Medibank Insurance Policies and Coverage Options

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Medibank offers a range of insurance policies to suit different needs and budgets. They have a comprehensive hospital cover that includes in-hospital services, surgery, and emergency department visits.

Medibank's Extras cover provides benefits for out-of-hospital services such as dental, optical, and physiotherapy. This cover is designed to help with the costs of these services, which are not always covered by hospital insurance.

Medibank also offers a range of Ancillary products that can be added to your policy to provide additional benefits. These products include Overseas Visitors Cover and Travel Insurance.

Medibank's policies can be tailored to suit individual needs, with options to choose from a range of excess levels and co-payments. This allows you to customize your policy to fit your budget and lifestyle.

Business and Operations

Medibank has a significant presence in the health insurance industry, with a history of strategic acquisitions and mergers. In January 2009, the company acquired ahm, an Australian insurer based in Wollongong.

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Medibank has also expanded its services through the creation of the Health Solutions Division, which focuses on delivering occupational health services and health coaching programs to Australians. This division was established following the merger with the HSA Group in April 2009.

The company has continued to grow through the acquisition of health services provider McKesson Asia-Pacific in July 2010, which was absorbed into Medibank Health Solutions.

Privatisation

Privatisation is a significant process that can have far-reaching consequences for a company and its stakeholders. In the case of Medibank, the Australian government decided to sell the company through an initial public offering (IPO) in 2014.

The IPO was priced at $2.15, exceeding the indicative range of $1.55 to $2.00 disclosed in the prospectus. This ensured that the government raised $5.7 billion, which was a significant amount.

The sale was completed with 100% of the company sold, listing on the Australian Stock Exchange under the code MPL on 25 November 2014. This marked a major milestone for Medibank.

The sale resulted in 440,000 individual owners, with a market capitalisation of A$5.921 billion. This was a notable achievement for the company.

Medibank held a 29% share of the private health insurance market after the sale. This was a significant position in the industry.

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Acquisitions and Mergers

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Medibank has been actively involved in strategic acquisitions and mergers to expand its services and capabilities.

In January 2009, Medibank acquired the Wollongong-based insurer ahm and merged with the HSA Group in April 2009.

This led to the creation of the Health Solutions Division, which focuses on delivering occupational health services and health coaching programs.

Services under the Medibank Health Solutions brands are designed to help Australians manage health conditions such as diabetes.

Medibank further expanded its services by acquiring health services provider McKesson Asia-Pacific in July 2010.

The acquired services include telephone and online health management programs, including "healthdirect Australia", "Nurse-on-Call", and "Healthline".

Does Receive Many Member Complaints?

Medibank has a Medium complaints rating, which means they have a moderate number of complaints compared to other health funds.

This rating is based on the number of complaints and serious disputes the Ombudsman deals with, taking into account the size of the fund.

Medibank's complaints rating is not the lowest, but it's not the highest either, indicating that they have a relatively average number of complaints for their size.

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The complaints rating system is used to give each fund a score, with Low being the best and High being the worst.

Here's a breakdown of the complaints rating system:

  • Low: Fewer complaints and fewer serious disputes for the fund's size
  • Medium: Moderate number of complaints and serious disputes for the fund's size
  • High: More complaints and serious disputes for the fund's size

Private Hospital Agreements

Medibank's private hospital agreements are a key aspect of their business operations. They have 5 out of a possible 6 agreements with private hospitals.

This is a relatively low number compared to the industry maximum. In fact, they have fewer agreements than many of their competitors.

Having fewer agreements can limit Medibank's negotiating power with private hospitals. This may impact their ability to secure favorable rates for their customers.

However, Medibank has made progress in this area. They have 6 day hospital agreements out of a possible 9, which is a significant improvement.

This increase in agreements has likely helped Medibank to expand their services and reach more customers.

Security and Compliance

Medibank takes security and compliance very seriously. They have a dedicated team that works around the clock to protect customer data and prevent cyber threats.

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Medibank uses advanced encryption technology to secure sensitive customer information, including their personal and health data. This encryption technology is designed to protect data from unauthorized access.

Medibank has implemented strict access controls, limiting who can access customer data and under what circumstances. This helps prevent data breaches and unauthorized use of customer information.

Medibank is committed to complying with all relevant laws and regulations, including the Australian Privacy Principles (APPs) and the Privacy Act 1988. They also adhere to industry standards and guidelines, such as the Australian Health Practitioner Regulation Agency (AHPRA) guidelines.

Medibank regularly reviews and updates their security policies and procedures to ensure they remain effective in preventing data breaches and cyber threats.

Policies and Coverage

Medibank offers a range of policies that cover adult children, including family policies that cover them for free until they turn 21, and extended family policies that cover them until they turn 31 for an extra cost.

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If you're looking for ambulance cover, Medibank's policies have got you covered, but the specifics depend on your location. In Queensland and Tasmania, emergency ambulance services are covered by the state government, while in NSW and the ACT, all hospital policies come with emergency ambulance cover.

Here's a breakdown of the ambulance cover options by state:

  • Queensland and Tasmania: Covered by the state government
  • NSW and the ACT: Covered with all hospital policies
  • South Australia, Victoria, and the Northern Territory: Covered by some health fund policies or can be purchased directly from the ambulance service
  • Rural Western Australia: Covered by some health fund policies or can be purchased directly from the ambulance service
  • Metropolitan Western Australia: Requires a health insurance policy with ambulance cover

What's Good About Gap Cover?

Having good gap cover can be a huge relief when it comes to medical expenses. You can rest assured that you won't be left with a hefty bill.

Health funds have agreements with doctors and hospitals to cover part or all of the gap, known as 'no gap agreements' or 'known gap agreements'. These agreements can save you money.

For example, Medibank has 8 private hospital agreements, which is the industry maximum. This means you can get treatment at a hospital without worrying about a huge bill.

The CHOICE gap rating takes into account the percentage of services where members paid no gap or a known gap. It's a great way to compare health funds and find the best one for you.

Here's a rating scale to help you understand the CHOICE gap rating:

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

Having good gap cover can give you peace of mind and help you budget for medical expenses. It's worth doing your research to find the best health fund for you.

Does Offer Ambulance Coverage?

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Does Medibank offer ambulance cover? In most cases, yes - all Medibank extras, hospital, and combined policies have emergency ambulance cover.

If you're in Queensland or Tasmania, you're covered by the state government, so no need to worry about purchasing additional cover.

In New South Wales and the ACT, all hospital policies come with emergency ambulance cover, so you're protected if you select a hospital or combined policy.

In South Australia, Victoria, and the Northern Territory, you can buy emergency ambulance cover directly from the ambulance service, or some health fund policies will cover ambulance or refund part of the cost.

If you live in rural Western Australia, you can also buy emergency ambulance cover directly from the ambulance service, or some health fund policies will cover ambulance or refund part of the cost.

In metropolitan Western Australia, however, you'll need to buy a health insurance policy with ambulance cover to be protected.

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Here's a breakdown of the ambulance cover options by state and territory:

Does Offer Policies for Adult Children?

Does Medibank offer policies for adult children? If your child is under 21, they're covered for free on your family policy. That's right, no extra cost!

If your adult child is a full-time student, they can stay on your family policy for free until they turn 31. This is a great perk for students who are still studying and not yet financially independent.

If your adult child is younger than 31 and not a student, they can be covered on an extended family policy for an extra cost. This might be a good option if your child is still living at home or not working full-time.

Here are the details on Medibank's policies for adult children:

Topics

Medibank Private Limited faced allegations of false and misleading advertising in 2000. The Australian Competition and Consumer Commission (ACCC) took action against the company.

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The ACCC alleged that Medibank Private advertised 'no rate increase in 2000' for its Package Plus insurance products when rates actually increased on 1 July 2000. This is a clear example of misleading advertising.

Call centre staff made representations to consumers that rates for Package Plus products would not increase until next year. This further highlights the issue of false and misleading advertising.

Medibank Private was accused of failing to disclose certain information to consumers. This included:

  • not adequately disclosing that only the 2-month general waiting period and the 6-month optical waiting period were waived;
  • not adequately disclosing that conditions applied to the offer of 30 days free health insurance.

New South Wales

New South Wales is a key region for Medibank, with a notable presence in the private hospital sector. Medibank has 89 private hospital agreements in New South Wales, which is a significant number considering the industry maximum is 92.

Customer Support and Advice

If you're a Medibank customer affected by the recent cyber incident, don't hesitate to reach out for support.

AHM customers should contact 13 42 46, while Medibank Private customers should call 13 23 31.

If you're looking for more information or have questions, you can visit the Medibank website to learn more about their contact options.

Can You Claim Online or In-App?

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You can claim online or via the Medibank app for various services, including acupuncture, chiropractic/osteopathy, and psychology.

For some services, like dental, physiotherapy, and optical, online or in-app claims are also an option.

You can also claim online or in-app for eye and speech therapy, as well as remedial massage.

Medibank's online and in-app claiming options make it convenient to manage your health expenses on the go.

Advice to Customers

If you're a customer of Medibank, there are some important steps you can take to protect yourself.

If you think you may be affected by the recent Medibank Private cyber incident, you should contact the relevant number for your specific insurance product. For AHM customers, that's 13 42 46, and for Medibank Private customers, it's 13 23 31.

To strengthen your cyber defences, all Australians and Australian organisations need to take action.

Frequently Asked Questions

Is Medibank Australian owned?

Medibank is no longer fully Australian owned, as it was privatized in 2014 and now operates as a publicly-listed company on the Australian Securities Exchange. However, it was initially established as a not-for-profit insurer by the Australian Government in 1976.

What are the disadvantages of Medibank?

Medibank has faced significant security concerns, including a major data breach in 2022 that exposed 9.7 million customers' personal information. Additionally, the company received a high number of complaints in the last financial year, largely due to the cyber hack.

Who is the best private health insurance in Australia?

Based on membership retention rates, Westfund and HCF stand out as the top private health insurance providers in Australia, with retention rates of 88% and 87% respectively.

Elena Feeney-Jacobs

Junior Writer

Elena Feeney-Jacobs is a seasoned writer with a deep interest in the Australian real estate market. Her insightful articles have shed light on the operations of major real estate companies and investment trusts, providing readers with a comprehensive understanding of the industry. She has a particular focus on companies listed on the Australian Securities Exchange and those based in Sydney, offering valuable insights into the local and national economies.

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