Medibank Private Health Insurance Review – Forbes Advisor Australia

Medibank offers a variety of health insurance plans to suit the needs of its individual consumers. Customers can choose from singles cover, couples cover, family cover or cover for single parents.

From there, consumers can choose to take out hospital only cover, extras only cover, or a plan that covers both hospital and extras–with varying amounts of excess and differing levels of inclusions, such as ‘Bronze Everyday’ or ‘Gold Complete’.

Whichever option a consumer chooses, it’s essential to select ‘cover for child birth’ when searching for a quote, as only a few Medibank insurance plans include the necessary hospital inclusions for giving birth.

Most Medibank hospital cover from basic to comprehensive include ambulance services and cover for accidents, while the majority of options for extras cover include general dental, physio and optical.

For more specific coverage, higher premium plans are required: such as hospital cover for chemotherapy or joint reconstructions, and extras cover for speech therapy or orthodontics.

It is always essential to read the product disclosure statement before taking out a health insurance policy to ensure you are covered for you and your family’s specific needs.

Across its differing plans, Medibank has a returned benefits percentage of 83.6%. This is the percentage of total contributions received by the insurer that are returned to the contributors in benefits.

The health insurer also has 86% member retention (on its hospital cover only plans), with its website and subsequent data showing good coverage for a wide array of needs. However, the 2022 data breach has affected public trust in the company and its overall reputation.

Wait Time

All health funds have waiting periods, which is a period of time you need to wait after taking out your cover before you can claim benefits.

At Medibank, for most services, the wait time is two months. However, for optical and ultra bonus for out-of-pocket expenses, the wait time is six months.

Medibank says it is standard practice in the private health insurance industry to apply a 12-month wait time before benefits are payable for pre-existing conditions, which Medicare includes.

It also has a 12-month waiting period for obstetrics-related services, major dental services and breathing appliances; however, it does not apply for hospital treatment for psychiatric treatment, rehabilitation treatment or palliative care.

There is a 24-month wait for blood glucose monitors, and 36 months’ wait for hearing aids and laser eye surgery.

No Gap Policy

A ‘no gap policy’ refers to the amount that your private health insurer will pay on your behalf for a consultation, treatment or surgery, leaving you with no out-of-pocket costs.

At Medibank, 85.5% of all services covered incur no-gap payable by the patient (as an average percentage across all policy types). This is after accounting for insurer benefits, schemes and agreements.

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