Compare Medibank health insurance


Launched in 1976, Medibank is today one of Australia's largest health funds.

Fund information


Medibank summary

Is Medibank nonprofit? 

Does Medibank get many complaints from members? 

How good is Medibank's gap cover? 

How many hospital agreements does Medibank have in my state? 

Does Medibank offer any discounts?

Does Medibank offer ambulance cover?

Does Medibank let you claim online or in-app?

What CHOICE Community says about Medibank


Medibank summary

Medibank

Medibank was launched by the Australian government in 1976, initially as nonprofit but converting to a for-profit entity in 2009. It was privatised in 2014 and is today one of Australia's largest health funds with 3.6 million members. It also owns the AHM Health Insurance brand.

Medibank contact details

Phone: 134 190

Email: N/A

Website: medibank.com.au


Is Medibank nonprofit?

No.


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Does Medibank get many complaints from members?

Medibank complaints rating: High

When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don't get automatically penalised for having more complaints.

  • The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.
  • The infographic below shows the complaints about the fund to the Ombudsman as a percentage of all complaints. Complaints can be about benefits or customer service. The most serious complaints are escalated for investigation.
  • The higher the share of complaints a fund receives above its market share, the worse its performance compared to other funds. If its share of complaints is below its market share, that's a better result.

Medibank accounts for...

26.9% of the health insurance market

34.4% of all complaints about benefit payments

71.4% of all complaints about service

26.3% of all complaints that are escalated to investigations.

How good is Medibank's gap cover?

A medical gap is the difference between Medicare's recommended fee and what your doctor actually charges for a treatment or service.

Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called 'no gap agreements', or part of that gap, which are called 'known gap agreements' (these will have lower out-of-pocket costs, usually less than $500).

Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.

Rating scale

  • Above average
  • Average
  • Below average
  • Well below average

We also display the percentage of medical services that Medibank covers with no gap, and compare it to the industry average. The higher the percentage, the more effective the fund's gap scheme is in a state or territory.

Medibank gap cover performance by state

New South Wales (NSW)

Average

Australian Capital Territory (ACT)

Average

Victoria (Vic)

Average

Queensland (Qld)

Average

South Australia (SA)

Above average

Western Australia (WA)

Below average

Tasmania (Tas)

Average

Northern Territory (NT)

Average

Percentage of medical services covered with no gap

New South Wales (NSW)

Medibank – 88.4%

Industry average – 86.3%

Australian Capital Territory (ACT) 

Medibank – 79.8%

Industry average – 76.7%

Victoria (Vic) 

Medibank – 84.6%

Industry average – 85.0%

Queensland (Qld) 

Medibank – 87.6%

Industry average – 85.1%

South Australia (SA) 

Medibank – 90.3%

Industry average – 86.8%

Western Australia (WA) 

Medibank – 73.6%

Industry average – 90.1%

Tasmania (Tas) 

Medibank – 92.2%

Industry average – 83.0%

Northern Territory (NT) 

Medibank – 81.6%

Industry average – 80.1%

How many hospital agreements does Medibank have in my state?

The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you're treated. 

The table below shows how many hospital agreements Medibank has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don't have agreements with specific funds and are generally treated as though they're agreement hospitals.

Medibank has

ACT

5 private hospital agreements out of an industry maximum of 7

4 day hospital agreements out of an industry maximum of 8

NSW

88 private hospital agreements out of an industry maximum of 100

75 day hospital agreements out of an industry maximum of 100

NT

1 private hospital agreements out of an industry maximum of 2

1 day hospital agreements out of an industry maximum of 2

Qld

52 private hospital agreements out of an industry maximum of 58

40 day hospital agreements out of an industry maximum of 53

SA

26 private hospital agreements out of an industry maximum of 27

19 day hospital agreements out of an industry maximum of 28

Tas

5 private hospital agreements out of an industry maximum of 8

4 day hospital agreements out of an industry maximum of 6

Vic

69 private hospital agreements out of an industry maximum of 79

53 day hospital agreements out of an industry maximum of 79

WA

20 private hospital agreements out of an industry maximum of 23

18 day hospital agreements out of an industry maximum of 29

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Does Medibank offer any discounts?

Discount for direct debit: None

Discount for annual prepay: None

Total discount for annual prepay via direct debit: None


Does Medibank offer ambulance cover?

All Medibank extras, hospital and combined policies have emergency ambulance cover.

Do you need ambulance cover?

Depending on where you live, you may not need a policy with ambulance cover. 

  • In Queensland or Tasmania, emergency ambulance services are covered by your state government. 
  • In NSW and the ACT, all hospital policies come with emergency ambulance cover – so you'll be covered with any hospital or combined policy you select. 
  • In South Australia, Victoria and the Northern Territory you can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover. 
  • Rural WA: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover. 
  • Metropolitan WA: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.


Does Medibank let you claim online or in-app?

Online claiming and app for acupuncture, chiropractic/osteopathy, psychology, dental, physiotherapy, dietetics, naturopathy, optical, orthodontics, eye and speech therapy, remedial massage.


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What CHOICE Community says about Medibank

CHOICE Community is the online forum for Australian consumers, open to CHOICE members and supporters. Join the conversation about Medibank to share your experiences or gain more insights into this health fund.