healthslips.com.au Policy Information

Medibank Private Limited

Basic Plus Everyday Essentials

$393.30 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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: Two adults (and no-one else).

Policy ID: MBP/J28/NDWN20

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
Dental surgery
Hernia and appendix
Hospital psychiatric services
Joint reconstructions
Palliative care
Rehabilitation
Tonsils, adenoids and grommets

This policy does not include 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
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
Implantation of hearing devices
Insulin pumps
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Pregnancy and birth
Skin
Sleep studies
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: You will have to pay an excess of $250 per admission. This is limited to a maximum of $250 per person per year.

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
  • 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

This policy only provides full benefits for appendix removal, surgical removal of wisdom teeth, removal of tonsils and adenoids, knee and shoulder reconstructions and investigations and treatment for injuries sustained in an accident after joining this cover

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

$400 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services

  • Initial visit: $27
  • Subsequent visit: $20
Chinese medicine 2

$400 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services

  • Initial visit: $16
  • Subsequent visit: $16
Chiropractic 2

$400 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services

  • Initial visit: $41.3
  • Subsequent visit: $28.4
Dietetics/dietary advice 2

$400 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services

  • Initial visit: $44.8
  • Subsequent visit: $24.6
Endodontic 12

$400 per person

combined limit for endodontic, general dental & major dental

  • Filling of one root canal: $105.3
Exercise physiology* 2

$400 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services

  • Initial visit: $16
  • Subsequent visit: $10
General dental* 2

$400 per person

combined limit for endodontic, general dental & major dental

  • Fluoride treatment: $14.2
  • Scale & clean: $46
  • Surgical tooth extraction: $113.7
  • Periodic oral examination: $23.5
Major dental 12

$400 per person

combined limit for endodontic, general dental & major dental

  • Full crown veneered: $400
Optical 6

$200 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Physiotherapy 2

$400 per person

combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services

  • Initial visit: $37.7
  • Subsequent visit: $31.5
Remedial massage 2

$100 per person

  • Initial visit: $37.8
  • Subsequent visit: $25.5

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $27}

{Subsequent visit: $20}

Chinese medicine

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $16}

{Subsequent visit: $16}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $41.3}

{Subsequent visit: $28.4}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $44.8}

{Subsequent visit: $24.6}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for endodontic, general dental & major dental}

Examples of maximum benefits

{Filling of one root canal: $105.3}

Exercise physiology*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $16}

{Subsequent visit: $10}

General dental*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for endodontic, general dental & major dental}

Examples of maximum benefits

{Fluoride treatment: $14.2}

{Scale & clean: $46}

{Surgical tooth extraction: $113.7}

{Periodic oral examination: $23.5}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for endodontic, general dental & major dental}

Examples of maximum benefits

{Full crown veneered: $400}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$200 per person}

Examples of maximum benefits

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

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

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person}

{combined limit for acupuncture, chinese medicine, chiropractic, dietetics/dietary advice, exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: $37.7}

{Subsequent visit: $31.5}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$100 per person}

Examples of maximum benefits

{Initial visit: $37.8}

{Subsequent visit: $25.5}

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

Ante-natal/Post-natal classes
Audiology
Blood glucose monitors
Eye therapy (orthoptics)
Health management / Healthy lifestyle
Hearing aids
Home nursing
Non PBS pharmaceuticals
Occupational therapy
Orthodontic
Orthotics (podiatric orthoses)
Osteopathy
Podiatry
Psychology
Speech therapy
Vaccinations

Ambulance cover

In NSW & ACT 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

Basic Plus Everyday Essentials

$393.30 / month

(Before Rebate, Discount & Loading)

Available in NSW & ACT

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/J28/NDWN20

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