Our verdict: nib has a good value Basic Essential Hospital Plus policy and some comprehensive inclusions on extras coverage. However, most of nib's hospital policies are more expensive than many of its major competitors.
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Pros
nib's accidental injury benefit gives you access to Gold Hospital cover for 90 days after the accident – not many funds offer this.
"Basic Essential Hospital Plus" is a good value policy, covering 9 treatments from around $77.97 a month. However, Bupa's "Basic Plus Starter Hospital" is cheaper and covers 9 services.
Most of nib's hospital policies aren't among the cheapest on the market, although "Basic Essential Hospital Plus" offers good value. The extras policies that nib offers are more competitively priced, although it lacks a very basic extras policy.
nib is good if:
You want a good value Basic Plus policy that can help you avoid the LHC and MLS.
You want basic extras with decent dental. "Core Extras" gives you 60% back and no annual claim limit on preventative dental from around $31.82 a month.
nib is not great if:
You want the best value Bronze, Silver or Gold hospital policy.
nib's Basic Essential Hospital Plus goes beyond the government's minimum requirement for a Basic policy by offering full cover for 9 other clinical categories including:
Tonsils, adenoids and grommets
Gynaecology
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.
A policy that includes cover for all bronze hospital services and a few more including:
Cover for the most commonly claimed services, Silver Hospital provides cover for 30 clinical categories of hospital treatments, including:
Plastic and reconstructive surgery (medically necessary)
Heart and vascular system
Implantation of hearing devices
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
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
Extras coverage
nib also offers 4 levels of extras cover: Core Extras, Core Extras Boost, Core and Wellbeing, and Top Extras. Each offers a range of treatments from optical to podiatry. nib also has great dental coverage with all 4 options including unlimited preventative dental:
Core Extras. Provides a 60% benefit on a basic range of extras, including general dental, major dental, optical and physiotherapy.
Core Extras Boost. This plan provides the same benefits as Core Extras, but with a higher annual limit.
Core and Wellbeing Extras. Provides a 60% benefit on the same range as Core Extras, with additional treatments including psychology and chiropractic.
Top Extras. nib's top-level extras plan provides a 75% benefit on a full range of services, including hearing aids, orthodontic, occupational therapy and podiatry.
Combined coverage
nib doesn't provide specific combined policies, instead letting you mix and match from among its individual hospital and extras options. Any of the stand-alone policies listed above can be bundled as a combined policy. In addition to any benefits provided by the policy you take out, nib offers the following to its members:
Reduced premiums. You could receive up to a 4% discount if you decide to pay your premiums via automatic direct debit.
nib Rewards. When you're a member at nib, you can get discounts on over 100 different retailers. These discounts extend to groceries, gym memberships, and more.
nib MediGap. With your hospital cover, you can avoid out-of-pocket costs entirely by ensuring you receive treatment from a participating nib MediGap health care provider.
100% optical and dental benefits. No matter what level of extras cover you choose, you'll get 100% of your costs back when you visit an nib eye care or dental care centre (up to your annual limits).
Ambulance coverage
Generally, all nib hospital and extras policies include cover for emergency ambulance services. nib may offer Ambulance Only cover, but its website says it requires a phone call to arrange. However this doesn't mean you're 100% covered for all ambulance expenses.
Emergency ambulance transport specifically refers to urgent life or death type situations, whether it's riding in an ambulance as a patient or having paramedics rush to you in order to perform life-saving treatment. This also includes related services, such as Flying Doctors.
Generally speaking, if an ambulance has its sirens on it's presumed to be an emergency situation. However, not every situation will ultimately be emergency, even if you thought it was when you made the call.
For example, if you call an ambulance to be on the safe side, or because you're unable to transport yourself, such as in the event of a broken leg, it may not qualify as an emergency. Here, you will not be covered by any nib health insurance policies.
Similarly, patient transfers between hospitals will not qualify as emergencies.
With an nib health insurance policy that covers emergency ambulances, you are not covered for:
Private ambulance services.
Claims that are not medically necessary.
Transport from hospital to your home.
Transport between hospitals, unless required as a result of the first hospital not specialising in the treatment required.
nib health insurance complaints
We looked at the 2020 Ombudsman health insurance complaints. Here's how nib stacked up:
nib received a smaller percentage of total complaints than its market share.
nib had proportionally more complaints than several other big health funds, including HBF, Bupa and Medibank.
This chart shows the weighted volume of complaints received by each health fund, according to the Commonwealth Ombudsman. The lower the number, the better. nib 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.
nib member retention
The chart below shows the 2020 member retention for each health fund (with a market share of at least 0.5%) according to the Commonwealth Ombudsman. A higher member retention percentage may indicate more satisfied customers, while a lower percentage may mean that customers were less satisfied with their service.
Of the big health funds, nib had the second lowest member retention (78%), just ahead of Medibank (75%).
nib frequently asked questions
No, nib is not a not-for-profit fund. It is a private fund with private shareholders.
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
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 5 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.
nib offers separate health insurance options for overseas students and working visitors.
Gary Hunter is a writer at Finder, specialising in insurance. He’s been writing about life, health, travel, home and pet insurance for over three years, has pored over hundreds of product disclosure statements and written more than 500 insurance articles. Gary holds a Tier 1 General Insurance (General Advice) certification and is passionate about helping Aussies understand their policies so that they can get better value for their money.
If you’d like to get a quote from nib health insurance, you may visit their website directly to get a quote.
Alternatively, we have listed the health insurers for visitors with visa 600. Please compare them as most of them have an ambulance and hospital covers.
Should you wish to have real-time answers to your questions, try our chatbox on the lower right corner of our page.
Can you please a comparison quote for our current cover with Bupa -Top Hospital Cover Family $250 excess and Premier Extra – Family. We are couple 71 + 68 and now don’t need Family cover.
You can enter your details through our health insurance search form to compare quotations from different brands.
You can also visit our list of private hospital cover to see a side by side comparison of cheap hospital cover.
When you are ready, you may then click on the “Go to site” button and you will be redirected to the insurer’s website where you can proceed with the application or get in touch with their representatives for further inquiries you may have.
Before applying, please ensure that you read through the relevant Product Disclosure Statements/Terms and Conditions when comparing your options before making a decision on whether it is right for you. You can also contact the provider if you have specific questions.
I have already had a partial mastectomy for invasive cancer and now need further surgery for a recurrence cancer. Does top Nib hospital and extras cover include cover for therapeutic mammography of my second breast so both breasts are the same size?
You have contacted finder.com.au, a comparison and information service. You would be well advised to get in touch with NIB health insurance directly to discuss if the therapeutic mammography is covered by their policy.
I have been in NIB for 16 years and have gold cover. I wish to have bariatric surgery and was told it is not covered. Can I move to top hospital cover only? If so would I be covered for this surgery then? How much per month for a couple?
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Hi, I would like to get a quote for visitor Visa 600, 6 months stay for 70 year old from South Africa, needing ambulance, hospital cover.
Hello Lesley,
Thank you for your comment.
If you’d like to get a quote from nib health insurance, you may visit their website directly to get a quote.
Alternatively, we have listed the health insurers for visitors with visa 600. Please compare them as most of them have an ambulance and hospital covers.
Should you wish to have real-time answers to your questions, try our chatbox on the lower right corner of our page.
Regards,
Jhezelyn
Hi, looking for a health insurance for my mother
on a retirement visa subclass 410.
Need full hospital cover ….age 86 female.
Thanks
rob
Hi Rob,
Thank you for your inquiry.
You may want to consider to check the available options here.
I hope this information has helped.
Cheers,
Harold
Can you please a comparison quote for our current cover with Bupa -Top Hospital Cover Family $250 excess and Premier Extra – Family. We are couple 71 + 68 and now don’t need Family cover.
Hi Manfred,
Thanks for your inquiry.
You can enter your details through our health insurance search form to compare quotations from different brands.
You can also visit our list of private hospital cover to see a side by side comparison of cheap hospital cover.
When you are ready, you may then click on the “Go to site” button and you will be redirected to the insurer’s website where you can proceed with the application or get in touch with their representatives for further inquiries you may have.
Before applying, please ensure that you read through the relevant Product Disclosure Statements/Terms and Conditions when comparing your options before making a decision on whether it is right for you. You can also contact the provider if you have specific questions.
Hope this information helps
Cheers,
Arnold
I have already had a partial mastectomy for invasive cancer and now need further surgery for a recurrence cancer. Does top Nib hospital and extras cover include cover for therapeutic mammography of my second breast so both breasts are the same size?
Hi Marg,
Thanks for your comment.
You have contacted finder.com.au, a comparison and information service. You would be well advised to get in touch with NIB health insurance directly to discuss if the therapeutic mammography is covered by their policy.
Regards,
Jhezelyn
I am travelling to Bangkok for Breast Augmentation Surgery, do you have a policy that would cover that?
I have been in NIB for 16 years and have gold cover. I wish to have bariatric surgery and was told it is not covered. Can I move to top hospital cover only? If so would I be covered for this surgery then? How much per month for a couple?
Hi Lyn!
Thanks for the comment.
You can contact NIB directly to confirm if changing covers will give you more benefits as well as for the premium computation.
Hope this helps.
Cheers,
Jonathan
Hi Adam,
Thank you for your question.
You have contacted finder.com.au, a comparison and information service and not actually a nib health fund.
nib health insurance does not provide cover while overseas. You may find our medical tourism insurance guide helpful.
All the best,
Zubair