healthslips.com.au Policy Information

Medibank Private Limited

Medibank Gold Ultra Health Cover

$716.05 / month

(Before Rebate, Discount & Loading)

Available in VIC

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 covers: Only one person.

Policy ID: MBP/J20/VCFK10

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy provides accident cover - check with insurer for details.
  • This policy provides benefits for travel or accommodation outside of hospital - check with insurer for details.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Assisted reproductive services
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
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.

The following payments may also apply for hospital admissions

Excess: No excess

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 12 months for pregnancy and birth (obstetrics)
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Medibank's most comprehensive cover. Gap bonus to use towards out-of-pocket costs in hospital. Private Room Priority for pre-booked admissions at a Members' Choice hospital. Where a two month waiting period applies to a service on your hospital cover, it may be waived for claims resulting from an Accident that occurred during this time, please contact Medibank for further information.

Extras Cover

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/#/.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$500 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $58
  • Subsequent visit: $42.9
Blood glucose monitors 24

$300 per policy

  • Per monitor: 100% of charge
Chinese medicine 2

$500 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $32.5
  • Subsequent visit: $32.5
Chiropractic 2

$750 per policy

combined limit for chiropractic & osteopathy

  • Initial visit: $69.3
  • Subsequent visit: $48.7
Dietetics/dietary advice 2

$600 per policy

  • Initial visit: $74.7
  • Subsequent visit: $46.8
Endodontic 12

$1,600 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: $209.9
Exercise physiology 2

$500 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $32.5
  • Subsequent visit: $32.5
Eye therapy (orthoptics) 2

$600 per policy

  • Initial visit: $60
  • Subsequent visit: $50
General dental* 2

No annual limit

  • Fluoride treatment: $22.4
  • Scale & clean: $79.5
  • Surgical tooth extraction: $169.6
  • Periodic oral examination: $41.1
Hearing aids 36

$1,600 per policy

  • Hearing aid: 100% of charge
Home nursing* 2

$500 per policy

  • Initial visit: 100% of charge
  • Subsequent visit: 100% of charge
Major dental 12

$1,600 per policy

combined limit for endodontic & major dental

  • Full crown veneered: $1159.6
Non PBS pharmaceuticals 2

$800 per policy

  • Per eligible prescription: $51
Occupational therapy 2

$600 per policy

  • Initial visit: $69.8
  • Subsequent visit: $50.9
Optical 6

$300 per policy

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic* 12

$1,500 per policy

$3,500 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge
Orthotics (podiatric orthoses) 2

$600 per policy

combined limit for orthotics (podiatric orthoses) & podiatry

  • Orthotics supply & fit: 100% of charge
Osteopathy 2

$750 per policy

combined limit for chiropractic & osteopathy

  • Initial visit: $69.3
  • Subsequent visit: $48.7
Physiotherapy 2

$1,000 per policy

  • Initial visit: $69.3
  • Subsequent visit: $55.3
Podiatry 2

$600 per policy

combined limit for orthotics (podiatric orthoses) & podiatry

  • Initial visit: $60.8
  • Subsequent visit: $47.4
Psychology 0

$600 per policy

  • Initial visit: $158.67
  • Subsequent visit: $137.97
Remedial massage 2

$500 per policy

combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage

  • Initial visit: $68.9
  • Subsequent visit: $46.4
Speech therapy 2

$600 per policy

  • Initial visit: $107.6
  • Subsequent visit: $61.8

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $58}

{Subsequent visit: $42.9}

Blood glucose monitors

Waiting period:  24 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

Examples of maximum benefits

{Per monitor: 100% of charge}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $32.5}

{Subsequent visit: $32.5}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $69.3}

{Subsequent visit: $48.7}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

Examples of maximum benefits

{Initial visit: $74.7}

{Subsequent visit: $46.8}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: $209.9}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $32.5}

{Subsequent visit: $32.5}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

Examples of maximum benefits

{Initial visit: $60}

{Subsequent visit: $50}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{No annual limit}

Examples of maximum benefits

{Fluoride treatment: $22.4}

{Scale & clean: $79.5}

{Surgical tooth extraction: $169.6}

{Periodic oral examination: $41.1}

Hearing aids

Waiting period:  36 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per policy}

Examples of maximum benefits

{Hearing aid: 100% of charge}

Home nursing*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

Examples of maximum benefits

{Initial visit: 100% of charge}

{Subsequent visit: 100% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,600 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Full crown veneered: $1159.6}

Non PBS pharmaceuticals

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$800 per policy}

Examples of maximum benefits

{Per eligible prescription: $51}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

Examples of maximum benefits

{Initial visit: $69.8}

{Subsequent visit: $50.9}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$300 per policy}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic*

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,500 per policy}

{$3,500 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 100% of charge}

Orthotics (podiatric orthoses)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for orthotics (podiatric orthoses) & podiatry}

Examples of maximum benefits

{Orthotics supply & fit: 100% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$750 per policy}

{combined limit for chiropractic & osteopathy}

Examples of maximum benefits

{Initial visit: $69.3}

{Subsequent visit: $48.7}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per policy}

Examples of maximum benefits

{Initial visit: $69.3}

{Subsequent visit: $55.3}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

{combined limit for orthotics (podiatric orthoses) & podiatry}

Examples of maximum benefits

{Initial visit: $60.8}

{Subsequent visit: $47.4}

Psychology

Waiting period:  0 month

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

Examples of maximum benefits

{Initial visit: $158.67}

{Subsequent visit: $137.97}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$500 per policy}

{combined limit for acupuncture, chinese medicine, exercise physiology & remedial massage}

Examples of maximum benefits

{Initial visit: $68.9}

{Subsequent visit: $46.4}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per policy}

Examples of maximum benefits

{Initial visit: $107.6}

{Subsequent visit: $61.8}

- Health appliance and external prostheses, (contact Medibank for further information) $600 per annum, 2 mth waiting period, fixed amount back per item up to annual limit. - Laser Eye Surgery (where no Medicare benefit is payable) $3,500 per lifetime limit, 36 mth waiting period, 100% back up to lifetime imit. - Blood pressure monitor (24 mth waiting period) and Breathing appliances (12 mth waiting period) included with Blood glucose monitors. - Health subscriptions (refer to Medibank for approved organisations) $100 per annum, 2 mth waiting period, 100% per subscription up to annual limit. - Health screening tests (where no Medicare benefit is payable) $200 per annum, 2 mth waiting period, 100% per test up to annual limit. Refer to Medibank for approved screening tests. - Private hospital accident and emergency facility fees, $250 per annum, 2 mth waiting period, 100% back up to annual limit. - Teeth whitening (must be provided by recognised dentist), $250 per annum, 2 mth waiting period, fixed amount payable. - Counselling (no waiting period) shares an annual limit with Psychology. Please contact Medibank for more information.

This policy does not include General treatment (Extras) cover for

Ante-natal/Post-natal classes
Audiology
Health management / Healthy lifestyle
Vaccinations

Other features of this general treatment cover: Comprehensive hospital and extras cover in one convenient package. Widest range of extras services including laser eye surgery, teeth whitening and much more. Our highest annual limits. Easy online and electronic claiming.

Ambulance cover

In VIC 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.

Other features of this ambulance cover: 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.

Insurer Details

Medibank Private Limited

Medibank Gold Ultra Health Cover

$716.05 / month

(Before Rebate, Discount & Loading)

Available in VIC

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/MBP/J20/VCFK10

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