Onemedifund overview

fund-iconOverview

Onemedifund is a relatively recent entrant into the health insurance market. The for-profit fund was established in 2007 and is owned by National Health Benefits Australia. It operates across Australia, and prides itself on high member retention.

Onemedifund’s name reflects that this is a slightly unusual fund in that it only offers one top-level hospital policy and one comprehensive extras plan.

Customers are entitled to increased limits on the Comprehensive Extras plan after five years with Onemedifund. All members can also access a range of free health programs.

fund-iconKey features

  • Offers only one top tier hospital and extras policy.
  • Access gap agreements with 36,000 doctors across Australia.
  • Optical discounts with many of Australia’s best known eyecare specialists.

fund-iconHospital cover

Nobody chooses to go to hospital. But when you do, appropriate 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. If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

With one top-level Gold plan, Onemedifund is suitable for people who want top health cover, without having to choose between policies.

Essentials Gold Hospital $250 Excess

Onemedifund’s only hospital plan is top-tier gold cover that includes most public and private hospital services. You’ll only pay a maximum of $250 excess per person per year, capped at $500 on a family policy, no matter how many times you need hospital treatment. 50% of the excess is payable for day surgery.

Key inclusions:

  • Pregnancy and birth
  • Weight loss surgery
  • Cataracts
  • Hospital psychiatric services

fund-iconAmbulance cover

Emergency ambulance cover is included with a 1 day waiting period. This includes land, sea and air ambulance with no annual limits.

fund-iconExtras cover

extras-coverExtras reset

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 each plan below, it’s always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, 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, you can speak to one of our experts.

Like hospital cover, Onemedifund only offers one comprehensive extras policy that covers a full range of services. You can combine this with their Gold Hospital policy.

Comprehensive Extras

This policy comes with unlimited general dental treatment and many services that allow you to claim back up to 80% – 100% on treatment. A number of annual limits increase after five years of membership.

fund-iconWaiting 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.

Gold Hospital $250 Excess

  • 1 day – ambulance
  • 2 months – rehabilitation, psychiatric and palliative care (including where the condition is pre-existing)
  • 2 months – all other hospital treatments
  • 2 months – health programs
  • 12 months – all other pre-existing conditions
  • 12 months – pregnancy and birth, and assisted reproductive services

fund-iconMember benefits

Members can access hospital substitution programs, including Hospital at Home, Rehab at Home and Chemo at Home.

There’s also a range of programs available to members, including mental health coaching, diabetes management, and chronic disease management. Members can also get optical discounts at Specsavers, OPSM and other opticians.

fund-iconHow to claim

Claim on the spot through the HICAPS payment system at your provider. You can also claim through the onemedifund app or online, or email, fax or post your claim form.

fund-iconHospital agreements

Onemedifund 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 Health Insurance Comparison can do this for you.

fund-iconCustomer service

Onemedifund received 0 complaints from 1 January to 30 March 2020. That’s pretty impressive, and indicates customer service is outstanding.

fund-iconFAQs

No, Onemedifund is for-profit.

Onemedifund has no restrictions on membership.

Onemedifund isn’t on our panel, but we’re confident we can get you a great deal on your health insurance if you’re looking to switch health insurance. Click here to get started.
No, providing you transfer to Onemedifund within 30 days of leaving your old fund on an equivalent or lower level of cover.
Yes, when you switch to Onemedifund you can join their top level cover even if it is higher than your previous cover. However, you will need to serve waiting periods for the extras services and/or higher benefits.
Most Australians are eligible to receive a rebate from the government. This will depend on your age and income. To learn what you’re entitled to, use our rebates calculator.
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.
Extras reset on 1 July each year.
Onemedifund allows dependent children on a family policy up to the age of 18. 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. Read our guide to learn more.
Visit onemedifund.com.au or call 1800 148 626
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