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MediGap

Medical gap cover for our members.

Please see below for our most up to date MediGap Terms and Conditions.

What is MediGap

nib MediGap aims to eliminate the out of pocket costs nib members pay for inpatient medical and surgical fees. The MediGap benefit is higher than the Medicare Benefits Schedule (MBS) benefit, as outlined in more detail in the MediGap Schedule of Benefits.

As a registered MediGap provider, you have the right to decide on a case-by-case basis if you wish to participate. When you participate in MediGap for a patient, you agree not to charge the nib member any out of pocket costs for their inpatient service. The benefits to you as a provider include receiving faster payment from nib, not having to chase your patients for payment of their invoice, and being listed in our MediGap specialist search directory.

To claim MediGap benefits, you must first be registered for MediGap. You, the patient, and the claim must also meet the eligibility criteria set out in the MediGap Terms and Conditions.

MediGap Terms and Conditions have been updated.

nib is making changes to our policies to reflect our commitment to sustainability in the communities in which we operate and across our contracted relationships with providers of services and goods to nib and its members.

The Australian Government recently introduced the Modern Slavery Act 2018 (Cth), which mandates that businesses which meet the relevant revenue threshold, including nib, must report on the risks of modern slavery in their supply chains. nib has embraced both these legislative requirements and the broader ethos of the fight against modern slavery.

nib has introduced a Supplier Code of Conduct (Code) because we recognise that how we conduct ourselves as a business impacts on the communities in which we operate. The Code sets out the commitments and principles we expect of all our supply chain partners including healthcare providers. We ask that you read the Code as we expect that you will act in accordance with the Code at all times in your provision of services to nib and its members.

We’ve updated our terms and conditions

We've updated our MediGap terms and conditions to support our stance against modern slavery. This includes the introduction of a new paragraph 10 (Modern Slavery), under which you are required to comply with the Code and modern slavery laws.

Please review the updated MediGap Terms and Conditions.

Innovative digital tools

nib members can search for a specialist who is registered to participate in MediGap in the following ways:

  • Using our Going to Hospital tool in Online Services
  • Through the find a provider tool on the nib website or on the nib App

MediGap FAQs

Male and female looking at some documents with a cup of coffee

More than 1 million Aussies trust nib with their health insurance.

Register to participate in MediGap and we'll introduce you to our members through our innovative specialist search tools.

Did you know?

nib underwrites APIA Health Insurance, Qantas Health Insurance, Suncorp, AAMI and United Healthcare Global for Medicare eligible residents in Australia.

The MediGap Schedule of Benefits for nib patients also applies for these customers.

Contact us

Registrations and updating details

For MediGap claim enquiries