(before any rebate, loading or discount)
Covers two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults)
Available in Victoria
# 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 children, students up to and including the age of 30 and non-students up to and including the age of 30, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.
This policy exempts you from the Medicare Levy Surcharge.
This policy provides accident cover - check with your insurer for details.
This policy does not provide benefits for travel or accommodation (outside of hospital).
| Assisted reproductive services | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| 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) | Hospital psychiatric services | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Cataracts | Implantation of hearing devices | Pregnancy and birth |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Insulin pumps | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Joint replacements | Sleep studies |
| Dialysis for chronic kidney failure | Kidney and bladder | Tonsils, adenoids and grommets |
| Digestive system | Lung and chest | Weight loss surgery |
| Ear, nose and throat | Male reproductive system |
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: You will have to pay an excess of $750 per admission. This is limited to a maximum of $750 per person and $1500 per policy per year.
Excess payments do not apply to hospital admissions for dependants.
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.
Our Going to Hospital Pack provides more ways to reduce out-of-pockets, ask us for your copy.
By using nib's First Choice providers, you will have lower out-of-pocket costs on many allied health services. A list of "preferred providers" is available from the health insurer. See https://www.nib.com.au/find-a-provider.
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
|---|---|---|---|
| General dental | 2 | $1,000 per person (no limit on preventative dental) | Periodic oral examination - 75% of charge Scale & clean - 75% of charge Fluoride treatment - 75% of charge |
| Major dental | 12 | $1,300 per person (combined limit for major dental & endodontic) | Surgical tooth extraction - 75% of charge Full crown veneered - 75% of charge |
| Endodontic | 12 | Filling of one root canal - 75% of charge | |
| Orthodontic | 12 | $800 per person $2,600 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 75% of charge |
| Optical | 6 | $350 per person | Single vision lenses & frames - 75% of charge Multi-focal lenses & frames - 75% of charge |
| Non PBS pharmaceuticals | 2 | $500 per person | Per eligible prescription - 75% of charge |
| Physiotherapy | 2 | $600 per person (combined limit for physiotherapy & other services) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Chiropractic | 2 | $500 per person (combined limit for chiropractic, osteopathy & other services) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Podiatry | 2 | $400 per person (combined limit for podiatry, orthotics (podiatric orthoses) & other services) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Psychology | 2 | $500 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Acupuncture | 2 | $450 per person (combined limit for acupuncture, remedial massage, chinese medicine & other services - Sub-limits apply) | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Remedial massage | 2 | Initial visit - 75% of charge Subsequent visit - 75% of charge | |
| Hearing aids | 36 | $1,200 per person 2 appliance(s) every 5 years (combined limit for hearing aids & other services) | Hearing aid - 75% of charge |
| Blood glucose monitors | 12 | $500 per person 1 appliance(s) every 1 year (combined limit for blood glucose monitors & other services) | Per monitor - 75% of charge |
| Ante-natal/Post-natal classes* | 2 | $300 per person | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Chinese medicine | 2 | Combined limit - see Acupuncture | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Dietetics/dietary advice | 2 | $700 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Exercise physiology | 2 | $400 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Eye therapy (orthoptics) | 2 | $300 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Health management / Healthy lifestyle | 6 | $200 per person | Health management - 75% of charge |
| Home nursing | 2 | $200 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Occupational therapy | 2 | $550 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Orthotics (podiatric orthoses) | 2 | Combined limit - see Podiatry | Orthotics supply & fit - 75% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Speech therapy | 2 | $450 per person | Initial visit - 75% of charge Subsequent visit - 75% of charge |
| Preventative Tests ($200) e.g. thin prep, bone density testing, bowel screening (Service limits apply). Health Aids ($500) e.g. spacer, peak flow meter, nebuliser, Irlen lens. Myotherapy: combined limit of $450 with acupuncture, remedial massage and Chinese herbalism. Sublimit of $250 for Remedial Message. Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT). Healthier Lifestyle ($200) includes nib approved weight management, quit smoking and health management programs (gym, personal trainer) and more. Use nib Rewards to access a range of rewards and discounts on services like groceries, petrol, entertainment, health, wellbeing and more! For Preventative dental service limits apply. Non-PBS pharmaceuticals have a sub limit of $150 for Weight Management Medication. | |||
| Other treatments - check with your insurer |
By choosing an nib First Choice provider it means you could pay less on dental treatment, physiotherapy and optical. Service limit apply to Preventative dental, Optical, Orthotics, Hearing Aids & Hearing Aids Repair, Health Aids and Preventative Test.
In Victoria 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.
All our health covers include unlimited emergency ambulance (1 day waiting period on all emergency ambulance). Emergency ambulance is when you need immediate transport by a State or Territory ambulance to get to a hospital or other facility for urgent medical treatment. No annual limits for emergency ambulance apply.
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.