The amount you can claim back at Members’ Choice providers, up to annual limits. Fixed amounts apply at non-Members’ Choice providers, up to annual limits.
The amount you pay before Medibank contributes to your hospital costs.
Hospital cover
- A broad level of cover for those who don't need Pregnancy & birth and Assisted reproductive services.
- Our Private Room Promise.**
- Emergency Ambulance Australia-wide.^
- No hospital excess for kids on a family membership.⁺⁺
- Benefits for home nursingᵟ and health screening services. ᶲ
What is a waiting period?
The time you need to wait before you can receive benefits for services or items listed in your cover.
When do they apply?
To new members, or when switching to a higher level of cover.
Switching funds?
If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served.
What is a pre-existing condition?
An ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by Medibank, the signs or symptoms existed at any time during the six months before you either took out your new cover, or transferred to a higher level of cover (12 month waiting period applies).
Inclusions | Waiting period
What is a waiting period? The time you need to wait before you can receive benefits for services or items listed in your cover. When do they apply? To new members, or when switching to a higher level of cover. Switching funds? If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served. What is a pre-existing condition? An ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by Medibank, the signs or symptoms existed at any time during the six months before you either took out your new cover, or transferred to a higher level of cover (12 month waiting period applies). |
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Nil | |
1 day | |
Nil | |
2 months | |
2 months | |
2 months | |
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
|
2 months
(12 months for pre-existing) |
Exclusions |
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Please note: Medibank does not pay any benefits towards the cost of cosmetic surgery/procedures e.g. surgery that isn’t clinically necessary and for which an MBS item is not billable.
Hospital costs explained
Hospital cover helps with the cost of treatments you receive in hospital as a private patient. Of course, everyone is different, and so our hospital covers come in all shapes and sizes to suit different priorities and stages in life.
For services included under each of our Hospital covers, we’ll pay benefits towards:
- Eligible ambulance services
- In-hospital medical services
- Overnight accommodation in a private hospital, or a shared room in a public hospital as a private patient
- Same-day admission
- Intensive care
- The minimum benefit for surgically implanted prostheses included on the Australian Government Prostheses List
Depending on your cover you may need to pay an excess or co-payment before we will pay any benefits towards your hospital admission.
- Services not included in your cover or for which you are serving waiting periods
- Some high-cost medications
- Services not covered by Medicare
- Prostheses in excess of approved benefits in the Government’s Prostheses List
- Cosmetic treatments
It's a good idea to call us on 1300 763 422 so we can take you through what we will pay benefits for, and let you know of any potential out-of-pockets for your procedure.
Extras cover
- $1,000 annual limit to use on General dental, Major dental and Orthodontics.
- $200 to use on optical every year (with 100% back at any recognised provider up to your limit¹).
- $350 annual limit on Physiotherapy and a separate $350 limit to use on Chiropractic, Osteopathy and Podiatry every year.
- 60% back on any Included extras up to annual limits.
- Claim at ANY recognised extras provider, anywhere in Australia.
Inclusions | Annual limits per person | Waiting period |
---|---|---|
Claim back percentage: | 60% | |
Claim back percentage: | ||
$200 | 6 months | |
$1,000 | 2 months | |
12 months | ||
12 months | ||
$350 | 2 months | |
$350 | 2 months | |
2 months | ||
$200 | 2 months | |
$400 | 2 months | |
2 months | ||
2 months | ||
Nil | ||
2 months | ||
2 months | ||
2 months |
What are annual limits?
The maximum amount of benefits payable towards services, items or groups of services and/or items in a calendar year.
Switching health funds?
Benefits paid under your previous cover will be taken into account in determining the benefits payable under your Medibank cover.
What is a waiting period?
The time you need to wait before you can receive benefits for services or items listed in your cover.
When do they apply?
To new members, or when switching to a higher level of cover.
Switching funds?
If you're switching from another health fund, on similar cover, we'll recognise waiting periods already served.
Extras costs explained
Extras cover gives you money back for non-hospital services such as dental, physio, optical and more. The amount of money you can claim back depends on the level of cover you have. Generally speaking, the higher the level of cover, the higher your annual limit and higher the percentage you can claim back. Which means more money back in your pocket.
If your extras provider isn't part of our Members' Choice network don't worry. As long as they're a Medibank recognised provider, you can still claim a set percentage back on included extras up to your cover limits.
Claim a set percentage back on included services at any recognised provider, up to your annual limits.
Use your extras how you want
Use your extras limit at any recognised provider, plus get a separate limit for optical (some lens coatings excluded, waiting periods apply).
Claim almost anywhere
Claim a set percentage back on Included services at any recognised provider nationwide, (up to annual limits and subject to any waiting periods).
100% back on Optical items
We'll reimburse you for 100% of the cost of your optical items at recognised providers, up to your annual limit (some lens coatings excluded, waiting periods apply).
100% on up to two dental check ups
100% back on up to two dental check-ups every year, including bitewing x-rays, at any Members’ Choice Advantage dentist. That’s on top of your annual limit, so you can get your check-up no matter how much dental you’ve already claimed. Two month waiting period applies. Limited to two dental check-ups on all extras annually. Maximum two bitewing x-rays per check-up, where clinically needed. Not available in all areas.

Awarded Outstanding Value Health Insurance 16 years running
We’re proud to deliver outstanding value health insurance products designed to suit your needs. But don’t just take our word for it.
Why choose Medibank?
Private Room Promise
Be cared for in a private room at a Members’ Choice hospital or receive a benefit of $50 per night, for up to 5 nights per stay. Conditions apply.**
100% optical
Join Medibank Extras today and get 100% back on optical items (up to your annual limit) at any recognised provider. Some services like lens coating are excluded and waiting periods apply.
Better health begins with better teeth
Medibank members with extras cover for 2 months or more can get 100% back on up to two dental check-ups every year, including bitewing x-rays, at any Members’ Choice Advantage dentist.²

Request a call back
Leave your details and a Medibank expert will be in touch to take you through your options. In providing your telephone number, you consent to Medibank contacting you about health insurance.
** You'll need to request a private room from the Members’ Choice hospital at least 24 hours prior to your stay, provide supporting documentation to Medibank from the hospital about this request and be eligible to receive benefits for the treatment you received during your stay. Does not apply for same-day admissions or admissions for sleep studies, or where your doctor specifically requests a shared room for clinical reasons.
^ Tasmania and Queensland have state schemes that cover ambulance services for residents of those States.
++ Other out-of-pocket expenses may apply.
ᵟ Home nursing benefits are payable toward the cost of private nursing services which do not involve a hospital intervention, and must be provided by a registered home nursing provider. Medibank currently has no Recognised Home Nursing providers in NT and TAS. Conditions apply, refer to your Cover Summary for details.
ᶲ Benefits for Health screening tests are payable towards health screening services approved by Medibank for the detection of an illness or condition and performed by a Medicare registered provider, and where no Medicare benefits are payable for that service. Conditions apply, refer to your Cover Summary for details.
# Medibank has Members' Choice providers for these services. Not available in all areas.
~ Some items and services may require a Referral Letter and may have a benefit replacement period. Please see the Cover Summary or Member Guide for more information.
1 Waiting periods apply. Some lens coatings excluded.
2 Members can claim a maximum of two 100% back dental check-ups per member, per year—either two check-ups at a Members’ Choice Advantage dentist (including up to two bitewing x-rays per check-up where required), or a first check-up at a Members’ Choice dentist (excluding x-rays) and a second check-up at a Members’ Choice Advantage dentist. These check-ups do not count towards annual limits. Waiting periods apply.