Medibank private health insurance review

Overview

As well as being one of Australia's largest for-profit health insurers, Medibank health insurance also offers a range of health services, including mental health and after-care support.

They offer Australians nine hospital plans, starting with a basic accident policy through to a premium Gold plan with everything included.

Four extras policies are also available.

All members have access to the Live Better rewards program that allows you to earn points for healthy actions that can be redeemed at a range of retailers.

Key Points

  • Gold level hospital benefits for all members in an accident.

  • 24/7 Medibank Nurse and Mental Health phone support.

  • 100% back on dental check-ups twice a year.

Medibank isn't on our panel but we're confident we can get you a great deal on your health insurance.

COMPARE & SAVE

Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget and personal circumstances.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

Medibank offers nine hospital plans to suit every life stage and budget.

From a no-frills accident plan, to Gold cover with all the bells and whistles, there's something for everyone.

Medibank Basic Accident and Ambulance

A basic policy for those on a tight budget and looking to avoid the Medicare Levy Surcharge.

Members get upgraded to Medibank's Gold level benefits in the event of an accident.

Key inclusions:

  • Emergency ambulance services

  • Avoids the Medicare Levy Surcharge

  • Rural and regional transport and accommodation support

Medibank Basic Plus Healthy Start

A basic hospital plan that includes a few common treatments, designed for the young and healthy.

Suitable for singles and couples on a budget.

Key inclusions:

  • Joint reconstructions

  • Hernia and appendix

  • Dental surgery

Medibank Bronze Everyday

More comprehensive cover for a broad range of common hospital procedures that also includes cancer treatment.

Key inclusions:

  • Chemotherapy

  • Gastrointestinal endoscopy

  • Gynaecology

Medibank Bronze Plus Progress

A Bronze plan that features a wide variety of procedures. The policy has no hospital excess for kids on a family membership.

Key inclusions:

  • Back, neck and spine

  • Tonsils, adenoids, and grommets

  • Implantation of hearing devices

Medibank Bronze Plus Assured

This is the most comprehensive level of Bronze cover available at Medibank. The policy has no hospital excess for kids on a family membership.

Key inclusions:

  • Brain and nervous system

  • Digestive system

  • Gynaecology

Medibank Silver Everyday

More expensive than Bronze, this cover level has a wide range of procedures to cover singles, couples, and families of all ages.

Key inclusions:

  • Heart and vascular system

  • Podiatric services

  • Plastic and reconstructive surgery

Medibank Silver Plus Assured

A more expensive higher level of cover with a long list of procedures.

It doesn't include pregnancy services, so may not be suitable for those looking to start a family.

Key inclusions:

  • Palliative care

  • Insulin pumps

  • Plastic and reconstructive surgery

Medibank Silver Plus Security

A premium level of cover with an extensive range of procedures.

This policy includes joint replacements, cataracts, and heart, but no pregnancy services, making it more suitable for older Australians.

Key inclusions:

  • Joint replacements

  • Cataracts

  • Dialysis for chronic kidney failure

Medibank Gold Complete

Medibank's top level of cover includes a private room promise.

With pregnancy and birth services, this plan is suitable if you're starting or growing your family.

Key inclusions:

  • Pregnancy and birth

  • Assisted reproductive services

  • Weight-loss surgery

Ambulance cover

Unlimited emergency ambulance cover is included on all extras policies after a one-day waiting period.

Medically necessary ambulance cover is included on all hospital policies after a one-day waiting period.

Not available to QLD & TAS residents, NSW & ACT residents who hold health insurance and WA residents if eligible for free state funded services.

Extras cover

Medibank’s extras reset on January 1 every year.

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we’ve summarised the key points of Medibank’s extras cover below, it’s always worth taking a closer look at potential gap fees, how much you can claim back, and whether your preferred healthcare provider is recognised by the health fund.

Take the time to work out what you need and what you're prepared to pay.

If this feels a bit overwhelming, our experts are here to help.

Medibank offers four extras policies to suit a range of needs, from fit and healthy singles, to couples and growing families.

Healthy Start Extras

Designed for the young and healthy, it allows members to claim 60% back on basics, including general and major dental, optical and physio. 100% back on selected services at preferred providers.

Key inclusions:

  • General dental

  • Optical

  • Physio 

Essentials Extras

Allows members to claim 75% back on dental, optical, physio, remedial massage, natural therapies and more. 100% back on selected services at preferred providers.

Key inclusions:

  • Chiropractic and Osteopathy

  • Physiotherapy

  • General dental

Growing Family Extras Only

Designed for the young and healthy, it allows members to claim 60% back on basics, including general and major dental, optical, and physio. This level of cover is only available with Bronze Plus Progress, Silver Plus Assured, or Gold Complete Hospital or as a stand-alone extras policy.

Key inclusions:

  • Supports mums and mums-to-be with cover for antenatal classes

  • Can choose between 60% and 70% back from Members Choice providers

  • 100% back on extras for kids up to annual limits at Members Choice providers

Top Extras

Medibank's top level of cover with all the extras.

This flexible plan gives you the option to claim 60%, 75%, or 90% back from Members' Choice providers.

Key inclusions:

  • Dietetics

  • Eye therapy

  • Hearing aids

COMPARE & SAVE

Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait.

But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

  • 12 months for pre-existing conditions, pregnancy, and birth

  • 2 months for hospital psychiatric services, rehabilitation, and palliative care as well as health programs, hospital substitution programs and all other services

  • 1 day for ambulance services

Extra waiting periods

  • 36 months for hearing aids and laser eye surgery

  • 24 months for blood glucose monitors

  • 12 months for major dental, obstetrics, orthodontics, and more

  • 6 months for optical and health management programs

  • 2 months for all other services

  • 1 day for ambulance services

Member benefits

Medibank members have access to the Live Better rewards program.

Accessed through an app, it encourages you to earn points on healthy actions, to redeem for a wide range of products and services.

Points can also be earned by shopping with partners such as HelloFresh.

How to claim

Claim on the spot through the HICAPS payment system at your provider.

You can also claim through the My Medibank online hub or mobile app. Or drop your claim form into a Medibank store or in the post.

Hospital agreements

Medibank has agreements with most private hospitals and day clinics across Australia.

When comparing policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

Medibank received 22.8% of complaints in 2021, and has a market share of 26.9%^.

COMPARE & SAVE

FAQs

1. Is Medibank a not-for-profit fund?

No, Medibank is a for-profit fund.

2. Who can apply? Are there restrictions?

Members must be aged 16 or over to apply.

3. Is it easy to switch to Medibank?

Medibank is not on Compare Club’s panel but they also own ahm, who we do compare.

We’re confident we can find you a good deal from the other funds we compare.

4. Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits

5. Can I change my level of cover?

Yes, you can choose a lower or higher level of cover.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

6. Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, read our rebate guide.

7. Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

8. Up to what age are children covered?

Medibank allows children to stay on family policies until they’re 21.

If they’re studying full time, dependents can be covered as a student under a family policy up to the age of 25.

Children must not be married or living in a de facto relationship.

COMPARE & SAVE

This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

 ^Private Health Ombudsman,Medibank, accessed 13 January 2022.