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nib health insurance at a glance

  • nib is one of Australia’s fastest growing health funds since it was established in 1952
  • Provides over 1.5 million Australians and New Zealand residents with health and medical insurance
  • Plays an active role in their community through the nib foundation and their reconciliation action plan.

About nib health insurance

Since 1952, nib has been committed to giving its members access to better health information, tools and services. By increasing health literacy, promoting healthy behaviours and reducing preventable diseases, nib proves to be more than just an insurance company.

Through the nib foundation, they have raised almost $25 million in funding for community health and wellbeing initiatives and committed almost 4,000 hours of their time to volunteer in their communities.

What does nib health insurance cover?

Nib offers a range of hospital and extras cover products for people at all life stages. Whether you’re a single and looking to maintain your health with extras cover, or a couple looking to give birth in a private hospital, nib has you covered.

Hospital cover

Nib hospital insurance covers you for hospital treatment as a private patient for services listed on the Medicare Benefits Schedule (MBS). With hospital cover, you can avoid public waiting lists, choose your treating doctor and stay in a private room (on availability).

Nib offers a full range of hospital cover products, with Basic, Bronze, Silver, Gold and Plus tiered policies. All nib hospital products also cover you for emergency ambulance services and accidental injury.

Extras cover

With nib extras cover, you can claim for services outside of hospital that aren’t paid for by Medicare. This includes services like dental, physiotherapy and optical.

Nib believes in giving its members the freedom of choice. That’s why nib will cover you for treatment at any recognised healthcare provider, provided the service is covered under your policy. Alternatively, you can visit a nib First Choice dentist, optometrist or physiotherapist and receive lower treatment fees and exclusive offers.

This information is current as of January 2023. For the full details of what’s covered on a nib health insurance policy, refer to the relevant policy documents.

Why choose nib health insurance?

  • Receive a 4% discount when you pay with direct debit (not applicable for Ambulance or Overseas cover)
  • Their easy-to-use app lets you check your extras limits, manage your cover and search for local healthcare providers
  • Take advantage of exclusive offers, discounts and promotions from a range of great brands
  • 100% back on dental check-ups at nib Dental Care Centres
  • Get 10% off nib travel insurance. Terms and conditions apply.

Frequently asked questions

Is ambulance cover included with nib health insurance?

Yes, you’re covered for emergency ambulance services on all nib extras and hospital products. You can also choose to take out ambulance-only cover. With nib ambulance cover, you’ll be covered for 100% of the ambulance service fee for emergency ambulance transport to hospital provided by a State or Territory government service. Ambulance cover is not available to members covered by their State ambulance scheme. A one-day waiting period applies.

Does nib health insurance cover pre-existing conditions?

Yes, as with all Australian health funds, nib will cover you for pre-existing conditions for treatment in hospital. However, you may need to serve a 12-month waiting period for treatment relating to your pre-existing condition.

A pre-existing condition won’t affect your cover for extras services.

Does nib health insurance have waiting periods?

Yes, the waiting periods are standard across all health funds for hospital cover. These are 12 months for pregnancy and birth and pre-existing conditions (excluding rehabilitation, psychiatric and palliative care), and 2 months for everything else.

For nib extras cover, the waiting periods are typically between 2 and 12 months, except for hearing aids which have a 36-month waiting period. Longer waiting periods are typically reserved for more expensive services that are claimed less often. This prevents people from signing up, claiming on a high-value product and cancelling their cover, which would raise premiums for everyone else.

How do I make a health insurance claim with nib insurance?

When you’re treated in hospital as a private patient for a service covered by your policy, the hospital will send the bill straight to nib, who will settle your account and reach out to you to pay any excess or out-of-pocket expenses.

For extras services, you can simply scan your nib membership card at your provider’s HICAPS machine or claim through their easy-to-use mobile app. Alternatively, you can pay upfront, fill out a claims form and send it to nib, who will reimburse you for your extras benefit.

How can I pay for my nib health insurance and is it cheaper to pay my premium annually?

You can choose to pay your nib health insurance premiums weekly, fortnightly, monthly, quarterly, half-yearly or yearly. Nib offers a range of payment options, including BPAY credit or debit card, mail or direct debit.

When you pay by direct debit, you can receive a 4% discount (not applicable for ambulance or overseas cover). While there’s no discount for paying annually, you can pay your premiums up to 13 months in advance, which could save you money by locking in a lower rate before the annual rate rise.

Do I have to pay an excess with nib health insurance?

Yes, with nib hospital cover, you’ll typically be required to pay an excess on the first hospital admission of the calendar year, although terms may vary between policies. You’ll need to pay this excess before receiving any treatment. Some hospital products will waive the excess for child dependants.

On select nib hospital insurance policies, you can elect to pay a higher excess in exchange for a lower premium or vice versa. This might be a good idea if you’re getting cover for the unexpected and don’t think you’ll be admitted to the hospital any time soon.

How do I cancel my nib health insurance?

To cancel your nib health insurance policy, simply give them a call and their friendly customer service team will walk you through the cancellation process. Alternatively, you could suspend your cover for a set period instead of cancelling due to financial hardship or international travel.

Compare health insurance today

Want to see how nib private health insurance measures up to other funds in the market? With our free comparison tool, you can see policies from our panel of trusted health funds side-by-side to compare their benefits, costs, exclusions and more.

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