(before any rebate, loading or discount)
Covers 2 adults (and no-one else)
Available in South Australia
Closed to new members
# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading, an age-based discount or an insurer discount. Check with your insurer for details.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover and benefits for travel or accommodation (outside of hospital) - check with your insurer for details.
| Back, neck and spine | Gastrointestinal endoscopy | Pain management |
| Blood | Gynaecology | Pain management with device |
| Bone, joint and muscle | Heart and vascular system | Palliative care |
| Brain and nervous system | Hernia and appendix | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Implantation of hearing devices | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Sleep studies |
| Digestive system | Lung and chest | Tonsils, adenoids and grommets |
| Ear, nose and throat | Male reproductive system | Hospital psychiatric services |
| Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Dialysis for chronic kidney failure | Pregnancy and birth |
| Cataracts | Joint replacements | Weight loss surgery |
The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.
Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.
Excess: No excess
Co-payments: No co-payments
Waiting periods:
This provider offers 'known gap' or 'no gap' cover for medical bills for this product.
The Medical Costs Finder lets you find out more about the cost of specialist medical services.
This cover has Accident Cover Boost. You’ll have access to all clinical categories included in Gold level hospital cover where you require hospital treatment as a result of injuries sustained in an Accident that occurred after joining your cover. Please see Member Guide for more information.
At Members' Choice extras providers you may get more for your cover. This includes 100% back on a dental check up, scale and clean each year and great optical deals. See https://www.medibank.com.au/health-insurance/find-provider/#/.
| Note, for items marked with an asterisk *: A 12 month waiting period applies to surgical tooth extraction. Orthodontics has an $800 opening balance then a top up of $400 per year up to a $2400 lifetime limit. | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | No annual limit (no limit on preventative dental) | Periodic oral examination - $26.50 Scale & clean - $51.70 Fluoride treatment - $15.60 Surgical tooth extraction - $109.30 |
| Major dental | 12 | $800 per person (combined limit for major dental & endodontic) | Full crown veneered - $723.80 |
| Endodontic | 12 | Filling of one root canal - $136.40 | |
| Orthodontic | 12 | $800 per person $2,400 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge |
| Optical | 6 | $250 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Physiotherapy | 2 | $600 per person | Initial visit - $44.60 Subsequent visit - $38.10 |
| Chiropractic | 2 | $400 per person (combined limit for chiropractic & osteopathy) | Initial visit - $47.30 Subsequent visit - $32.20 |
| Podiatry | 2 | $500 per person (combined limit for podiatry, psychology, acupuncture, blood glucose monitors, chinese medicine, dietetics/dietary advice, exercise physiology, orthotics (podiatric orthoses), speech therapy & other services) | Initial visit - $38.70 Subsequent visit - $30.00 |
| Psychology | 0 | Initial visit - $131.96 Subsequent visit - $109.28 | |
| Acupuncture | 2 | Initial visit - $35.70 Subsequent visit - $28.80 | |
| Remedial massage | 2 | $200 per person | Initial visit - $41.40 Subsequent visit - $29.90 |
| Blood glucose monitors | 24 | Combined limit - see Podiatry | Per monitor - 100% of charge |
| Chinese medicine | 2 | Combined limit - see Podiatry | Initial visit - $21.50 Subsequent visit - $21.50 |
| Dietetics/dietary advice | 2 | Combined limit - see Podiatry | Initial visit - $53.80 Subsequent visit - $26.40 |
| Exercise physiology* | 2 | Combined limit - see Podiatry | Initial visit - $21.50 Subsequent visit - $12.00 |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Podiatry | Orthotics supply & fit - 70% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $47.30 Subsequent visit - $32.20 |
| Speech therapy | 2 | Combined limit - see Podiatry | Initial visit - $70.30 Subsequent visit - $41.70 |
| Health appliances and external prostheses 2mth waiting period, Breathing appliances 12 mth waiting period, Blood pressure monitor 24 mth waiting period, Health subscriptions 2mth waiting period, Health screening tests 2mth waiting periods, fixed benefits, sublimits and benefit replacement periods apply share combined annual limit with Podiatry (contact Medibank for further information). – Private hospital accident and emergency fees, 2mth waiting period applies to child and student dependants only, annual limit $250. – MembershipBonus, 6 mth waiting period, starts at $100 per membership per year. - Counselling (no waiting period) shares an annual limit with Psychology. Please contact Medibank for more information. | |||
| Hearing aids | Non PBS pharmaceuticals | Other treatments - check with your insurer |
Cover for extras services that older families are more likely to need such as orthodontics. Plus on some extras services we increase the amount you can claim back each year to a maximum of 5 years. You'll also get a $100 annual membership bonus to use towards your extras and other approved services.
In South Australia this policy provides:
Emergency: Unlimited with a waiting period of 1 day.
Call-out fees: will be paid for each attendance, including emergency treatment without transport to hospital.
Cover for an ambulance when you require immediate professional attention and you need to be transported to hospital or other approved facility and your medical condition is such that you cannot be transported any other way, or where an ambulance is called but transport is not needed. Cover for air ambulance where pre-approval has been obtained from Medibank. In all cases the ambulance provider must be Medibank approved. Please contact Medibank for further details.
The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.
These categories are not covered by this policy.