(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 cover is available to select nib corporate groups
This policy exempts you from the Medicare Levy Surcharge.
This policy does not provide accident cover or benefits for travel and 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 $300 per admission. This is limited to a maximum of $300 per person and $600 per policy per year.
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 our FirstChoice providers, you may 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.
| Note, for items marked with an asterisk *: Benefit paid after current PBS patient contribution deducted | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental | 2 | $1,500 per policy (combined limit for general dental, major dental, endodontic & orthodontic) | Periodic oral examination - 100% of charge Scale & clean - 100% of charge Fluoride treatment - 100% of charge Surgical tooth extraction - 80% of charge |
| Major dental | 12 | Full crown veneered - 65% of charge | |
| Endodontic | 12 | Filling of one root canal - 80% of charge | |
| Orthodontic | 12 | Braces for upper & lower teeth, including removal plus fitting of retainer - 65% of charge | |
| Optical | 6 | $200 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals* | 2 | $500 per policy | Per eligible prescription - 100% of charge |
| Physiotherapy | 2 | $700 per policy (combined limit for physiotherapy, ante-natal/post-natal classes, exercise physiology, eye therapy (orthoptics), occupational therapy & speech therapy) | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Chiropractic | 2 | $700 per policy (combined limit for chiropractic, acupuncture, remedial massage, dietetics/dietary advice, osteopathy & other services) | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Podiatry | 2 | $200 per policy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Acupuncture | 2 | Combined limit - see Chiropractic | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Remedial massage | 2 | Combined limit - see Chiropractic | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Hearing aids | 36 | $600 per policy 2 appliance(s) every 5 years (combined limit for hearing aids, blood glucose monitors & other services) | Hearing aid - 100% of charge |
| Blood glucose monitors | 12 | Per monitor - 100% of charge | |
| Ante-natal/Post-natal classes | 2 | Combined limit - see Physiotherapy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Dietetics/dietary advice | 2 | Combined limit - see Chiropractic | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Eye therapy (orthoptics) | 2 | Combined limit - see Physiotherapy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Home nursing | 2 | $1,000 per policy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Occupational therapy | 2 | Combined limit - see Physiotherapy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Orthotics (podiatric orthoses) | 2 | $200 per policy | Orthotics supply & fit - 100% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Speech therapy | 2 | Combined limit - see Physiotherapy | Initial visit - 100% of charge Subsequent visit - 100% of charge |
| Combined Other Therapies ($700) includes antenatal services (No benefit for post-natal services), exercise physiology, eye therapy, occupational therapy, physiotherapy and speech pathology. Chiropractic / Osteopathy / Natural Therapies ($700) includes acupuncture, chiropractic, dietary advice, osteopathy and remedial massage. hearing aids / Artificial aids ($600) e.g. spacer, peak flow meter, nebuliser, Irlen lens. Orthopaedic shoes/boots ($130). Non-PBS pharmaceuticals have a sub limit of $150 for Weight Management Medication. | |||
| Psychology | Other treatments - check with your insurer |
Of course you can see your choice of provider, but by choosing an nib First Choice provider, you may have less to pay towards the cost of your treatment. We’ve created the nib First Choice network to help you access quality healthcare when you need it most. These health providers will deliver quality care and value for money and a better deal for you and your family. We’ve locked in lower costs with nib First Choice providers, so you can enjoy competitive treatment fees when you visit the dentist or a discount the next time you claim for glasses.
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.