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nib hospital cover only plans

See what nib offers with its standalone hospital health insurance

Hospital cover is an important core component of health insurance plans, and nib is one of the fastest growing fund. It now covers more than a million Australian and New Zealand residents.

Its mission is to provide affordable healthcare with uncompromising quality and service for all Australians.

Compare hospital cover from nib

The hospital cover options

The four standalone hospital plans are Basic, Standard, Advantage and Top cover. Each plan covers a wider range of services than the one before.

BasicStandardAdvantageTop
Excess$250 or $500$500$250 or $500$250 or $500
Hospital accommodation
  • yes
  • yes
  • yes
  • yes
Day surgery, overnight and special care unit accommodation
  • yes
  • yes
  • yes
  • yes
Operating theatre
  • yes
  • yes
  • yes
  • yes
Accidental injury
  • yes
  • yes
  • yes
  • yes
Emergency ambulance
  • yes
  • yes
  • yes
  • yes
Appendix
  • yes
  • yes
  • yes
  • yes
Colonoscopy
  • yes
  • yes
  • yes
  • yes
Dental surgery
  • yes
  • yes
  • yes
  • yes
Gastroscopy
  • yes
  • yes
  • yes
  • yes
Grommets in ears
  • yes
  • yes
  • yes
  • yes
Gynaecology
  • yes
  • yes
  • yes
  • yes
Hernia repair
  • yes
  • yes
  • yes
  • yes
Joint investigations
  • yes
  • yes
  • yes
  • yes
Joint reconstructions
  • yes
  • yes
  • yes
  • yes
Tonsil and adenoid removal
  • yes
  • yes
  • yes
  • yes
Brain surgery
  • no
  • yes
  • yes
  • yes
Cancer treatments
  • no
  • yes
  • yes
  • yes
Heart procedures
  • no
  • yes
  • yes
  • yes
Palliative careMinimum only
  • yes
  • yes
  • yes
RehabilitationMinimum only
  • yes
  • yes
  • yes
Stroke treatment
  • no
  • yes
  • yes
  • yes
Back surgery
  • no
  • no
  • yes
  • yes
Eye treatments
  • no
  • no
  • yes
  • yes
Joint replacements
  • no
  • no
  • yes
  • yes
Renal dialysis
  • no
  • no
  • yes
  • yes
Assisted reproductive services
  • no
  • no
  • no
  • yes
Infertility investigations
  • no
  • no
  • no
  • yes
Obesity and weight loss surgery
  • no
  • no
  • no
  • yes
Pregnancy and birth services
  • no
  • no
  • no
  • yes
Psychiatric treatmentMinimum onlyMinimum onlyMinimum only12-month benefit limitation period

What are the benefits of joining nib for hospital cover?

nib hospital cover delivers clear, straightforward and affordable health cover to help minimise or eliminate your out-of-pocket expenses. No matter which hospital cover level you choose, you’ll get the following:

  • Cover for ward fees, day surgery, special care unit accommodation, nursing expenses and operating theatre fees. These important cover features are not always available with basic hospital plans.
  • Access to the nib MediGap scheme. By using participating practitioners, you’re much less likely to incur out-of-pocket expenses.
  • Unlimited emergency ambulance cover.
  • No excess for kids. No excess is payable for hospital admissions of dependent children up to the age of 21.
  • A 4% discount on premiums for setting up a direct debit payment plan.

Each cover option also offers wide-ranging benefits that may be more cost-effective than what’s available with other providers. For example, you can start getting the full private hospital benefits of your cover for rehabilitation and palliative care with Standard cover.

nib Top hospital cover also includes cover for psychiatric treatments at private facilities after a 12-month benefit limitation period. With many plans, this will not be available even at the most comprehensive level.

Limitations and waiting periods to be aware of

Some expenses will not be covered or may not be completely covered. You will typically incur out-of-pocket expenses for the following:

  • The hospital excess, which applies once per person, per calendar year
  • Private hospital emergency or outpatient fees
  • Private room accommodation for a same-day procedure or booking fees that may be charged by a practitioner
  • Services not covered by Medicare, such as purely cosmetic procedures or experimental treatments
  • Special nursing care, respite care and services rendered in a retirement home
  • Non-PBS pharmaceuticals
  • Procedures performed in a doctor’s surgery
  • Personal hospital expenses, such as phone calls, TV hire, parking or take-home items like crutches
  • Services in non-agreement private hospitals

You cannot make claims during the following waiting periods:

  • 1 day. Accidents, ambulance
  • 12 months. Pregnancy, fertility and birth-related services and pre-existing conditions
  • 2 months. All other services as well as psychiatric, rehabilitation and palliative care even when it’s a pre-existing condition

How to make claims

At agreement private or public hospitals, the hospital will typically be able to claim costs directly from nib. You will need to pay the excess and other applicable fees directly to the hospital.

When required, you can fill in a claims form and send it to the address specified on the form using one of the specified methods.

How to pay premiums

nib offers the following range of payment options:

  • Direct debit from your bank, building society or credit union account for a 4% premium discount
  • BPAY via Internet or phone banking
  • Credit card direct debit with Mastercard, Visa or American Express cards
  • Online credit card payment
  • In person at nib retail centres
  • Mail with a cheque payable to nib health funds

Receive quotes for nib hospital only health insurance

Andrew Munro

Andrew writes for finder.com.au, comparing products, writing guides, sniffing out deals and looking for new ways to help people get the most out of their money.

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