Unsure what you’re covered for and want to get the most from your membership? We’ve created an easy guide to check what you’re covered for, and answered some frequently asked questions.
Am I covered for an Emergency?
Most of our health cover packages include unlimited emergency ambulances with a one-day waiting period*. Find out what's covered on our Ambulance cover page, or head to what to do in an emergency to find out more.
What is Hospital cover?
It’s all in the name, with Hospital cover helping to cover your costs in hospital. Before heading off to hospital, take a look at our going to hospital guide to find out what options you have and learn how to get the most from your cover.
What's covered when you go to the hospital?
Both nib and Medicare may help cover the cost of your hospital fees. However, not all services will be covered, so see what is covered to find out more.
What are out of pocket expenses?
Out of pocket expenses are when you are charged more for a medical service than what you get back from your health cover and Medicare. These fees will depend on the specific hospital and doctor you choose. However, by choosing a specialist that participates in nib Medigap and an nib Agreement Hospital, you may be able to significantly reduce your out of pocket expenses. Use the find a provider tool to find a hospital or specialist in your area.
What are international members covered for?
International members can check what they are covered for by logging into your Member account or the nib App. If you’re looking to switch, extend or join an nib health cover, check out our Overseas Student Health Cover (OSHC) or Overseas Visitors Health Cover (OVHC) to discover what is included in our international health covers.
How do I know if I'm covered for a procedure or treatment?
In your member account, you can search your medical item number in our Going to Hospital tool to see if you are covered for a procedure or treatment. You can also read through our going to hospital guide to help you prepare for your upcoming admission.
What are in- vs. out-patient services in the hospital?
The difference between inpatient and outpatient services depends on if a patient has been formally admitted to hospital for medical treatment. Whether you are an in- vs. out-patient will impact your hospital costs and cover.
For more information, check out Inpatient Vs. Outpatient: What’s the difference?
Does health insurance cover x-rays?
Most of the time, x-rays you get while you’re an in-patient in a private hospital will be covered, but you are generally not covered for outpatient x-rays. To check if x-rays are covered in your health insurance, login to
your member account.
How can I see which hospitals and specialists offer the best value?
Use the find a provider search to find specialists and hospitals in our network in your local area.
What are the waiting periods?
Whenever you join or update your health cover, a ‘waiting period’ is in most cases, required. This is the time frame you must wait before claiming any benefits on your health cover. For more information, visit our waiting periods page.
Still have questions?
* Emergency Ambulance cover is not available to: (i) QLD & TAS residents who have ambulance services provided by their State ambulance schemes; (ii) TAS residents who are covered under state ambulance schemes in TAS and when travelling in mainland Australia except NSW, SA or QLD; or (iii) pension and health care card holders who have ambulance services provided by State ambulance schemes (check entitlements with Centrelink if unsure).