Chemotherapy

nib partners with experienced and reputable health professionals who enable eligible patients to receive health care treatments from the comfort of their home where appropriate. Search registered providers with our Find a Provider tool.

To be eligible, your patient must:

• Be a member of nib or GU Health (Australian residents only), this includes anyone who holds a health insurance policy underwritten by nib but sold under third party brands such as Qantas, APIA, Suncorp, AAMI, ING, Australian Seniors, Real Insurance and Priceline.

• Be 18 years old and above

• Have a hospital product which includes chemotherapy services & have served all relevant waiting periods

• Requires IV chemotherapy or subcutaneous or intramuscular chemotherapy for cancer

• Suitable to complete chemo at home as clinically assessed by their specialist

nib Fund Rules, opens in a new tab and Policy Booklet Terms, opens in a new tab apply.

Included:

• Services covered are to be in line with services covered for an admitted patient in hospital

• Other services or infusion services that are required to be paid with MBS item 13950 (chemotherapy)

• PBS Medication (for intended use)

• Hospital substitution services only

• Prosthesis only associated with MBS item number 13950 and paid in line with PL

• Patients switching from public to private

Excluded:

• Out-patient delivered chemotherapy

• Type C chemotherapy services

• Other infusion services not related to MBS item 13950 (chemotherapy)

• Orally or topically applied chemotherapy

• Clinical trials (we would still pay for the normal delivery of chemotherapy as part of the clinical trial)

• High-cost drugs

• International / NZ members

• Cancellation fees (to be covered by patient if due to patient fault)

• Patients who are on frequent/daily treatments who find it difficult to travel to a hospital

• Patients who don't have a good support network for attending hospital appointments

• Patients with families that need to take time off work to drive loved ones to appointments

• Patients who find it difficult to attend appointments during regular office hours

• Frail or elderly patients with other co-morbidities

• Patients with young families

• Patients who are clinically appropriate to receive chemotherapy in the home treatment.

Please contact the provider with the most clinically appropriate service for your patient for more information on program locations. You can use the Find a Provider tool to locate a provider.

If your patient meets the eligibility criteria above and you consider that they are clinically suited to the program, nib Health Care @ Home – Chemotherapy at Home, will be covered with no out of pocket expenses.

Members do not need to pay an excess for Chemotherapy at Home. However, if they are admitted to the hospital as an in-patient at any point, they must pay the excess (where applicable).