Medibank Health Insurance Packages

Review Medibank Health Fund packages to find out if the cover’s right for you.

Medibank is one of the largest names in Australian health insurance, providing private health insurance and health solutions to 3.8 million Australians.

For both hospital and extras cover from Medibank, you can pick and choose your hospital and extras cover, or you can get them both in combined packages that cover different life stages and needs.

finder.com.au does not currently have access to this health insurance brand. You may wish to compare options available on the health insurance homepage.

What are the package options available from Medibank?

There are different “series” of packages available with different levels of cover available within each series.

  • The Everyday series. This is basic cover that offers an affordable combination of hospital and extras and has three options to choose from.
  • The Growing Families series. This is for people who are looking to have children or plan on having more children. It comes with three cover levels to suit different needs and includes a range of benefits for kids and pregnancy cover.
  • The Settled Families series. This package is for settled families that don’t plan on any more children. It keeps family benefits but does not include pregnancy-related cover. There are two cover levels to choose from with this series.
  • The Security series. This is a significantly higher level of cover than the Everyday series. It is for singles or childless couples who want a higher level of health insurance and comes with two different options.
  • Ultra Health Cover. This package provides top hospital and top extras, including a range of unlimited services and additional features. Only one level of Ultra cover is available.

While each package is geared towards certain needs, they are all available to anyone eligible. For example, a single person could take out a Settled Families package or a family might look at Everyday cover.

What does each package include?

Take a peek at how each of the package benefits stack up, with approximate pricing. Note that the pricing was correct as of June 2017, and may change over time. You can use the symbols below as a guide to what's covered or not:

  • This service is covered.
  • This service is restricted. This means you may only claim minimum shared room benefits, and will typically incur significant out-of-pocket expenses when trying to claim them on your plan, such as by attending a private hospital.
  • This service is excluded, and you cannot claim it against your health insurance.

The Everyday series

The Everyday series is for singles and couples without children or with no plans to start a family soon. This series includes three basic, but affordable options. One option is considerably more comprehensive, but is still relatively affordable.

Everyday StarterEveryday EssentialsEveryday Comprehensive
PriceFrom $19.87 per week (singles)From $39.74 per week (couples)From $22.01 per week (singles)From $44.02 per week (couples)From $33.42 per weekFrom $66.84 per week (couples)
Excess options$250 or $500$250 or $500$250 or $500
The hospital cover
Everyday StarterEveryday EssentialsEveryday Comprehensive
Cover for all non-excluded or restricted Medicare services
  • no
  • no
  • yes
Ambulance cover
  • yes
  • yes
  • yes
Accident cover
  • yes
  • yes
  • yes
Tonsils and adenoids removal
  • no
  • yes
  • yes
Surgical removal of wisdom teeth
  • no
  • yes
  • yes
Pregnancy related
  • no
  • no
  • no
Fertility treatments
  • no
  • no
  • no
Major eye surgery
  • no
  • no
  • no
Joint replacements
  • no
  • no
  • no
Renal dialysis
  • no
  • no
  • no
Psychiatric
  • restricted
  • restricted
  • restricted
Rehabilitation
  • restricted
  • restricted
  • restricted
Palliative care
  • restricted
  • restricted
  • restricted
The extras cover
Everyday StarterEveryday EssentialsEveryday Comprehensive
Typical percent back at Members’ Choice providers60%60%70%
Total maximum amount claimable per year$950$1,100$2,275
Emergency ambulance
  • yes
  • yes
  • yes
General dental
  • yes
  • yes
  • yes
Major dental
  • no
  • yes
  • yes
Optical100% back, up to $150 per year100% back, up to $200 per year100% back, up to $225 per year
Remedial massage
  • yes
  • yes
  • yes
Chiropractic and osteopathy
  • yes
  • yes
  • yes
Physiotherapy
  • yes
  • yes
  • yes
Natural therapies
  • yes
  • yes
  • yes
Dietetics
  • yes
  • yes
  • yes
Membership bonus
  • no
  • no
$50 per single and $100 per couple per year, up to $500 and $1,000 respectively

About the Everyday plans

All of the Everyday plans may be well suited for those who do not have any specific health needs and are mainly looking for hospital cover in the event of an accident. All Everyday cover levels include an “accident override”, which essentially means that you’re covered as though you had top hospital cover for conditions that result from an accident.

Similarly, all the Everyday plans include useful extras cover, including general dental and optical. Getting the most of your extras cover may be largely dependent on being able to access Members’ Choice providers, so it can be a good idea to check provider availability in your area and consider how much you will be able to claim.

  • Everyday Starter is affordable and very basic hospital and extras cover.
  • Everyday Essentials lets you go to private hospital for tonsil, adenoid and wisdom teeth removal and also adds major dental cover (except for dentures) to your cover.
  • Everyday Comprehensive delivers a substantially higher level of hospital cover and significantly increases your claimable extras limits.

The Growing Families series

These packages are for couples who are planning on having children or for families that might be expecting new members.

Growing Family CoreGrowing Family Essentials PlusGrowing Family Complete
PriceFrom $45.08 per week (single parents)From $55.80 per week (family)From $60.62 per week (single parents)From $66.39 per week (family)From $69.95 per week (single parents)From $80.91 per week (family)
Excess options$250 or $500$250 or $500$0, $250 or $500
No hospital excess for kids
  • yes
  • yes
  • yes
The hospital cover
Growing Family CoreGrowing Family Essentials PlusGrowing Family Complete
Cover for non-excluded or restricted Medicare services
  • yes
  • yes
  • yes
Emergency ambulance cover
  • yes
  • yes
  • yes
Accident cover
  • yes
  • yes
  • yes
Obstetrics and pregnancy
  • no
  • restricted
  • yes
Fertility treatment
  • no
  • no
  • yes
Minor gynaecological surgery
  • yes
  • yes
  • yes
Major gynaecological surgery
  • no
  • yes
  • yes
Spinal fusion
  • no
  • yes
  • yes
Heart-related medical and surgical admissions
  • no
  • yes
  • yes
Plastic and reconstructive surgery
  • no
  • yes
  • yes
Major eye surgery
  • no
  • restricted
  • yes
Hip and knee joint replacement surgery
  • no
  • restricted
  • yes
Other joint replacements
  • no
  • yes
  • yes
Renal dialysis
  • no
  • no
  • yes
Nerve treatment
  • no
  • yes
  • yes
Vascular surgery
  • no
  • yes
  • yes
Weight loss surgery
  • no
  • no
  • yes
Psychiatric
  • restricted
  • restricted
  • yes
Rehabilitation
  • restricted
  • yes
  • yes
Palliative care
  • yes
  • yes
  • yes
The extras cover
Growing Family CoreGrowing Family Essentials PlusGrowing Family Complete
Typical percent back at Members’ Choice providersChoice of 60% or 70%Choice of 60% or 70%Choice of 60% or 70%
Total maximum amount claimable per year$2,150$2,150$2,150
Antenatal classes and pregnancy compression garments
  • yes
  • yes
  • yes
100% back on kids extras, up to annual limits
  • yes
  • yes
  • yes
100% back on annual dental check-up and clean at Members’ Choice dentists
  • yes
  • yes
  • yes
Emergency ambulance
  • yes
  • yes
  • yes
General dental
  • yes
  • yes
  • yes
Major dental
  • yes
  • yes
  • yes
Orthodontics
  • yes
  • yes
  • yes
Optical
  • yes
  • yes
  • yes
Remedial massage
  • yes
  • yes
  • yes
Physiotherapy
  • yes
  • yes
  • yes
Chiropractic and Osteopathy
  • yes
  • yes
  • yes
Podiatry
  • yes
  • yes
  • yes
Natural therapies
  • yes
  • yes
  • yes
Dietetics
  • yes
  • yes
  • yes
Speech therapy
  • yes
  • yes
  • yes
Psychology
  • yes
  • yes
  • yes
Non-PBS pharmaceuticals
  • yes
  • yes
  • yes
Breathing appliances
  • yes
  • yes
  • yes
Blood glucose and blood pressure monitors
  • yes
  • yes
  • yes
Health appliances and external prostheses
  • yes
  • yes
  • yes
Australian Breastfeeding Association membership
  • yes
  • yes
  • yes
TENS machine
  • yes
  • yes
  • yes

About the Growing Family plans

The extras cover found with each of the Growing Family packages is almost identical, including features such as cover for antenatal classes, 100% on kids’ extras at Members’ Choice providers and identical orthodontics cover, starting at $100 per year and increasing by $100 per year up to a lifetime limit of $1,200.

It also includes useful benefits for the whole family, including 100% back on one yearly check-up and clean (excluding x-rays) per member at a Members’ Choice dentist. This service doesn’t count towards your annual limits. All of these plans may be able to deliver a range of useful benefits for those who are looking to start a family.

When picking a plan in the Growing Family series, you may want to make a choice based on the level of hospital cover available. All include full private hospital cover for medical attention following an accident, but include very different pregnancy cover and related cover.

If you’re looking for a health insurance package to cover pregnancy, it may be specifically worth considering how the hospital cover differs for the following services.

Growing Family CoreGrowing Family Essentials PlusGrowing Family Complete
Obstetrics (pregnancy related, including hospital accommodation for pregnancy)
  • no
  • yes
  • yes
Fertility treatment (eg, IVF)
  • no
  • no
  • yes
Minor gynaecological surgery (eg, endometriosis)
  • yes
  • yes
  • yes
Major gynaecological surgery (eg, hysterectomy, ovarian surgery)
  • no
  • yes
  • yes

The Settled Families series

The Settled Family series offers health cover with kids and family benefits but without pregnancy or related cover to help keep costs down.

The hospital and extras cover may be a good fit for active kids as well as parents who might be getting a bit older.

Settled Families EssentialsSettled Families Comprehensive
PriceFrom $54.70 per week (single parents)From $62.12 per week (family)From $72.64 per week (single parents)From $82.52 per week (family)
Excess options$250 or $500$250 or $500
No hospital excess for kids
  • yes
  • yes
The hospital cover
Settled Families EssentialsSettled Families Comprehensive
Cover for all Medicare services not excluded or restricted
  • yes
  • yes
Emergency ambulance cover
  • yes
  • yes
Accident cover
  • yes
  • yes
Obstetrics and pregnancy related
  • no
  • no
Fertility treatment
  • no
  • no
Major eye surgery
  • no
  • no
Hip and knee joint replacement surgery
  • no
  • no
Other joint replacement surgery
  • no
  • no
Renal dialysis
  • no
  • no
Psychiatric
  • restricted
  • restricted
Palliative care
  • restricted
  • yes
Rehabilitation
  • restricted
  • yes
The extras cover
Settled Families EssentialsSettled Families Comprehensive
Typical percent back at Members’ Choice providers55%70%
Total maximum amount claimable per year$2,200$3,550
Membership bonus$100 per year, up to $1,000$100 per year, up to $1,000
Emergency ambulance
  • yes
  • yes
General dental
  • yes
  • yes
Major dental
  • yes
  • yes
Orthodontics
  • yes
  • yes
Optical
  • yes
  • yes
Remedial massage
  • yes
  • yes
Physiotherapy
  • yes
  • yes
Chiropractic and osteopathy
  • yes
  • yes
Podiatry
  • yes
  • yes
Natural therapies
  • yes
  • yes
Dietetics
  • yes
  • yes
Speech therapy
  • yes
  • yes
Psychology
  • yes
  • yes
Health subscriptions
  • yes
  • yes
Health screening tests
  • yes
  • yes
Health appliances and external prostheses
  • yes
  • yes
Breathing appliances
  • yes
  • yes
Blood glucose and blood pressure monitors
  • yes
  • yes

About the Settled Families plans

The hospital cover offered by each of the plans is relatively similar as is the breadth of extras services covered.

The primary difference in the hospital cover is that the comprehensive plan also offers private hospital cover for palliative care and rehabilitation services, which might be an important feature if you’re looking for additional “worst case scenario” cover, such as the event of someone on the plan needing to deal with life-limiting illness or disability.

The range of extras services covered under these plans is very similar, but you are able to claim substantially more with the comprehensive plan, with higher limits as well as a higher reimbursement amount. After five years of continuous cover, the difference between the two plans is even more considerable, especially for orthodontics cover.

As such, getting value for money from the Comprehensive Settled Families plan, compared to the Essential Settled Families plan, may be dependent on knowing you are able to make full use of your extras, such as if you have a child with health or dental issues.

The Security series

The Medibank Security packages offer all-around cover for those who may want a higher level of hospital and extras cover than what the Everyday series offers.

Security EssentialsSecurity Comprehensive
PriceFrom $45.89 per week (singles)From $91.80 per week (couples)From $51.72 per week (singles)From $103.45 per week (couples)
Excess options$0, $250 or $500$0, $250 or $500
The hospital cover
Security EssentialsSecurity Comprehensive
Cover for all Medicare services not excluded or restricted
  • yes
  • yes
Emergency ambulance cover
  • yes
  • yes
Accident cover
  • yes
  • yes
Obstetrics and pregnancy related
  • no
  • no
Fertility treatments
  • no
  • no
Major eye surgery
  • no
  • yes
Renal dialysis
  • no
  • yes
Psychiatric
  • restricted
  • restricted
Palliative care
  • restricted
  • yes
The extras cover
Settled Families EssentialsSettled Families Comprehensive
Typical percent back at Members’ Choice providers70%70%
Total maximum amount claimable per year$2,850$3,450
Membership bonus$50 and $100 per year for singles and couples, up to $500 and $1,000$50 and $100 per year for singles and couples, up to $500 and $1,000
Emergency ambulance
  • yes
  • yes
General dentalUnlimitedUnlimited
Major dental
  • yes
  • yes
Optical
  • yes
  • yes
Remedial massage
  • yes
  • yes
Physiotherapy
  • yes
  • yes
Chiropractic and osteopathy
  • yes
  • yes
Podiatry
  • yes
  • yes
Natural therapies
  • yes
  • yes
Dietetics
  • yes
  • yes
Speech therapy
  • yes
  • yes
Psychology
  • yes
  • yes
Health subscriptions
  • yes
  • yes
Health appliances and external prostheses
  • yes
  • yes
Breathing appliances
  • yes
  • yes
Blood glucose and blood pressure monitors
  • yes
  • yes
Hearing aids
  • yes
  • yes

About the Security plans

In general, both of the Security plans deliver a relatively high level of hospital cover. With the extras cover, you are able to get 100% back on annual dental check-ups and cleans at Member’s Choice dentists and 100% back on optical services from all registered providers, regardless of whether they are a Members’ Choice provider. However, there are other useful extras benefits which are not available under these plans that you might find elsewhere in equivalently priced extras policies.

By excluding services that an older person or couple might not need, such as dropping pregnancy and fertility from its hospital cover and orthodontics from its extras, these plans present a relatively affordable option for people who are looking for fairly comprehensive hospital and extras cover.

However, the Essentials plan excludes a few procedures that may be of particular use in later life, specifically dialysis, major eye surgery (such as glaucoma treatments) and palliative care. As such, it might be well suited to someone who is young and in relatively good health but still wants a high level of cover just in case.

While the extras cover for both plans covers a similar range of services, there are some limitations to be aware of.

  • No cover for health screening services or pharmaceuticals. These can be found with other cover types, but are absent from the Security plans. People who are interested in this level of cover might be especially interested in preventative health screening and pharmaceutical cover, so they might want to compare other plans.
  • Combined health appliance limits. The actual amount claimable on all health appliances covered under these plans is distinctly limited. Hearing aids, insulin pumps, blood pressure and blood glucose monitors, foot orthoses, splints and external prostheses all share a combined limit. Under the Essentials plan, this is limited to $400 per year, while the Comprehensive plan limits it to $800 per year. Unusually, this limit is also shared by psychology and speech therapy. If you are looking for a plan to cover any of these appliances or services, it’s worth being aware of these limits and assessing whether you will be able to get value for money.
  • Benefit replacement periods. The above limits may greatly affect the suitability of these plans for someone who believes they will be claiming multiple health appliances. Benefit replacement periods also apply, which affect how frequently you may claim appliances. For most appliances, these limits are once every 12 months to once every 3 years. However, for hearing aids, you are restricted to only claiming benefits once every 5 years. This type of limitation is common for health funds, but a more typical benefit replacement period for hearing aids is 3 years. If you are looking for a plan to claim hearing aids, then these packages may not be the most suitable choice, especially if you also plan on claiming speech therapy, psychology or other health aids or appliances.

Ultra Health Cover

This is a highly comprehensive hospital and extras in one package, with additional features to help reduce out-of-pocket expenses and enjoy more comfortable admissions.

Ultra Health Cover
PriceFrom $76.79 per week (singles)From $153.56 per week (couples)
Excess options$0

The hospital cover

Ultra Health Cover
Cover for all Medicare services
  • yes
Are there any excluded or restricted procedures?No restricted or excluded procedures
UltraBonus
  • yes
Private room priority
  • yes

The extras cover

Ultra Health Cover
Typical percent back at Members’ Choice providers100%
Emergency ambulance
  • yes
General dentalUnlimited
Major dental$1,600
Orthodontics$1,500, plus $500 per year up to $3,500 lifetime limit
Teeth whitening$400 every 3 years
Optical$300
Remedial massage$500 (combined limit with natural therapies)
Physiotherapy$1,000
Chiropractic and osteopathy$750
Podiatry$600
Natural therapies$500 (combined limit with remedial massage)
Dietetics$600
Breathing appliances, blood glucose and blood pressure monitors$300
Speech therapy$600
Psychology$600
Health appliances and external prostheses$600
Health subscriptions$100
Health screening tests$200
Hearing aids$1,600
Non-PBS prescription pharmaceuticals$800
Occupational therapy$600
Eye therapy$600
Hospital emergency department fees$250
Home nursing$500
Laser eye surgery$3,500 lifetime limit

About Ultra Health Cover

This plan may be one of the most comprehensive health insurance packages available in Australia. The services covered by both the hospital and extras are generally equivalent to some of the most comprehensive plans available from other providers but also include a range of additional benefits that are not necessarily available elsewhere.

While the UltraBonus and Private Room Priority features of the hospital cover may not be very beneficial for someone who finds Ultra cover affordable, there are a range of extras services available that can be difficult to find elsewhere, such as teeth whitening, laser eye surgery and emergency department fees.

There are some limitations to be aware of as well, however. As with all the other Medibank packages, getting value for money out of these plans is largely dependent on being able to access Members’ Choice providers. If you are not able to use these providers, you may want to consider another health fund.

Also, while Ultra Health Cover includes relatively high limits, it will not cover actual services provided in many cases and will instead only cover consultations. This limitation applies to the following services:

  • Chiropractic and osteopathy
  • Dietetics
  • Psychology
  • Occupational therapy
  • Eye therapy
  • Speech therapy

What is the advantage of getting a package?

Many of the packages contain specific benefits that would not be available by simply combining hospital and extras cover, such as additional cover for kids in the family plans. These are also a potentially more cost-effective option than one might find by combining equivalent cover.

What are the disadvantages and limitations?

Many of the extras benefits, and the overall value for money, offered by all Medibank packages are dependent on being able to access Members’ Choice providers. In many cases, you will be able to claim more back on services when visiting a Members’ Choice provider, while in many other cases you cannot claim at all for services gotten elsewhere, even if it’s for something that your plan covers.

As such, it is a good idea to check for the availability of these providers before you sign up. If there are no Members’ Choice providers in your area, or if your preferred dentist, optometrist or other service providers is not a Members’ Choice provider, you may want to reconsider signing up for these packages and compare other health funds.

The other key disadvantage of these packages, and packages from other health funds, is that you are generally not able to customise your own level of hospital and extras cover. If you want a top hospital plan but only basic extras, for example, you may want to look at building your own cover and even consider taking out two policies from two different health funds.

You should look at each plan in detail before signing up, and may want to compare the costs and benefits of packages with the prices you can get by picking out your own preferred hospital and extras cover.

How can I make a claim?

When attending agreement private hospitals within the Medibank Private network, the hospital will typically send bills directly to Medibank and Medicare. Where there are out-of-pocket expenses, such as a gap or an excess, you may need to pay it directly to the relevant practitioner or hospital.

Should the hospital not send an eligible bill directly to Medicare or Medibank, you can send in a claims form within two years of receiving the service to get reimbursed.

You can typically claim extras services by swiping your membership card through the Medibank app or by sending in a claims form.

How can I pay for my premium?

Your payment options include financial institution or credit card direct debits as well as a range of direct payment options. If you’d like to pay directly, you can select this option while signing up to receive an account which explains these in more detail.


Andrew Munro

Andrew writes for finder.com, comparing products, writing guides and looking for new ways to help people make smart decisions. He's a fan of insurance, business news and cryptocurrency.

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