nib Health Insurance

Do a side-by-side of nib's policy range and get covered

nib Health Insurance options

nib offers Hospital and Extras cover for singles, couples and families, with four levels of Hospital cover including Basic, Standard, Advantage and Top. nib also offers two levels of Extras cover: Top Extras and Core Extras (which can be tailored to help meet your needs).

Hospital cover

Basic Hospital

• Basic Hospital includes treatment for accidental injury, ambulance, appendix, tonsils and adenoid removal, colonoscopies, dental surgery, gastroscopies, treatment for ear infections, gynaecological services, hernia repair and joint investigations and reconstructions.
• Excludes back surgery, brain surgery, obesity surgery, heart procedures, stroke treatment, cancer treatment, eye treatments, joint replacements, renal dialysis, IVF, infertility investigations, pregnancy and birth services and cosmetic surgery.

Standard Hospital

• Standard Hospital includes everything offered in Basic Hospital cover plus brain surgery, cancer treatment, heart procedures and stroke treatment.
• Excludes back surgery, obesity surgery, eye treatments, joint replacements, renal dialysis, IVF, infertility investigations, pregnancy and birth services and cosmetic surgery.

Advantage Hospital

• Advantage Hospital includes everything covered in Standard Hospital cover plus back surgery, eye treatments, joint replacements and renal dialysis.
• Excludes obesity surgery, IVF, infertility investigations, pregnancy and birth services and cosmetic surgery.

Top Hospital

• Top Hospital includes everything covered in Advantage Hospital plus IVF, infertility investigations, obesity surgery, pregnancy and birth services.
• Excludes cosmetic surgery.

Extras cover

nib also offers two levels of Extras cover; Core Extras and Top Extras. Core Extras is basic extras cover (dental, optical, physio and ambulance) which you can add bundles to in order to create a package more tailored to your needs. You can add up to two extra bundles to your Core Extras from three different categories including Family, Wellbeing and Young at Heart.

• Family Extras – this bundle adds extras that would be useful to a typical family and includes orthodontia, speech pathology, podiatry, orthotics, occupational therapy, antenatal and postnatal services, family health aids and preventative tests.
• Wellbeing Extras – this bundle adds extras suitable for those seeking to maintain a healthy lifestyle. They include chiro, osteo, natural therapies, dietary advice, psychology, wellbeing health aids, preventative tests and a healthier lifestyle benefit.
• Young at Heart Extras – this bundle contains extras most useful for those wanting to maintain their health in later life. They include podiatry, orthotics, dietary advice, pharmaceutical prescriptions, hearing aids, preventative tests and young at heart health aids.

For those wanting premium extras, nib’s Top Extras provides the ultimate cover. It includes an extensive range of extras with higher annual limits including ambulance, dental, optical, physio, antenatal and postnatal services, chiro, osteo, dietary advice, exercise physiology, eye therapy, top health aids, a healthier lifestyle benefit, hearing aids and speech processors, home nursing, natural therapies, occupational therapy, orthodontia, pharmaceutical prescriptions, podiatry, orthotics, preventative tests, psychology and speech pathology.

How many members does nib service?

nib provides health and medical insurance cover to more than one million Australians. This gives it a market share of 8.1%.

Does nib get many complaints?

nib accounts for:

• 8.1% of the health insurance market
• 10.6% of all complaints about benefit payments
• 5.2% of all complaints about service
• 6.1% of all complaints that require investigation

^{_{Source: Private Health Insurance Ombudsman, State of the Health Fund Report 2016}}

How many hospital agreements does nib have in my state and in total?

The benefit your health fund pays for hospital service isn’t just determined by the level of cover you have in place; it’s also affected by whether or not your health fund has an agreement with the hospital where you are treated.

The number of hospital agreements nib has in each Australian state and territory is shown in the table below. The industry maximum figure for all health funds across Australia is also included for your reference.

Is there an option for overseas visitors?

nib offers a health insurance option for overseas students and working visitors through a wholly owned subsidiary company called IMAN Australian Health Plans. IMAN offers a range of different covers for working visitors, these include: Budget, Value, Basic, Mid and Top Visitor Cover. There are a number of different benefits that its cover offers:

• It meets the Department of Immigration and Citizenship (DIAC) working visa requirements
• You won’t pay any hospital Excess
• It covers ambulance and medical repatriation cover
• They will provide you with a confirmation of health cover letter
• It covers 100% of the cost of private and public hospitals.

Are there any additional benefits?

nib offers a 30-day guarantee to all of its new customers. This means that if you aren’t happy with your cover it will refund your premiums as long as you contact it within the first 30 days of signing up and you haven’t already made a claim. Not to mention nib is a well-known health fund with a good reputation, which will give you confidence knowing that your health is in good hands.

How much does cover cost?

The cost of nib’s Health Insurance depends on a number of factors such as:

• The cover option you select. The amount of money you pay depends on what cover option you select. If you select singles health insurance then you will pay less because you are paying to cover one person. Couples is almost doubled because you are paying for two people and family health insurance is the most expensive because you are paying for your whole family.
• What level of cover you select. The level of cover you select will impact the amount you pay. The higher level of cover the more you pay and the more you are covered for.
• What Extras you select. The additional extras you select will also add to the cost of insurance. The cost will go up depending on how many you choose.
• Hospital Excess. nib has two different levels of hospital excess, $250 or $500. The amount of excess you pay will reduce the amount that you pay for your insurance per week.

Paying your nib health insurance premiums

There are several payment methods available:

• Direct debit. This option is available from your bank account or credit card, and you may be entitled to a discount if you select to pay from your bank account.
• Payroll deduction. This option is available for customers on an nib Corporate Health Plan.
• Online. Online credit card payment can be made via nib Online Services.
• Over the phone. You can use the Phone Pay service and make a credit card payment by calling 13 14 63.
• At an nib Retail Centre. Credit card, EFTPOS and cheque payments are accepted.
• By mail. Cheques are accepted if they’re made payable to ‘nib Health Funds’.
• Auspost and BPAY. These payment options are also accepted.

If you have ambulance-only cover, you have the option of paying your premiums half-yearly or yearly. For all other policies, the following payment schedules are available:

• Direct debit: fortnightly, monthly, quarterly, half yearly and yearly.
• Payroll deduction: weekly, fortnightly, monthly, quarterly, half yearly and yearly.
• At an nib Retail Centre, by Phone Pay, by mail or at an Australia Post Office: monthly, quarterly, half yearly and yearly.

How to save on your policy

• Choosing the right cover for you. Tailor your policy to your specific health requirements, then you are less likely to be paying for cover that you don’t need.
• Medicare Levy Surcharge. Rather than paying the Medicare Levy, people earning over the threshold can spend it on their private health care.
• Having Health Insurance saves you money. While paying a weekly fee may seem costly at the time, if you actually do get sick, health insurance will help reduce the cost of hospital fees and may save you money in the long run.

What excesses apply to cover?

An excess charge is the amount that you pay for a stay in hospital. With nib there are two levels of excess you can choose, $250 or $500 per person. The number of times that you pay excess per calendar year is determined by your policy. The less excess you pay the more your premium will be. Most hospitals expect that you pay your excess before admission into the hospital. Something to be aware of is that nib doesn’t cover hospital excess and neither does Medicare

Making 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 five 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.

Get the nib claims app

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What exclusions apply to nib cover?

With any policy there will be exclusions involved but it is always good to make sure that your health insurance doesn’t exclude something you need. Some of the exclusions from nib’s health cover are:

• Any service listed as Excluded on a Customer’s Policy
• Any Hospital Excess
• Pharmaceuticals available under the PBS
• Services rendered in a nursing home
• Respite care
• Special nursing

Frequently asked questions about nib

• Is nib nonprofit?

  No.

• Does nib offer ambulance cover?

  Yes. All nib extras, hospital and combined policies provide emergency ambulance cover.

• Can I get dental cover with nib?

  Yes. All nib extras policies provide some level of dental cover.

• Can I get optical cover with nib?

  Yes. Optical cover is a standard inclusion in both of nib’s base-level extras policies, Core Extras and Core Extras Plus.

• Can I get physio cover with nib?

  Yes. Physio cover is a standard inclusion in both of nib’s base-level extras policies, Core Extras and Core Extras Plus.

• Can I get chiro cover with nib?

  Yes. Chiropractic cover is included in the Wellbeing Extras and Top Extras policies.

• Can I get pharmacy cover with nib?

  Yes. Young at Heart Extras and Top Extras policies from nib include cover for pharmaceutical prescriptions.

• Can I get natural therapies cover with nib?

  Yes. Natural therapies cover is included in the Wellbeing Extras and Top Extras policies.

• Can I get acupuncture cover with nib?

  Yes. Acupuncture cover is included in the Wellbeing Extras and Top Extras policies.

• Can I get psych/group therapy cover with nib?

  Yes. Psychology cover is included in the Wellbeing Extras and Top Extras policies.

• Can I get preventative cover with nib?

  Yes. A Healthier Lifestyle Benefit is included in the Wellbeing Extras and Top Extras policies. It covers expenses such as weight management, quit smoking, first aid and health management programs.

• Can I get hearing aid cover with nib?

  Yes. Hearing aids are covered by Young at Heart Extras and Top Extras.

• Can I get nib health insurance as an international student?

  Yes. nib offers overseas student health cover (OSHC) to suit singles, couples and families.

• Can I get overseas visitor health cover (OVHC) with nib?

  Yes. nib offers five levels of cover for working visa holders: Budget, Value Plus, Basic, Mid and Top.