Is Medibank overseas visitor cover value for money?
There’s a range of health insurance providers in Australia and many of the larger ones offer overseas visitor health cover for students, those on an extended holiday or a working visa.
Medibank is one of Australia’s most prominent providers with a range of cover options available. To ensure your cover meets applicable visa requirements it’s important to find the right type.
Medibank options are:
- Overseas Student Health Cover (OSHC). Student cover for visa subclass 500 and more.
- Overseas Visitor Health Cover (OVHC). Visitors’ cover for visa subclass 600, 601, 651 and more
- Working Visa Health Cover. Cover for working in Australia, for visa subclass 457, 485, 400, 403, 407, 408, 417, 462, 489 and more.
Medibank overseas student health cover
There are two levels of cover available:
- Essentials OSHC. Meets student visa requirements plus delivers an important level of cover and a range of additional benefits.
- Comprehensive OSHC. A specialised level of cover only available through certain schools and universities. Contact your educational institution to learn more.
|Medicare OSHC (Essentials and Comprehensive)|
|Comprehensive hospital cover|
|Private and public hospital accommodation|
|Prescription medicine outside of hospital|
Overseas Visitor Health Cover (OVHC)
|Mid-level hospital cover|
|Private and public hospital accommodation|
|Prescription medicine outside of hospital|
Working Visa Health Cover
There are four levels of cover to choose from:
- Basic cover. Cover for a range of hospital services and out of hospital doctor visits
- Hospital Insurance. Hospital only cover for essential procedures, without cover for out of hospital visits.
- Hospital and medical insurance. Comprehensive hospital health insurance, plus cover for out of hospital visits.
- Top 85. A high level of cover for in-hospital and out of hospital services, plus a wide range of ancillary health cover and additional benefits.
|Basic Cover||Hospital Insurance||Hospital and Medical Insurance||Top 85|
|Visa suitability||Meets working visa requirements||Meets working visa requirements||Meets working visa requirements||Meets working visa requirements|
|Hospital cover||Mid level - covers all non-excluded treatments||Comprehensive - no excluded hospital treatments||Comprehensive - no excluded treatments||Comprehensive - covers all non-excluded treatments|
|Excluded treatments||Fertility treatmentsBone marrow and organ transplants||No cover for any out of hospital services||None||None|
|Private and public hospital accommodation||Overnight and same day admissionsPrivate hospital intensive care and operating theatre feesPublic hospital emergency department fees||Overnight and same day admissionsPrivate hospital intensive care and operating theatre feesPublic hospital emergency department fees||Overnight and same day admissionsPrivate hospital intensive care and operating theatre feesPublic hospital emergency department fees|
|Doctor fees||Fees for in-hospital services 100% of MBS amount for out of hospital services||Fees for in-hospital services||Fees for in-hospital services 100% of MBS amount for out of hospital services||Fees for in-hospital services 100% of MBS amount for out of hospital services|
|Prescription medicine outside of hospital||When prescribed as part of a hospital admission||When prescribed as part of a hospital admission||When prescribed outside of a hospital, or as part of a hospital admission||When prescribed outside of a hospital, or as part of a hospital admission, plus non-PBS extras cover|
|Support services||Health support servicesRepatriation||Health support servicesRepatriation||Health support servicesRepatriation||Health support servicesRepatriationExtras cover|
How it works
- Medicare procedures. These are specified medically-necessary procedures. With this cover you can access all Medicare procedures in a private hospital, except fertility treatments.
- Excluded treatments. Generally, your health insurance will only ever pay for Medicare procedures. When a treatment is excluded, it specifically refers to a Medicare procedure that’s not covered. Non-medically-necessary treatments, such as cosmetic surgery, aren’t covered either despite not being specified as an exclusion.
- Gap Expenses. This is the difference between the amount charged by a hospital or medical practitioner and could vary depending on the hospital, doctor and treatment. Before undergoing medical treatments you can check the cost of a procedure and if you’ll have any gap expenses.
- MBS amount. The cost of a treatment as specified by the Medicare Benefits Schedule (MBS). Some doctors might charge more than the MBS amount for their services, but where specified you’ll still only be able to claim the MBS amount and will have to pay any difference yourself.
- PBS amount. This is the Pharmaceutical Benefits Scheme amount. You’ll need to pay a set amount yourself and can then claim up to the specified amount on your health cover for the remainder.
Waiting periods and limitations
Regardless of which cover type you choose, some exclusions and waiting periods will apply.
You can’t claim for certain services within a waiting period. These may vary depending on the policy and cover level you select, but generally you can expect:
- 12 months. Pregnancy, fertility and obstetrics-related services and pre-existing medical conditions.
- 2 months. All other hospital services including rehabilitation, psychiatric and palliative care even when it’s a pre-existing conditions.
- None. Accident cover for treatments needed as a result of accidental injuries.
The extras services found in Top 85 Working Visa Cover also carry their own exclusions.
Depending on your level of cover a hospital excess may apply. This is an amount paid per hospital admission up to a set maximum per year (typically one or two admissions).
Depending on your cover, you might:
- Have no excess at all
- Have a set excess
- Be able to choose your own excess
Where you’re able to choose your own excess, you can select a higher amount for lower premiums or a lower amount for higher premiums.
Private and public hospital limitations
The hospital accommodation cover refers to room fees and special fees that a hospital may charge, separate to the actual cost of a treatment.
- A room. The cost of a room, whether private or shared.
- Special ward or theatre fees. Additional costs for using certain facilities. For example, labour ward fees will typically be incurred as part of pregnancy “treatment” while certain surgeries will incur operating theatre fees.
Your accommodation cover might vary depending on:
- Whether you attend a public or a private hospital.
- Which private hospital you attend.
- Whether you’ve been formally admitted to a hospital or are receiving treatment in the emergency department prior to admission.
- Whether you’re admitted to hospital for a same-day procedure or an overnight stay.
How you’re covered for accommodation costs depends on your level of cover, as well as the situation. Where possible, contact Medibank prior to hospital admission to find out how you’ll be covered.
Hospital and non-hospital admissions
You’re covered in a different way for hospital services and non-hospital services.
- Hospital services. Treatments received after an official hospital admission for the purposes of treating a clear condition.
- Non-hospital services. All services that aren’t received as part of a formal hospital stay.
For example, you might go to hospital only to get an x-ray. This won’t be a hospital service even though it’s within a hospital. However, if you’re admitted to hospital following a car accident and get x-rays, this is a hospital service.
How to use your health insurance
- When you go to hospital. Typically, a hospital will arrange payment directly with Medibank and you’ll pay the excess or gap expenses where applicable.
- Claiming out of hospital doctors services. You can arrange this with your doctor in consultation with Medibank, or pay up front and claim the cost from Medibank yourself online or by sending in a form.
- Claiming support services. You can generally make use of additional support services, like health care guidance, by phoning Medicare directly.
- Claiming extras (Working Visa Top 85 cover only): Your Medibank card can be swiped at participating providers to claim the cost of extras on the spot and you can simply pay the difference yourself.
How to pay premiums
Premiums will need to be paid in advance for the upcoming period. You can generally choose whether to pay for 12 months or 1 month in advance.
Premiums are payable by:
- Direct debit from a bank account or credit card.
- Direct payment. Medibank will send you a form with the specific options available.
Compare your health insurance options today