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.
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.
|Excess||$250 or $500||$500||$250 or $500||$250 or $500|
|Day surgery, overnight and special care unit accommodation|
|Grommets in ears|
|Tonsil and adenoid removal|
|Palliative care||Minimum only|
|Assisted reproductive services|
|Obesity and weight loss surgery|
|Pregnancy and birth services|
|Psychiatric treatment||Minimum only||Minimum only||Minimum only||12-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