hospital cover

Why choose Medibank?Helping you live better

Medibank cares about the health and wellbeing for all Australians. That’s why we created Live Better to support you towards a healthier, happier life, with tools to help you eat, move, and feel better.

Get inspired. Visit Live Better online for your guide to a healthier and happier you, with health and wellbeing inspiration and advice online, or subscribe to have it delivered straight to your inbox.

Get involved. We want Australians to get moving! Using Live Better activities you can join hundreds of regular free, fun, social activities across Australia.

Get rewarded. Eligible Medibank members with Hospital or Extras cover can earn rewards with the Medibank Live Better App, like savings on their health cover or great rewards from our partners, simply by looking after their health and wellbeing.

Find out more and get involved at medibank.com.au/livebetter

Understanding your cover

The more you understand your health cover, the more you’ll get out of it. So to help you out, we have a range of material available for you to access at your convenience from medibank.com.au which includes:

Member Guide. Our Member Guide gives you a detailed rundown of how your membership works, and a summary of our Fund Rules.

Cover Summary. Your Cover Summary will outline the services and items included in the cover you have chosen. There is a Cover Summary for every policy we offer.

Glossary of terms. Head to medibank.com.au/glossary for a full list of useful terms and explanations.

Find out more

If you’d like to talk to someone about cover that may be right for you, call us on 132 331, or learn more at medibank.com.au

Medibank Live Better terms and conditions: Must be 18 years or over and have a valid Australian residential address to register for Medibank Live Better. Must be a Medibank member with Hospital cover, Extras cover, or Hospital and Extras cover, be up-to-date with premium payments and have signed up to Medibank Live Better with My Medibank or have linked their MyMedibank account with their Live Better account to redeem rewards. Excludes Overseas Visitor Health Cover, Working Visa Health Cover, Overseas Student Health Cover (OSHC), Ambulance only cover, ahm covers and other selected covers. Additional terms and conditions may apply to the redemption of a reward depending on the type of reward chosen. See full Medibank Live Better terms at medibank.com.au/livebetter/rewards/terms

# Excludes claims covered by third parties such as WorkCover. See Accidental Injury Benefit in the table for more information.* For emergency ambulance attendance or transportation. TAS and QLD have state schemes to cover ambulance for residents of those states. See the

table for more information.

What’s Hospital cover?If you’re ever admittted to hospital for an illness or injury as a private patient, Hospital cover can help with the costs. It pays towards doctor’s fees for in-hospital admitted services, same day and overnight hospital accommodation, and eligible ambulance services. The amount you can claim back depends on your level of cover and any excess you need to pay. To learn more, refer to the Hospital cover table or see our Member Guide at medibank.com.au

You choose who, where, and whenIf an illness or injury means you’re admitted to hospital, it helps to be able to choose which hospital you go to and who treats you. Plus depending on your doctor, you may be able to choose when you’re admitted.

Accidents happenLife can be unpredictable, which is why our Hospital covers pay towards treatment if you’re injured in an Accident, regardless of your level of cover.#

Unlimited emergency ambulanceIf the unexpected happens, you can rest assured knowing that whatever cover you’re on, it offers unlimited emergency ambulance, Australia-wide.*

24/7 Medibank Nurse phone serviceFor members with Hospital cover, our team of nurses is available round the clock on our 24/7 Medibank Nurse phone service. Just call 1800 644 325.

Members’ Choice hospitalsWe have arrangements with most private hospitals and day surgeries in Australia, so you generally get better value at these providers so long as the service isn’t Restricted or Excluded under your cover. If you’re treated at a non-Members’ Choice private hospital, we generally pay less towards your accommodation, which means you could have significant out-of-pocket expenses. When you’re treated as a private patient in a public hospital, we pay towards overnight and same-day accommodation in a shared room. Learn more in our Member Guide at medibank.com.au

Waiting periodsWaiting periods may apply to hospital services and items when you join us, or change your cover to include new or upgraded services or items. We don’t pay towards any services or items you receive while you’re serving a waiting period. Waiting periods are 1 day for ambulance services, 2 months for hospital services, and 12 months for pregnancy and birth services and pre-existing conditions. The pre-existing condition waiting period is not applicable for hospital psychiatric services, rehabilitation and palliative care. See the Member Guide at medibank.com.au for detailed rules and policies.

Hospital cover to prepare betterLife can be unpredictable, and if the unexpected happens, it pays to be prepared. Which is why we offer a range of flexible Hospital covers to help with all life’s twists and turns.

Canstar award for ‘Outstanding Value Health Insurance’ 13 years in a rowWe’re proud to deliver outstanding value health insurance products designed to suit your needs. But don’t just take our word for it.

Choose the right cover for you

Medibank Silver Plus SecurityComprehensive Hospital cover for those who want peace of mind but who don’t want

pregnancy and birth. Includes cover for joint replacements, rehabilitation and cataracts.

Medibank Silver Plus AssuredWe’ve designed this Hospital cover to give you a little more than Silver Everyday.

Rehabilitation, palliative care and sleep studies are all included.

Medibank Silver EverydayHospital cover that provides a wide range of services,

including heart and vascular procedures.

Medibank Bronze Plus ProgressThis Hospital cover includes a wide range of common procedures,

including back, neck & spine and chemotherapy.

Medibank Bronze Plus AssuredWe’ve designed this Hospital cover to provide a little more than Bronze Plus Progress

with plastic and reconstructive surgery included.

Medibank Bronze EverydayCost-effective Hospital cover for a wide range of procedures that includes

endoscopies and chemotherapy.

Medibank Basic Plus Healthy StartHospital cover designed to meet the needs of the young and healthy. Includes procedures for joint reconstructions (things like knees and shoulders), dental surgery, hernia and appendix.

Medibank Gold CompleteFrom pregnancy and birth to psychiatric services and heart and vascular procedures, this

Hospital cover will give you the confidence of knowing you’ll be looked after, no matter what.

We have a range of Hospital covers to choose from. With some covers you can pay a lower premium by choosing a higher excess, which is an amount you pay

towards hospital treatment and applies per person per calendar year.

Hospital cover

# Other out-of-pocket expenses may apply.± Medibank Basic Plus Healthy Start is for single or couples memberships only.

~ For ambulance attendance or transportation to a hospital where immediate professional attention is required and your medical condition is such that you couldn’t be transported any other way. TAS and QLD have State schemes to cover ambulance services for residents of those States.

* Your hospital cover does not include non-PBS drugs. We will only pay towards cancer-related surgery where that surgery is an Included service under your cover.

^ For Dental surgery performed by a dentist rather than a medical practitioner we only pay benefits towards hospital charges. If the surgery is performed by a medical practitioner and Medicare benefits are payable, we will pay benefits towards the hospital and medical charges.

+ For Podiatric surgery we only pay benefits towards hospital charges. There are no Medicare benefits payable for podiatric surgery. This means we also don’t pay any benefits towards the podiatric surgeon’s fees under Hospital cover and you could incur significant out-of-pocket expenses.

Accidental Injury Benefit Services which are normally Restricted or Excluded will be treated as an Included service where treatment is required for injuries sustained in an Accident that occurs after joining cover. Refer to Cover Summary for full details.

Ambulance services Attendance or transportation to a hospital where immediate professional attention is required and your medical condition is such that you couldn’t be transported any other way.~

Excess An amount you have to pay towards your hospital admission (same-day or overnight). It applies per person per calendar year.

No hospital excess for kids One less worry with no hospital excess for kids on all family covers.#

We pay benefits for c but not for b. ‘Restricted’ means we pay minimum benefits (see table for more details).

BA

SIC

BR

ON

ZES

ILV

ER

GO

LD

Item or Medical Service Medibank Basic Plus Healthy Start±

Medibank Bronze Everyday

Medibank Bronze Plus Progress

Medibank Bronze Plus Assured

Medibank Silver Everyday

Medibank Silver Plus Assured

Medibank Silver Plus Security

Medibank Gold Complete

Excess $0, $750$250, $500,

$750$250, $500,

$750$250, $500,

$750$250, $500,

$750$250, $500,

$750$250, $500,

$750$0, $250,

$500, $750

No Excess for kids N/A cc cc cc cc cc cc cc

Private room promise b b b b b b b cc

Ambulance services~ cc cc cc cc cc cc cc cc

Accidental Injury Benefit cc cc cc cc cc cc cc N/A

Rehabilitation Restricted Restricted Restricted Restricted Restricted cc cc cc

Hospital psychiatric services Restricted Restricted Restricted Restricted Restricted Restricted Restricted cc

Palliative care Restricted Restricted cc cc Restricted cc cc cc

Brain and nervous system b cc cc cc cc cc cc cc

Eye (not cataracts) b cc cc cc cc cc cc cc

Ear, nose and throat b cc cc cc cc cc cc cc

Tonsils, adenoids and grommets b cc cc cc cc cc cc cc

Bone, joint and muscle b cc cc cc cc cc cc cc

Joint reconstructions cc cc cc cc cc cc cc cc

Kidney and bladder b cc cc cc cc cc cc cc

Male reproductive system b cc cc cc cc cc cc cc

Digestive system b cc cc cc cc cc cc cc

Hernia and appendix cc cc cc cc cc cc cc cc

Gastrointestinal endoscopy b cc cc cc cc cc cc cc

Gynaecology b cc cc cc cc cc cc cc

Miscarriage and termination of pregnancy b cc cc cc cc cc cc cc

Chemotherapy, radiotherapy and immunotherapy for cancer* b cc cc cc cc cc cc cc

Pain management b cc cc cc cc cc cc cc

Skin b cc cc cc cc cc cc cc

Breast surgery (medically necessary) b cc cc cc cc cc cc cc

Diabetes management (excluding insulin pumps) b cc cc cc cc cc cc cc

Heart and vascular system b b b b cc cc cc cc

Lung and chest b b cc cc cc cc cc cc

Blood b b cc cc cc cc cc cc

Back, neck and spine b b cc cc cc cc cc cc

Plastic and reconstructive surgery (medically necessary) b b b cc cc cc cc cc

Dental surgery^ cc b cc cc cc cc cc cc

Podiatric surgery (provided by a registered podiatric surgeon)+ b b b cc cc cc cc cc

Implantation of hearing devices b b cc cc cc cc cc cc

Cataracts b b b b b b cc cc

Joint replacements b b b b b b cc cc

Dialysis for chronic kidney failure b b b b b b cc cc

Pregnancy and birth b b b b b b b cc

Assisted reproductive services b b b b b b b cc

Weight loss surgery b b b b b b b cc

Insulin pumps b b cc cc b cc cc cc

Pain management with device b b b b b b b cc

Sleep studies b b cc cc b cc cc cc

BA

SIC

BR

ON

ZESI

LVER

GO

LD

This information is current as at January 2021 and subject to change from time to time. Membership of Medibank Private is subject to our Fund Rules and policies which we can change from time to time and are summarised in our Member Guide. The covers described in this brochure are generally not suitable for visitors from overseas, including visitors from countries with which the Australian Government has Reciprocal Health Care Arrangements. Please refer to our brochures for international students and visitors, for health cover that may be more appropriate. Medibank Private Limited ABN 47 080 890 259.

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