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What is covered?

nib Hospital cover pays an amount towards your treatment depending on your level of cover and the hospital you choose to stay in (nib Agreement Private Hospital, non-agreement private hospital or any public hospital).

Before going to hospital, you should always check what you’re covered for. Contact us or log in for more information.

What's covered when you go to hospital?

Combined with Medicare, your health insurance will help cover the cost of your treatment as a private patient in a private hospital. However, it’s important to remember that health insurance will only pay benefits for services included in your hospital cover. Providing your procedure is covered and you attend an nib Agreement Private Hospital (or any public hospital as a private patient) nib covers you for:

  • Hospital accommodation (i.e. your bed and a private room if one is available)
  • Operating theatre fees
  • Intensive care fees
  • Labour ward fees
  • Meals
  • Common treatments and support treatments*
  • Associated treatment for complications and associated unplanned treatment^

nib will also cover the following in-line with our agreement with the hospital. You may have an out of pocket expense in some cases for these services:

  • Pharmaceuticals related to and provided during your admission. Any prescription medication dispensed on the discharge day may be claimable through your Extras cover but only if claimed at a pharmacy that is not on the hospital grounds
  • Other allied health services relevant to your treatment and provided during your admission such as physiotherapy, hydrotherapy or occupational therapy
  • Dressings, sutures, needles and other disposable items.

Please refer to the Policy Booklet for more information about what’s covered in hospital.

What’s not covered?

There are some things that are not covered. Excluding these services helps to keep the cost of your health insurance down.

  • Luxury rooms and private room accommodation for same day procedures
  • TV hire, phone calls, newspapers, magazines, beauty salon services
  • Respite care
  • Take home items like crutches and drugs
  • Experimental treatments (and their disposable items) not recognised by Medicare
  • Procedures normally performed in a doctors surgery
  • Private hospital emergency fees
  • Donated blood, blood products, blood collection and storage
  • Outpatient services performed by a doctor or specialist
  • Theatre or specialist fees for procedures performed by a Podiatric Surgeon as these services are not eligible for a rebate through Medicare

Are you an Overseas Students Hospital Cover (OSHC) customer?

Enjoy peace of mind knowing you are covered for hospital treatment and accommodation. As an nib member you have the choice of being admitted to a public or private hospital. Private hospitals allow you to avoid long public hospital waiting lists and allow you to choose your preferred specialist. Learn what your Hospital cover includes.

You should always check what you're covered for before you go to hospital. Contact us so we can help you keep any extra expenses to a minimum.

*Common treatments means a number of Medical Benefits Schedule (MBS) items commonly used across services covered by your policy. Support treatments means a number of MBS items used to support a principal treatment covered by your policy. Common and support treatments will be covered in line with the level of cover your product provides for the principal treatment. Refer to the Policy Booklet for more information.

^Associated treatment for complications means treatment provided during an episode of covered hospital treatment to address a complication that arises during that episode. Associated unplanned treatment means unplanned treatment provided during an episode of covered planned surgery that is, in the view of the medical practitioner providing the unplanned treatment, medically necessary and urgent. Associated treatments will be covered in line with the level of cover your product provides for the principal treatment. Refer to the Policy Booklet for more information.

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