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At Medibank, we are motivated by improving the health of our customers and Australians. We are passionate about building a better health system that is centered on people and sustainable in the long term.
Medibank OSHC Insurance - Marketplace
Medibank is a leading private health insurer, with more than 40 years of experience delivering better health to Australians. We look after the health cover needs of more than 3.7 million customers through our Medibank and ahm brands and distribute travel, life, and pet insurance.
In addition, Medibank provides a range of health services in Australia including mental health support, preventative and better-integrated primary, care, and after-hours health support.
Medibank Private Limited is listed on the Australian Securities Exchange (ASX: MPL) and is headquartered in Melbourne.
Recruitment markets
insurance is available for all markets around the world.
Destination market
Australia.
Product
Essentials OSHC
Hospital cover
Hospital cover can pay towards services you receive when you’re admitted to the hospital and treated as a private patient. Here are the hospital services that are Included or Excluded under your cover. You may still incur out-of-pocket expenses above the amount we pay. Before booking your treatment, call us to find out the benefits you can expect to receive, and any out-of-pocket expenses you might incur.
Medical cover
Your cover includes benefits towards medical services provided by a doctor, that are listed in the government’s Medicare Benefits Schedule (MBS).
The MBS is a list of medical services and corresponding fees. For Included services, We pay 100% of the MBS fee for In-hospital medical services provided as part of an Included service (for example, surgeon fees, anesthetist fees).
General practitioner (GP) consultations. We pay 85% of the MBS fee for other medical services provided out-of-hospital (for example, specialists, pathology, and x-rays), except for Assisted reproductive services.
Allied Health services billed with an MBS item number (for example, eye checks and services related to chronic disease and mental health management plans). You must pay any difference between the benefit we pay and the actual fee charged by the doctor.
Prescription medicines (pharmaceuticals)
Essentials OSHC provides benefits (up to annual limits) towards the cost of eligible prescription medicines.
You will be required to pay a set contribution towards the cost of each eligible prescription medicine before we pay any benefits.
For eligible prescription medicines:
Member contribution - $30
The amount we’ll pay (maximum per item) - -$70
Annual limit - Single membership - $300
Annual limit - Couple/Family membership - -$300 per member / $600 per membership
- If the cost of the prescription medicine is higher than the benefit we pay, you must pay the difference.
- Benefits are payable only for prescription-only medicines prescribed by a doctor (GP or specialist) to treat an illness, injury, or condition.
- We don’t pay benefits towards medicines prescribed for a contraceptive or cosmetic purpose or for prescription medicines that relate to a service that is an Excluded service.
It’s important to note that you may have large out-of-pocket expenses if you need treatment that uses high-cost pharmaceuticals (for example, cancer treatment).
Things you need to know about your OSHC
Annual limits
An annual limit is the maximum amount of benefits payable per member and/or per membership, within a calendar year (1 January to 31 December).
Waiting periods
A waiting period applies when you join Essentials OSHC. We won’t pay benefits for any items purchased or services received while you are serving a waiting period.
Switching from another health insurer?
You may not need to re-serve waiting periods if you join Essentials OSHC within two months of leaving your previous Australian health insurer, and you’ve already served the waiting period for that service.
Waiting periods
None: Ambulance services. Out-of-hospital medical services (e.g GP consultations). Prescription medicines. Hospital psychiatric services (including those which are pre-existing conditions). Treatment for conditions requiring hospitalization that are not deemed pre-existing conditions.
12 months: Pre-existing conditions An ailment, illness, or condition that, in the opinion of a medical practitioner appointed by us, the signs or symptoms of which existed at any time in the six months before the day that you became insured under Essentials OSHC. Pregnancy and birth.
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