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Compare NIB health insurance

How NIB rates for member complaints, gap cover and ambulance.

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NIB summary

NIB provides health cover to more than a million Australians. It was established over 60 years ago and is a for-profit company. There are NIB eyecare and dental centres in NSW and Victoria.

NIB contact details

Phone: 13 16 42

Email: nib@nib.com.au

Website: nib.com.au

Is NIB nonprofit?

No.

Does NIB get many complaints from members?

NIB complaints rating: Medium

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.

How good is NIB'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 NIB 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.

How many hospital agreements does NIB 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 NIB 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.

Does NIB offer any discounts?

Discount for direct debit: Up to 4% for eligible customers

Discount for annual prepay: None

Total discount for annual prepay via direct debit: Up to 4% for eligible customers.

Does NIB offer ambulance cover?

All NIB 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 NIB offer family policies that cover adult children?

Yes, adult children are covered up to age 21 and up to age 25 if in full-time study. The Extended Family policy covers adult children aged 21-25 if not living with a partner.

Does NIB let you claim online or in-app?

Online claiming and app for all services.

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