Medibank Private Health Insurance Review
Medibank Private Health Insurance offers 9 Health Insurance plans, including Bronze Plus Assured, Silver Plus Core, and Gold Protect, starting from 19.83 AUD per week up to 2,910.00 AUD per year. Medibank Private Health Insurance also provides unique features such as the Live Better Rewards Program and a No Gap Program where eligible members can avoid additional costs for certain medical services.
| 🔎 Date Established | 1976 |
| 📌 Headquartered | Melbourne, Victoria, Australia |
| 📍 Registration Number | 609 694 093 (Medibank Private Limited ACN) |
| 👤 Average Number of Members | Over 4.1 million |
| 👥 Number of Employees | 3,220 as of June 30, 2024 |
| 🛡️ APRA-Regulated | ✅Yes |
| 📉 Most Recent Market Cap Reported | Approximately AUD 10.16 billion |
| 📈 Average Customer Rating | 3.5/5 |
| 📊 Average Number of Reviews | Thousands |
| 💹 Market Share | Approximately 26.9% of the private health insurance market in Australia |
| 💱 Number of Plans Offered | 9 |
| ❤️ Sponsorships | Sponsors Australian Olympic and Paralympic teams, Medibank Melbourne Marathon, and other health initiatives |
| 📲 Mobile App Offered | My Medibank App |
| ⚙️ Medical Claims Portal | Available via My Medibank App |
| ⏰ Customer Support Operating Hours | Monday – Friday 8 am to 8 ppm AEST, Saturdays 10 am – 2 pm |
| ↪️ Information Hub and Blog | Available through their website |
| 💊 Chronic Illness Benefits | Through programs like CareComplete |
| 🩺 Screening and Prevention Offered | Various preventive health services available, including health checks |
| 🍼 Maternity Benefit | Depending on the specific plan |
| 💴 Health Insurance Contribution Range (AUD) | Starting from 19.83 AUD per week up to 2,910 AUD per year |
| 📉 Average Waiting Period | Varies by service, ranging from 1 day to 12 months |
| 📈 Is International Medical Cover Offered | Available through Medibank’s Overseas Visitors and Overseas Workers Cover |
| 📊 International Travel Benefit | Available through various insurance plans |
Medibank Private Health Insurance Plan Overview
| 🔎 Plan | 💷 Premium Range AUD | 📌 Exclusions | ❤️ Ideal For | ↪️ Gap Cover | 📍 Rebate Percentage | ⏰ Average Waiting Period | 🔏 Key Features |
| 🥇 Medibank Basic Accident and Ambulance | From $19.83 per week to $1,034.52 per year | Elective and specialised treatments, plastic and reconstructive surgery | Individuals who want essential accident and ambulance coverage with basic protection | ✅Yes | 8.202% to 32.812% | 1 day for accidents, 2 months for ambulance services, 12 months for pre-existing conditions | Emergency ambulance transport and accidental injury benefits, GapCover, travel benefits |
| 🥈 Medibank Basic Plus Healthy Start | From $21.03 per week to $1,097.40 per year | Complex procedures, pregnancy services, cancer treatments | Ideal for singles and couples needing foundational protection against essential and emergency medical costs | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Services for joint reconstructions, dental surgery, and hernia and appendix treatments, flexibility in choosing doctors and hospital accommodations, GapCover |
| 🥉 Medibank Bronze Everyday | From $21.15 per week to $1,103.28 per year | Weight loss surgery, assisted reproductive services, and joint replacements | Ideal for individuals and couples needing cost-effective protection for common hospital treatments and emergencies | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Essential hospital services, emergency ambulance transport, and accident benefits, flexibility to choose doctors, includes travel and accommodation benefits and GapCover |
| 🏅 Medibank Bronze Plus Progress | From $26.96 per week to $1,406.40 per year | Pregnancy services, weight loss surgeries, joint replacements | Best for individuals and couples seeking additional coverage for common procedures | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Comprehensive hospital coverage, GapCover and accommodation benefits |
| 🎖️ Medibank Bronze Plus Assured | From $28.61 per week to $1,492.80 per year | Weight loss surgery, assisted reproductive services, private room guarantees | Ideal for those needing flexible hospital coverage for more frequent treatments | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Covers ENT treatments, joint reconstructions, and medically necessary breast surgeries, GapCover and travel benefits |
| 🥇 Medibank Silver Plus Core | From $26.96 per week to $1,406.40 per year | Assisted reproductive services, pregnancy services, cataracts | Ideal for individuals and couples needing moderate hospital coverage with specific exclusions | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Heart treatments and joint replacements, accommodation benefits and flexibility in doctor selection |
| 🥈 Medibank Silver Plus Support | From $40.43 per week to $2,109.72 per year | Private room guarantees, elective plastic surgeries | Designed for those looking for broad coverage as they age | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Extensive hospital services, including cataract surgeries, heart and vascular system treatments, and pain management, GapCover and No Gap Programs |
| 🥉 Medibank Silver Plus Secure | From $55.77 per week to $2,910.00 per year | Weight loss surgery, elective plastic surgeries | Best for individuals and families seeking secure, comprehensive hospital coverage | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Comprehensive coverage for joint replacements, cancer therapies, and cardiac services, GapCover, extensive private hospital options, travel benefits |
| 🏅 Medibank Gold Protect | From $55.77 per week to $2,910.00 per year | Outpatient services, GP visits | Designed for families and couples seeking the highest level of coverage available | ✅Yes | 8.202% to 32.812% | 2 months for most services, 12 months for pre-existing conditions | Offers comprehensive coverage for pregnancy services, weight loss surgeries, and high-cost treatments, GapCover, extensive flexibility in selecting private hospitals and doctors |
Medibank Private Health Insurance Plans – Features and Benefits
Medibank offers nine health insurance plans, each offering different coverage levels, with options from basic accident-only to more comprehensive hospital plans.
The plans also offer benefits such as ambulance services, gap cover to reduce out-of-pocket expenses, and access to Medibank’s dedicated health services like 24/7 nurse support and the My Medibank app.
Medibank Basic Accident and Ambulance
| 📉 Premium Range | $19.83/week to $1,034.52/year |
| 📈 Coverage Inclusions | Ambulance transport, emergency admissions due to accidents, basic in-hospital services |
| 📊 Coverage Exclusions | Elective surgeries, complex treatments, maternity, assisted reproductive services |
| 💹 Ideal Target Audience | Singles and young adults |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $500 or $750 per year, payable at the time of hospital admission |
| 📍 Average Waiting Periods | Ambulance: 1 day, Accident-related hospital services: 2 months |
| ⭐ Key Features | Emergency ambulance cover, accidental injury benefits, basic hospital admission benefits |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| 💚 Singles | Low-cost accident coverage, Emergency ambulance services, Basic hospital admissions included | Excludes elective and complex treatments, Limited coverage scope |
| 💙 Couples | Joint accident and emergency coverage, Access to GapCover for reducing in-hospital costs, Digital tools for management through My Medibank app | Does not cover surgeries like joint replacements, Gap cover does not apply to all services |
| 🩷 Families | Emergency protection for accidents, No restrictions on emergency ambulance usage, Support for basic hospital stays | No elective or maternity services covered, Limited flexibility in hospital services selection |
| 💜 Single Parents | Comprehensive emergency ambulance services, Support for managing policies digitally, Instant access to nurse advice via helplines | Excludes key procedures for children, May require additional add-ons for broader coverage |
Medibank Basic Plus Healthy Start
| 📉 Premium Range | $21.03/week to $1,097.40/year |
| 📈 Coverage Inclusions | Joint reconstructions, hernia and appendix surgeries, dental surgeries, emergency ambulance transport |
| 📊 Coverage Exclusions | Complex heart treatments, cancer treatments, pregnancy and birth services, weight loss surgeries |
| 💹 Ideal Target Audience | Young singles and couples |
| 💱 Gap Cover Availability | Yes |
| 🅰️ Excess Options | Nil or $750 per member per year |
| 🅱️ Average Waiting Periods | Ambulance: 1 day, Accident-related hospital services: 2 months |
| ⭐ Key Features | Emergency ambulance cover, accidental injury benefits, flexibility in choosing healthcare providers |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| ❤️ Singles | Flexible provider choices, Emergency coverage, Low-cost accident benefits | Excludes complex services, Limited hospital treatment options |
| 🧡 Couples | Joint coverage for essential hospital services, Minimal waiting periods, Easy-to-manage digital platform | Limited maternity coverage, Not suitable for families with children |
| 💛 Families | Emergency coverage for essential services, Practical for basic family needs, Digital management tools available | Limited pediatric services, Additional coverage needed for comprehensive care |
| 💚 Single Parents | Reliable emergency coverage, Flexibility in provider choices, 24/7 medical advice available via helplines | Excludes vital child services, Limited outpatient treatment options |
Medibank Bronze Everyday
| 📉 Premium Range | $21.15/week to $1,103/year |
| 📈 Coverage Inclusions | Emergency admissions, chemotherapy, and basic joint reconstructions |
| 📊 Coverage Exclusions | Maternity services, weight loss surgery, assisted reproductive treatments |
| 💹 Ideal Target Audience | Cost-conscious individuals and families needing essential hospital coverage |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $500 or $750 per year |
| 📍 Average Waiting Periods | 2 months for hospital services |
| ⭐ Key Features | Offers accident-related benefits, 24/7 nurse helpline, and flexibility in choosing doctors and hospitals |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| 🩷 Singles | Broad coverage scope, Emergency protection, Choosing hospitals and doctors | No specialised or elective surgeries covered, Higher out-of-pocket expenses for certain treatments |
| 💜 Couples | Joint accident coverage, Flexible hospital and doctor choice, Gap cover options | No maternity or weight loss procedures, Limited surgical options |
| 💚 Families | Coverage for key hospital services, Emergency ambulance cover, Pediatric surgical procedures | Lack of comprehensive care for chronic conditions, No maternity coverage |
| 💛 Single Parents | Affordable hospital cover, Accident benefits, 24/7 medical support for emergencies | Limited services for child-specific needs, No maternity or chronic condition coverage |
Medibank Bronze Plus Progress
| 📉 Premium Range | $32.55/week to $1,698/year |
| 📈 Coverage Inclusions | Bone, joint, and muscle treatments, general surgeries, and emergency services |
| 📊 Coverage Exclusions | Complex surgeries, heart surgeries, dialysis |
| 💹 Ideal Target Audience | Individuals and couples wanting broader coverage beyond basic hospital plans |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $500 or $750 |
| 📍 Average Waiting Periods | 2 to 12 months |
| ⭐ Key Features | Extensive in-hospital services, accident-related benefits, 24/7 nurse support for guidance |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| 💚 Singles | Broad hospital coverage, Accident-related benefits, Flexible doctor choices | Excludes complex and major surgeries, Limited to chronic conditions |
| 💙 Couples | Joint cover for surgical and emergency care, Gap cover to reduce doctor fees | Limited to moderate-level care, Not suited for families expecting children |
| 🩷 Families | Covers general surgeries and joint treatments, Offers support services like 24/7 nurse access | Lacks specialised pediatric care, No childbirth services included |
| 💜 Single Parents | Provides emergency and moderate hospital services, Access to emergency medical advice | Not tailored for child-focused healthcare, Lacks critical condition coverage |
Medibank Bronze Plus Assured
| 📉 Premium Range | $23.02/week to $1,201.44/year |
| 📈 Coverage Inclusions | Brain and nervous system, joint reconstructions, ENT procedures, chemotherapy, pain management, and more |
| 📊 Coverage Exclusions | Complex surgeries, joint replacements, heart treatments, maternity services |
| 💹 Ideal Target Audience | Individuals and couples needing flexibility in choosing hospital treatments and services |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $250, $500, and $750 per member per year |
| 📍 Average Waiting Periods | Ambulance: 1 day, Accident-related hospital services: 2 months |
| ⭐ Key Features | Comprehensive medical procedures, travel and accommodation benefits, 24/7 nurse support, GapCover availability |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| 🩷 Singles | Flexibility in doctor choice, Comprehensive treatment range, Minimal restrictions | Higher premiums compared to basic plans, Excludes elective surgeries |
| 🧡 Couples | Shared comprehensive coverage, Mid-range plan with good benefits, Ideal for essential hospital needs | No maternity or pregnancy coverage, Limited access to high-cost procedures |
| 💙 Families | Covers essential family treatments, Includes access to GapCover for in-hospital charges, Transport support for rural members | Excludes several pediatric services, Potential higher out-of-pocket costs for specialised services |
| 💚 Single Parents | Comprehensive hospital services, Emergency ambulance transport included, Flexible hospital admissions | Lacks pediatric focus, Limitations in complex medical treatments |
Medibank Silver Plus Core
| 📉 Premium Range | $26.18/week to $1,365.60/year |
| 📈 Coverage Inclusions | Heart and vascular treatments, lung and chest, joint reconstructions, diabetes management, and more |
| 📊 Coverage Exclusions | Cataract surgeries, weight loss surgeries, assisted reproductive services |
| 💹 Ideal Target Audience | Singles, couples, and families seeking an affordable mid-level hospital cover |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $250, $500, and $750 per member per year |
| 📍 Average Waiting Periods | Emergency services: 1 day; specialised services: 2-12 months |
| ⭐ Key Features | Comprehensive treatments, access to private room guarantees, and 24/7 nurse support services |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| 💚 Singles | Coverage for essential services, Support for specialised treatments, Flexibility in hospital admissions | No assisted reproductive or weight loss surgeries, Higher premiums compared to basic plans |
| 💙 Couples | Joint coverage for hospital services, Comprehensive treatment options, Good mid-range plan | Excludes maternity and certain high-cost procedures, Less flexibility in elective care |
| 🩷 Families | Covers key family services, Access to emergency and accident support, Gap cover availability for children’s treatments | Limited pediatric care, Restricted access to advanced surgeries |
| 💜 Single Parents | Affordable mid-level plan, Comprehensive hospital coverage, Accessible travel and accommodation benefits | No specialised child services, Exclusion of weight loss surgeries |
Medibank Silver Plus Support
| 📉 Premium Range | $38.10/week to $2,100/year |
| 📈 Coverage Inclusions | Heart and vascular surgeries, lung and chest, chronic condition support, diabetes management, and more |
| 📊 Coverage Exclusions | Complex elective surgeries, weight loss treatments, assisted reproductive services |
| 💹 Ideal Target Audience | Individuals with chronic health conditions or those needing extensive hospital support |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $250, $500, and $750 per member per year |
| 📍 Average Waiting Periods | 1 to 12 months |
| ⭐ Key Features | Comprehensive chronic treatment support, extensive hospital services, 24/7 medical assistance |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| ❤️ Singles | Strong support for chronic conditions, Wide range of hospital services, Access to medical assistance helpline | High premiums, Excludes elective surgeries |
| 🩷 Couples | Shared extensive coverage, Chronic illness support, Comprehensive hospital benefits | Excludes assisted reproductive services, Limited options for elective care |
| 💙 Families | Comprehensive chronic condition coverage for all family members, Flexible in-hospital admissions, Access to private rooms | Excludes pediatric focus, High-cost services may require additional coverage |
| 💚 Single Parents | Comprehensive chronic treatment support, Emergency ambulance cover, Hospital flexibility | Excludes specific child services, Limited elective and maternity coverage |
Medibank Silver Plus Secure
| 📉 Premium Range | $45.50/week to $2,500/year |
| 📈 Coverage Inclusions | Joint reconstructions, chronic condition support, diabetes management, heart treatments, and more |
| 📊 Coverage Exclusions | Pregnancy services, elective surgeries, assisted reproductive services |
| 💹 Ideal Target Audience | Families and couples seeking secure, broad hospital coverage |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $250, $500, and $750 per member per year |
| 📍 Average Waiting Periods | 2 to 12 months |
| ⭐ Key Features | Comprehensive chronic support, wide hospital service range, access to private emergency benefits |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| 💚 Singles | Broad hospital service coverage, Secure chronic support services, Access to emergency transport | Higher premiums, Limited elective procedures |
| 💙 Couples | Shared secure coverage, Comprehensive chronic illness support, Flexibility in choosing hospital treatments | Excludes maternity services, Limited elective treatment options |
| ❤️ Families | Comprehensive family support, Private emergency coverage, Access to secure services in hospitals | Higher costs, Lack of elective and advanced pediatric services |
| 🧡 Single Parents | Secure hospital coverage, Broad support for chronic issues, Emergency care benefits | Limited child-specific services, Fewer elective treatment options |
Medibank Gold Protect
| 📉 Premium Range | $55.77/week to $2,910/year |
| 📈 Coverage Inclusions | Pregnancy and birth services, weight loss surgeries, heart and vascular treatments, and more |
| 📊 Coverage Exclusions | None explicitly stated |
| 💹 Ideal Target Audience | Families and individuals needing comprehensive protection across all healthcare areas |
| 💱 Gap Cover Availability | Yes |
| 📌 Excess Options | $250, $500, and $750 per member per year |
| 📍 Average Waiting Periods | 2 to 12 months |
| ⭐ Key Features | Complete coverage, including maternity services, weight loss, elective surgeries, and more |
Benefits and Drawbacks for Members
| 🔎 Membership Type | 🔋 Benefits | 🪫 Drawbacks |
| ❤️ Singles | Extensive hospital coverage, Members can choose their doctors and specialists, Access to additional services like the 24/7 nurse helpline | Premiums can be higher compared to lower-tier plans, Mandatory excess payment per hospital admission, Some outpatient services like general dental and optical require additional coverage through an extras plan |
| 💙 Couples | Comprehensive shared coverage for essential and elective hospital services, Plan includes GapCover, Access to health and wellness programs like Live Better | Extras such as optical and dental, High premiums, Limited travel benefits must be acquired separately |
| 🧡 Families | Covers ENT treatments, Pediatric surgeries, Maternity services, Emergency ambulance services and accident coverage, GapCover reduces in-hospital costs for family members | Some specialised services require additional costs beyond GapCover benefits, Limited flexibility in selecting private hospital rooms, High premiums for comprehensive coverage |
| 💚 Single Parents | Comprehensive coverage for essential and specialised medical treatments, Emergency ambulance services, Digital management tools through the My Medibank app, Access to 24/7 nurse support, Providing flexibility and immediate assistance | High premiums could be challenging for single parents, Mandatory excess per hospital admission can add up if the parent and children require multiple hospitalisations, Elective services are not covered |
Recent User Reviews
🥇 Long-Term Confidence in Coverage
I’ve had Medibank’s hospital coverage for more than a decade. All of my claims, including a lengthy rehabilitation stay, were entirely covered, and the large hospital network gave me confidence in my coverage whenever I needed it. – Clark
🥈 Positive Experience with Customer Support
I switched to Medibank following a suggestion and am glad I did. The support team has always been helpful, and the service quality shows that they value their customers. – Lucy
🥉 Peace of Mind with Consistent Service
Medibank has provided me with peace of mind. Their service is consistent, and while the costs aren’t the lowest, the support and hospital network make it worthwhile when dealing with unanticipated health difficulties. – Michael
Medibank Private Health Extras Only Options
The Healthy Living Extras plan starts at $3.45 per week and provides basic coverage, including one annual dental check-up and cleaning at Members’ Choice Network providers, plus access to member perks. It’s ideal for the young and healthy.
The Healthy Start Extras plan, starting at $6.40 per week, is perfect for those new to health coverage. It offers two dental check-ups per year, optical services, physiotherapy, and mental health support. The Essential Extras plan, at $9.67 per week, offers broader coverage for common services like dental, optical, physiotherapy, and chiropractic care, with added value through the Members’ Choice network.
The Growing Family Extras Only plan, at $12.18 per week, is tailored for families, covering key services like dental, optical, antenatal and postnatal care, and mental health support, with a focus on children’s health needs.
Finally, the Top Extras plan, starting at $13.31 per week, provides comprehensive coverage with high limits on dental, optical, and allied health services, offering flexibility with both Members’ Choice and non-Members’ Choice providers.
Medibank Private Health Insurance vs HCF Health Insurance vs Qantas Health Insurance – A Comparison
| 🔎 Providers | 🥇 Medibank Private Health Insurance | 🥈 HCF Health Insurance | 🥉 Qantas Health Insurance |
| 📌 Years in Operation | 48 years | Since 1932 | Since 2016 (as Qantas Assure) |
| 👤 Average Number of Members | Over 4.1 million | Over 1.8 million | Not specified; under NIB umbrella, 9.6% market share |
| 📍 APRA Regulation | ✅Yes | ✅Yes | ✅Yes |
| 👥 Number of Employees | 3,220 | Over 1,800 | 26,000+ (including partnerships and subsidiaries under NIB) |
| 📉 Market Share | 26.9% | Approximately 12.5% | Operates under Nib Holdings (with a 9.6% market share), has a 52.5% market share (more or less) |
| 📈 Market Coverage | Australia | Primarily Australia, with an extensive branch network | Nationwide with a focus on digital tools like the Wellbeing App |
| ❤️ Customer Rating | 3.5/5 | High satisfaction ratings with multiple awards | Average rating of 4.11/5 |
| 🔢 Number of reviews | Thousands | Over 5,000 across major platforms | Thousands |
| 📲 Mobile App | My Medibank App | My Membership App | Qantas Wellbeing App |
| 💴 Premium Range (AUD) | From 19.83 AUD per week up to 2,910 AUD per year | Varies by plan and location | Varies by plan and location |
| 🌎 International Travel Benefit | Available through various insurance plans | Limited coverage through additional policies | Limited coverage for medical emergencies while abroad |
| 💶 Market Capitalisation | Approximately AUD 10.16 billion | Not applicable (Not-for-profit) | Under Nib Holdings (Nib reported a solid market position) |
| ⭐ Unique Features | GapCover, 24/7 nurse and mental health support, Better Minds program, comprehensive travel insurance options | No-Gap dental, Home healthcare programs, community-driven approach | Qantas Points Earning, Accidental Injury Cover, 24/7 Assistance via Wellbeing App |
Advantages of Using Medibank Private Health Insurance – Unique Selling Points
Medibank Private Health Insurance offers several advantages over competitors. Members have access to 24/7 health support, including qualified nurses and mental health professionals, available through phone or the My Medibank app. This provides expert guidance for managing health concerns or getting advice on mental well-being.
Medibank also promotes a healthy lifestyle through its Live Better Rewards program, where members can earn points by completing activities like walking challenges or healthy eating goals. These points can be redeemed for discounts on premiums or a range of products and services from Medibank’s partners.
The GapCover helps reduce out-of-pocket expenses for hospital visits, minimizing financial strain for members. Additionally, Medibank offers extra health services such as the Better Minds mental health programs, support for chronic conditions, and Medibank at Home services.
Medibank Private Health Insurance Gap Cover
Medibank Private Health Insurance GapCover helps reduce out-of-pocket costs by covering the difference between what Medicare pays and what doctors charge, making it especially beneficial for those undergoing specialised medical treatments or surgeries with high bills.
Some key features of Medibank’s GapCover include the No Gap program, which allows members to pay no out-of-pocket costs for certain hospitals and procedures, provided the doctor participates. Members can also choose from excess payment options ranging from $250 to $750, with higher excesses reducing upfront premium costs, though the payment is required when admitted to the hospital.
Additionally, GapCover provides up to $400 annually for private hospital emergency department admissions. While GapCover reduces most in-hospital costs, it does not apply to outpatient care, diagnostic imaging, or services outside hospital admissions.
Lastly, it covers travel costs for members who travel more than 200 km round-trip for hospital treatment, with a combined cap on accommodation and travel expenses per admission.
Medibank Private Health Insurance App Features
The Medibank Private Health Insurance App, available on iOS and Android devices, helps members manage their policies easily from anywhere. This app is a central hub where users can access important features, track expenses, and obtain guidance conveniently from their mobile devices. Here are the features members can expect:
| 🔎 Feature | 📌 Description |
| 📉 Claims Management | Users can submit claims directly through the app and track claim status and history |
| 📈 Out-of-Pocket Estimator | Helps members estimate potential costs before visiting healthcare providers |
| 📊 Extras Limits Tracker | Displays remaining limits for extras like dental and physiotherapy, aiding members in planning services |
| 💹 Find Members’ Choice Providers | Locates nearby Members’ Choice providers, helping users access the Medibank network of healthcare services |
| 💱 Digital Card Integration | Provides the ability to add the Medibank card to Apple Wallet for contactless claiming and secure login |
| ❤️ Challenges and Health Goals | Allows members to set personal health challenges and track progress, encouraging healthier lifestyle habits |
| ⚙️ Symptom Checker | Offers access to a tool that helps members assess symptoms and receive basic guidance |
How to apply for Health Insurance with Medibank Private Health Insurance
To apply for Health Insurance through Medibank Private Health Insurance, you can:
Review and Compare Plans
Visit Medibank’s website or contact their customer service to explore different health insurance options. Take time to evaluate your healthcare needs and budget, and understand the benefits and limitations of each plan.
Choose the Right Plan
After reviewing the options, select a plan that fits your needs. Medibank offers hospital-only, extras, or combined plans. Consider features like waiting periods and specific cover details when making your choice.
Prepare Required Information
Gather personal identification details, relevant medical history, and payment information. This will help set up your policy and ensure the coverage meets your needs.
Submit Your Application
Apply for health insurance online through Medibank’s website or by visiting a Medibank branch. During the application, you’ll provide personal details, choose your coverage options, and set up your payment method.
Review and Confirm
Before finalizing, carefully review your policy details, including premiums, coverage inclusions, exclusions, and any waiting periods. Once you’re satisfied, confirm your acceptance, and Medibank will send you your policy documents.
📌 Read more about the Best Private Health Insurance
How to apply for Gap Cover with Medibank Private Health Insurance
Here’s an easy-to-read, step-by-step guide to applying for GapCover with Medibank:
Check Plan Compatibility
Ensure that your chosen hospital cover includes GapCover. Not all Medibank plans offer this feature.
Discuss with Your Healthcare Provider
When planning a medical procedure, talk to your doctor and hospital about GapCover. Confirm that both are participants in the Medibank GapCover program.
Automatic Application
If you’re eligible, GapCover will automatically apply to your policy. However, if additional documentation is required (like proof of the procedure or doctor participation), submit these details to Medibank for approval.
Review the Terms
Carefully review the terms of GapCover, including any potential costs that may not be covered.
How to Submit a Claim with Medibank Private Health Insurance
When you want to claim from Medibank, you can follow these steps:
Log into Your Account
Open the My Medibank app or website and log in securely using your member details.
Go to the ‘Make a Claim’ Section
Navigate to the ‘Make a Claim’ section on the app or website and follow the instructions to provide details about the medical services you are claiming.
Upload Documents and Submit
Upload all required documents and submit the claim through the app.
Claim Processing and Payment
Medibank will process your claim, and if approved, payment will be made directly into your nominated bank account.
If your claim can’t be processed online, send your completed claim form and supporting documents by post or visit a Medibank branch for assistance.
How to Downgrade My Plan with Medibank Private Health Insurance
If you need to downgrade your plan, you can follow these steps:
- You can call, visit a branch, or log in to the My Medibank app to request a downgrade. Ensure you have your policy details on hand.
- Before confirming the downgrade, check if any waiting periods apply or if there are limitations on services after downgrading.
Once you’ve reviewed the impact on coverage and agreed to the new terms, confirm the downgrade with Medibank. You will receive updated policy documents reflecting your revised coverage and premiums.
How do I add a Beneficiary to Medibank Private Health Insurance?
If you want to add a child or adult dependent, you can log in to your Medibank Private Health Insurance profile and follow these steps:
- Log in to your My Medibank account through the app or the website. Navigate to the policy management section to view and update details.
- Adding a beneficiary may require submitting specific information, such as identification documents for the new beneficiary.
After entering the details, submit the request for adding the beneficiary. Medibank may take some time to process the changes and provide confirmation once approved.
How to Submit a Compliment or Complaint with Medibank Private Health Insurance
Whether you have a compliment or complaint, there are clear steps to follow.
- You can submit feedback through the Medibank website or app or by visiting a branch.
- If submitting online or through the app, navigate to the feedback section and provide specific details about your experience. Include your contact information if you wish to receive a response or follow-up.
Medibank will review and respond to your feedback. If you have raised a complaint, Medibank might reach out for further clarification or provide updates on the resolution.
How to Switch my Health Insurance to Medibank Private Health Insurance
When switching to Medibank Private Health Insurance, there are a few steps to follow to ensure a seamless transition without losing coverage.
- Choose a Medibank policy that aligns with your current or desired level of coverage.
- Next, contact Medibank to initiate the transfer process, providing information about your existing policy and insurer.
- During this process, Medibank will coordinate with your previous insurer to transfer relevant details, ensuring continuity of coverage.
- Review and confirm waiting periods, especially if upgrading your level of coverage, as you might need to re-serve waiting periods for new benefits not previously covered.
Submit any required documents and confirm the switch, after which you’ll receive your Medibank policy details.
Medibank Private Health Insurance Pet Cover
Medibank offers comprehensive pet insurance with several plans designed to support pet owners. Here are the key features:
Plan Options
Medibank provides three levels of coverage: Pet Protect, Pet Plus, and Pet Max. Annual limits range from $10,000 to $30,000, and benefit percentages range from 70% to 90%.
Coverage for Accidents and Illnesses
All plans cover accidental injuries and illnesses, ensuring essential treatments and emergency care for your pets.
Extra Care Benefit
Provides additional benefits for specific dental conditions and specialized therapies such as chiropractic manipulation and physiotherapy.
Emergency Boarding
Covers emergency boarding if the pet owner is hospitalized.
Routine Care (Optional)
Covers expenses like desexing, vaccinations, microchipping, and teeth cleaning as part of an optional non-insurance benefit.
GapOnly® Service
Allows for on-the-spot claims processing at participating vets.
24/7 VetChat Access
Provides consultation services with registered veterinarians through online chat or video calls during the policy period.
Exclusions to Be Aware Of.
While Medibank’s pet cover is comprehensive, there are some exclusions to consider:
Pre-Existing Conditions
Conditions that existed before the policy started are generally excluded unless eligible for review after 18 months.
Specialised Treatments and Surgeries
Surgeries like hip replacements and other specialised treatments may have specific sub-limits or exclusions. It’s important to review the Product Disclosure Statement for full details.
Medibank Private Health Insurance Travel Insurance
Medibank’s travel insurance provides financial protection and support for domestic and international trips. Medibank’s travel insurance includes several comprehensive plans:
International Comprehensive Plan
- Offers extensive coverage for medical emergencies, including hospitalisation, evacuation, and urgent dental treatments.
- Covers costs related to trip cancellations, travel delays, and loss or damage of personal belongings, such as electronics and luggage.
- Coverage limits are high to ensure adequate protection during extended or high-risk trips.
International Medical Only Plan
- Geared towards anyone who wants focused medical coverage while travelling.
- Covers essential medical and dental emergencies.
- Includes access to Medibank’s 24/7 emergency assistance services.
Domestic Travel Insurance
- Ideal for members travelling within Australia.
- Covers trip cancellations, delays, amendments, and rental car excess expenses in the event of damage or theft.
- Includes benefits for unexpected medical costs and other travel disruptions.
Additional Benefits for Medibank Travel Insurance
| 🔎 Choice of Policy Excess Levels | Lower premiums by selecting different excess levels to pay in the event of a claim |
| 🧸 Cover for Children | Includes free coverage for children or grandchildren under 21 travelling with a parent or grandparent |
| 🔢 21-Day Cooling-Off Period | Allows policy cancellation within 21 days of purchase with a full refund if no claims are made or trips taken |
| 📉 Cover for Some Pre-existing Conditions | Automatic cover for a limited number of pre-existing conditions |
| 📈 COVID-19 Travel Insurance | Specific coverage for COVID-19-related medical expenses, cancellations, and interruptions |
| 📊 Additional Luggage Limits | Lets members increase coverage for higher-value luggage and personal items |
| ☃️ Winter Sports and Cruise Cover | Optional add-ons for activities such as skiing and for cruises |
| 🚗 Free Cover for Rental Car Excess | Coverage towards rental car insurance excess |
| 📌 Multi-Trip Policy Option | Comprehensive coverage for all international trips taken within a year |
Medibank Private Health Insurance Corporate Responsibility
Medibank fosters a sustainable and healthy community by participating in several projects and initiatives, including the following:
- Medibank’s RAP emphasises reconciliation initiatives in Australia, emphasising Indigenous health fairness and promoting Indigenous enterprises.
- Medibank Better Health Foundation drives positive change through research, policy, and clinical practice.
Medibank sponsors programs and events encouraging a healthy body, mind, and spirit. This includes Parkrun Australia and AFLW collaborations that promote exercise and community.
Medibank Private Health Insurance Regulation
In Australia, private health insurance is regulated by the Australian Prudential Regulation Authority (APRA) and the Australian Competition and Consumer Commission (ACCC). Medibank Private Health Insurance operates under Medibank Private Limited (ABN 47 080 890 259) and is a member of APRA. The primary regulatory framework for private health insurance is governed by the Private Health Insurance Act 2007, with oversight from both APRA and the ACCC.
The key responsibilities and focus areas of these regulatory bodies include:
- Maintaining Financial Stability: APRA monitors private health insurers through regular risk assessments and financial stress testing to ensure their solvency and ability to meet obligations.
- Ensuring Fair Pricing and Transparency: The ACCC oversees premium adjustments, ensuring any increases are fair and comply with regulatory standards to protect consumers.
- Protecting Members’ Interests: Both APRA and the ACCC work to maintain market integrity and protect members from misconduct and financial risks.
In summary, the APRA and ACCC play crucial roles in ensuring the stability, fairness, and protection of consumers in the private health insurance sector, allowing members to trust that their health coverage is secure and reliable.
Medibank Private Health Insurance Awards and Recognition
Here are some of the awards that Medibank has recently won:
- Mozo’s Experts Choice Awards (2022 & 2023): Medibank was recognised for its outstanding travel insurance offerings.
- The My Medibank app has been commended for its digital innovation, providing members convenient access to their health insurance details and services.
- In 2024, Medibank received the Canstar Outstanding Value Health Insurance Award for the 17th consecutive year.
- Mozo’s People’s Choice Award (2024) highlights Medibank’s consumer popularity.
- Mozo’s 2024 Experts Choice Award for Exceptional Quality Pet Insurance: Medibank’s Pet Plus and Pet Max plans were acknowledged for superior coverage options.
- Medibank’s innovative Live Better Rewards program has also been recognised for encouraging healthy lifestyles.
Moreover, Medibank was honoured with the Roy Morgan Customer Satisfaction Award based on its members’ positive feedback and high satisfaction levels.
Medibank Private Health Insurance Customer Support and Contact Details
Medibank offers customer support through a few channels, including:
Customer Support Phone Number
For general inquiries and customer support, members can call 132 331 Monday to Friday 8 am to 8 pm and Saturdays 10 am to 2 pm. Non-members can call Medibank on 1200 645 078.
Online and App-Based Services
Members can use the My Medibank app or online portal to manage their policies, submit claims, track benefits, and access self-service options for everyday inquiries.
24/7 Nurse Support
Members can call qualified nurses at 1800 644 325 or chat online through the app to receive medical guidance and advice at no additional cost.
24/7 Mental Health Support
Medibank offers a dedicated helpline where members can speak with professionals about emotional or mental health concerns.
Medibank Registered Office
Located at Medibank Melbourne Hub, Level 2, 695 Collins St, Docklands VIC 3008.
Moreover, Members can access detailed information and manage their accounts at www.medibank.com.au.
Medibank Private Health Insurance Rebates and Discounts
Here are some of the rebates and discounts available from Medibank Private Health Insurance:
- Medibank offers lifetime health cover (LHC) discounts to younger customers who join before age 31.
- Members who pay their premiums yearly or by direct debit might get extra discounts.
- Members are eligible for a certain rebate proportion depending on their income tier, which is updated annually. Lower-income members receive larger rebates, with categories established for singles and families.
Members aged 65 to 69 receive a higher rebate percentage, which increases further for those over 70. This age-based adjustment helps older members keep their health coverage.
Medibank Private Health Insurance Additional Health Services and Products
Medibank offers Better Minds, a suite of mental health services, including consultations with psychologists or counsellors, available to members with eligible cover. Furthermore:
- Medibank at Home Programs lets eligible members receive certain treatments and healthcare services like rehabilitation, chemotherapy, and palliative care support from home.
- Type 2 Diabetes Program includes meal plans, regular dietitian consultations, and ongoing health monitoring to help eligible members manage and improve their condition.
- Different health insurance plans have zero out-of-pocket costs for select surgeries and procedures like joint replacements, ACL reconstructions, and colonoscopies at participating hospitals.
- Members can participate in health challenges, track activities, and earn reward points for engaging in healthy behaviours, redeemable for discounts and benefits.
Finally, Health Concierge Service offers personalised assistance for eligible members preparing for or recovering from hospital stays.
Medibank Private Health Insurance Pros and Cons
| ✅ Pros | ❌ Cons |
| Digital management tools through the My Medibank app | Excludes key elective procedures like weight loss surgeries |
| Dedicated support for chronic conditions | Some plans do not include outpatient and GP visit coverage |
| There are flexible health insurance plans for all types of members and family dynamics | Restrictions on coverage for specific child-focused services |
| Offers a comprehensive gap cover | Additional coverage is needed for specialised pediatric care |
| Covers essential family services and emergency benefits | Higher premiums for comprehensive coverage plans |
| Provides 24/7 nurse and mental health support | Limited flexibility in selecting private rooms at hospitals |
In Conclusion
Our review of Medibank Private Health Insurance reveals a solid provider with comprehensive services but not without a few drawbacks.
Medibank excels in offering tailored plans. Digital tools like the My Medibank app enhance convenience, letting members manage their policies and claims effortlessly.
However, the higher premiums associated with some plans and limited child-specific services in certain tiers could deter families who want full-scale protection.
While Medibank’s GapCover program minimises out-of-pocket expenses, coverage exclusions in some plans could be limiting for members with specialised needs.
Overall, Medibank has diverse options and supportive health programs, yet prospective members should weigh benefits against specific exclusions and premium costs.
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- Latrobe Health Insurance
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Frequently Asked Questions
Is Medibank a non-profit organisation?
No, Medibank is a for-profit health insurance corporation.
How can I make a Medibank claim?
You can make a claim on the spot using the HICAPS system or the My Medibank app to file an online claim.
Who can apply for Medibank health insurance?
Members must be 16 or older to apply, with options available for individuals, couples, families, and single parents.
Can I modify my Medibank level of coverage?
Yes, you can upgrade or downgrade your coverage, but greater coverage adjustments frequently result in new waiting periods for additional services.
