaecology, miscarriage and termination of pregnancy and dental surgery.
You can choose an excess of $250, $500 or $750.
Bronze Hospital Plus
A policy that includes cover for all bronze hospital services and a few more including:
- Gastrointestinal endoscopy
- Miscarriage and termination of pregnancy
Cover for the most commonly claimed services, Silver Hospital provides cover for 26 clinical categories of hospital treatments, including:
- Plastic and reconstructive surgery (medically necessary)
- Heart and vascular system
- Implantation of hearing devices
Silver Advantage Hospital Plus
The Silver Advantage Hospital Plus covers everything the Bronze policies cover plus additional clinical categories required by the government including:
- Back, neck and spine
- Plastic and reconstructive surgery (medically necessary)
- Lung and chest
It goes beyond the requirements by covering several additional clinical categories not required by the government including:
- Kidney dialysis
- Sleep studies
Gold Top Hospital
The Gold Top Hospital policy offers full covers for all 38 clinical categories as mandated by the Australian government for all Gold policies. Some additional cover not found on the Silver Advantage Hospital Plus policy include:
- Pregnancy and birth
- Assisted reproductive services (like IVF)
- Weight loss surgery
|Benefit||Basic Essential Hospital Plus||Bronze Hospital Plus||Silver Hospital||Silver Advantage Hospital Plus||Gold Top Hospital|
|Emergency Ambulance Cover|
|Accidental injury benefit|
|Hernia and appendix|
|Miscarriage and termination of pregnancy|
|Tonsils, adenoids and grommets|
|Bone, joint and muscle|
|Brain and nervous system|
|Breast surgery (medically necessary)|
|Chemotherapy, radiotherapy and immunotherapy for cancer||Diabetes management (excluding insulin pumps)|
|Ear, nose and throat|
|Eye (not cataracts)|
|Kidney and bladder|
|Lung and chest|
|Male reproductive system|
|Pain management with device|
|Plastic and reconstructive surgery (medically necessary)|
|Sleep studies||Heart and vascular system|
|Implantation of hearing devices|
|Back, neck and spine|
|Dialysis for chronic kidney failure|
|Assisted reproductive services|
|Hospital psychiatric services|
|Pregnancy and birth|
|Weight loss surgery|
|Podiatric surgery (provided by a registered podiatric surgeon)|
|Services not covered by Medicare|
nib also offers four levels of Extras cover; Core Extras, Core Extras Plus, Core & Wellbeing and Top Extras. Each offers a range of treatments from optical to podiatry. nib also have great dental coverage with all four options including unlimited preventative dental:
|Benefit||Core Extras||Core Extras Boost||Core and Wellbeing Extras||Top Extras|
|Unlimited preventative dental|
|Chiropractic / Osteopathy|
|Antenatal & postnatal services|
|Eye therapy (also known as orthoptics)|
|Hearing aids / Speech processors|
|Home nursing services|
|Podiatry / Orthotics|
|Speech pathology (speech therapy)|
|Top health aids|
|Wellbeing health aids|
Young people discount
nib offers an age based discount to customers between the ages of 18-29. The amount of discount you receive depends on what age you were on the Discount Assessment Date, which is 1 April 2019 or the date you first took out a policy with nib after 1 April 2019.
You'll keep your discount until age 40 at which point it decreases by 2% per year.
Here's what your discount will be based on the age you were on your Discount Assessment date:
- 18-25: 10% discount
- 26: 8% discount
- 27: 6% discount
- 28: 4% discount
- 29: 2% discount
How to make a claim
There are several options to choose from when you need to make an extras claim with nib:
- Swipe your nib card. All you have to do is swipe your nib card when you visit your service provider to claim on the spot.
- Claim online. You can use nib Online Claiming 24/7 and claim for extras services by uploading a photo of your receipt. Benefits will be paid into your account within 2-4 working days.
- Claim via the nib app. There are iPhone, iPad and Android apps available so you can claim on the go.
- Visit an nib retail centre. You can visit your nearest nib retail centre to lodge a claim in person.
- Claim by mail. Download and complete an nib claim form, then mail it and your original receipts to nib health funds, Locked Bag 2010, Newcastle NSW 2300.
Overseas visitors or Students
nib offers separate health insurance options for overseas students and working visitors.
All three of these offer the following:
- They meet the Department of Immigration and Citizenship (DIAC) visa requirements.
- They have no excess.
- They cover emergency ambulance rides.
- They cover 100% of the Medicare benefits schedule fee for every covered treatment.
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