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Managing your family’s cover

No matter what shape or size your family is, it’s important to make sure the whole family is taken care of.

Pregnancy and newborns

If you’re planning on having a baby, make sure you have the right level of health cover. Pregnancy isn’t covered on every nib policy, so you need to choose a Gold level cover which includes pregnancy and birth-related services.

A 12 month waiting period will apply if you are a new member or have just upgraded your level of cover. If you are moving over to us from a different health fund and you have already served your pregnancy waiting periods, you won’t have to re-serve them.

This means that if you’re planning a baby, and you’d like to use your health insurance to go to a private hospital, you’ll need to be on a health cover that includes pregnancy at least three months before you start trying to fall pregnant.

Please note, if you do need to be admitted for a pregnancy-related complication (such as preeclampsia) but haven't yet served your waiting period in full, you won't be covered.

Contact us to ensure you have an appropriate level of cover.

How to add a newborn to your health cover
If you already have a family health cover when your baby comes along, simply contact us to add your baby’s name to your cover. Your baby should be added to the policy within 24 months of birth to have the same health cover entitlements as the longest serving parent.

If you have a singles or couples policy, you'll need to upgrade to a family cover within two months of your baby's birth to ensure they don't need to serve any waiting periods.

Child dependants

A child dependant is someone who is under the age of 21 and is not married or in a defacto relationship.

Good news for families

On most of our family covers, you won’t need to pay an excess if one of your kids (up to 21 years of age) has to go to hospital. Please call us to confirm your cover details.

Student dependant

A student dependant is a full-time student, single (not married or in a defacto relationship) and aged between 21 and 25. This person is covered under the family’s health cover at no extra cost.

Adult dependant

An adult dependant is someone aged between 21 and 25, single (not married or in a defacto relationship) and not studying full-time, who can be added to your family’s cover for an additional fee determined by us.

Frequently asked questions

Q: Are ultrasounds, obstetrician or doctor consultations covered?

A: Any ultrasounds, obstetrician or doctor consultations during your pregnancy are considered outpatient services - which means they are not claimable with nib. Medicare may cover some of the costs involved in these consultations.

Q: What happens if my baby needs immediate treatment?

A: Your baby will be covered for services that the longest serving parent on the policy is covered for. You’ll still need to add your baby to your policy within an appropriate time frame.

Q: What happens if my baby arrives prematurely and I’m still within my waiting periods?

A: As long as your baby’s Expected Delivery Date (also known as Confinement Date) is after you've served your pregnancy waiting period, you'll be covered for the birth. If you’re concerned your baby will arrive early, we will need a letter from your obstetrician and/or a scan showing the Expected Delivery Date so we can confirm your baby is due after your waiting period ends.

For example, if your waiting period for pregnancy ends on 10 October but your baby is due on 11 October, and you’re concerned the baby might come early, you’ll need to provide us with a Expected Delivery Date letter and/or scan showing the baby is due 11 October.

Q: Does nib cover IVF services?

A: We can cover some of the costs relating to IVF and GIFT inpatient services depending on your level of cover, if the hospital is an nib Agreement Hospital, and how much the specialist charges.

Most of the IVF process is as an outpatient, which means you will most likely have large out of pocket expenses. Outpatient specialist fees or other outpatient fees in relation to assisted reproductive services (for example, laboratory and storage fees) are not covered.

As with pregnancy cover, there is a 12 month waiting period to be able to claim for this service. Any ultrasounds, obstetrician or doctor consultations during pregnancy are considered outpatient services which means they are not claimable with nib. Medicare may cover some of the costs involved in these consultations.

Q: How do I add a foster child to my health cover?

A: A foster child is placed with a person or family to be cared for, usually by local welfare services or by court order. Foster children can also be in the care of their grandparents, aunt, uncle or other extended family members.

To add a foster child to your policy, you will need to provide at least one supporting document from a solicitor or family welfare to nib. The documentation must state the date the child has come into your care.

Some examples of supporting documentation include:

  • Medicare card showing the child/children in your care

  • Confirmation from Centrelink that you receive support payments for the child/children

  • A will granting care to you

  • A court order

  • A statutory declaration from the parent stating that they have relinquished care to you

  • A letter from the foster association

Foster children and state ward children must serve all relevant waiting periods unless transferring from another registered health fund.

Q: How do I add my adopted child to my health cover?

A: To add an adopted child to your policy, you will need to provide nib with documentation from the court that shows the child has been legally adopted and the date the child came into your care. The child will be given immediate cover and won’t have to serve waiting periods.

Q: How do I add or remove someone from my policy?

A: To add or remove someone from your policy please contact us. Adding or removing a member may mean that you need to change the cover you’re on.

Q: Is a dependant completing an apprenticeship an adult or student dependant?

A: An apprenticeship counts as employment so they’ll need to be added as an adult dependant.

Q: What if I’m no longer a dependant?

A: If you have finished full-time study or turned 25, you’ll most probably need to move off your family’s cover and onto your own health cover. To make sure you don’t have to re-serve any waiting periods, you'll need to get health cover that is equal to or lesser than your family’s health cover.

If you have a break between coming off your family's cover and getting your own, you might have to re-serve waiting periods. To avoid that, get your own nib health cover organised within 30 days of coming off your family’s cover. You'll need to make sure it's backdated (and the difference paid for) to start when you came off your family’s cover, or to when you turned 25.

If you're switching to your own nib health cover from a different health insurer, you'll have 59 days to join without affecting your continuity of cover.

Get your bank details, Medicare card and the name of your family's health fund (if it isn’t nib, of course!) and join online today.

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