NIB health insurance review

The fund provides cover to more than 130,000 international students and workers in Australia.

Nib also owns World Nomads Group, one of the top providers of travel insurance in Australia.

The fund offers a wide range of hospital and extras policies to suit different life stages and budgets.

Members have access to the nib Rewards program, with discounts and offers at over 150 retailers, as well as fitness programs that encourage healthy living.

NIB is on our panel, so compare health insurers with ease below.

Hospital cover

Nobody chooses to go to hospital.

But when you do, hospital cover will help you get the treatment you need, where and when you want it.

It also helps to pay the bills, as fees for hospital rooms and specialists can add up.

Think about what services you're likely to need, in line with your budget.

If you earn over $90,000 individually or $180,000 as a couple, you could avoid paying the Medicare Levy Surcharge.

nib offers five hospital plans, ranging from Basic to Gold.

Basic Essentials Hospital Plus

nib's Basic cover offers minimal cover but allows you to avoid the Medicare Levy Surcharge, as well as offering some hospital services and emergency ambulance.

Key inclusions:

• Tonsils, adenoids and grommets

• Hernia and appendix

• Joint reconstructions

Bronze Hospital Plus

More comprehensive than Basic policies, nib's Bronze policy is designed for budget-conscious Aussies and is the fund's most popular cover tier.

Key inclusions:

• Diabetes management

• Ear, nose and throat

• Bones, joints and muscle

Silver Hospital

Comprehensive cover that includes many of nib's most commonly claimed services.

Excludes some of the more expensive hospital procedures you're less likely to need.

Key inclusions:

• Heart and vascular system

• Plastic and reconstructive surgery (medically necessary)

• Implantation of hearing devices

Silver Advantage Hospital Plus

A policy for people who want extensive cover but don't need pregnancy services, making it a viable option for families and the over 50s.

Key inclusions:

• Cataracts

• Joint replacements

• Dialysis for chronic kidney failure

Gold Top Hospital

This is nib's most comprehensive cover option, and must be purchased with an extras cover.

It covers all hospital procedures, making it suitable for those planning a family or simply want the top level of cover.

Key inclusions:

• Pregnancy and birth

• Assisted reproductive services

• Weight loss surgery

Ambulance cover

All nib hospital cover options include emergency ambulance services with no annual limits (QLD and TAS residents are covered by their state schemes).

Extras cover

nib’s extras reset on January 1 every year.

From dental, to optical, to chiro and more, extras insurance helps cover the bills for routine treatments with rebates of up to 100%.

While we’ve summarised the key points of nib’s extras cover below, it’s always worth taking a closer look at gap fees, how much you can claim back, and whether your preferred healthcare provider is recognised by the health fund.

Take the time to work out what you need and what you're prepared to pay.

If this feels a bit overwhelming, our experts are here to help.

nib has four extras options to choose from with the basic level of cover offering 60% back.

Core Extras

Get a 60% benefit on a basic range of extras, including optical, physio and general, preventative, and major dental.

Key inclusions:

• General dental

• No limit on preventative dental

• Physiotherapy

Core Extras Boost

This extras plan provides the same benefits as Core Extras, but offers higher annual limits.

Key inclusions:

• General dental and major dental

• No limit on preventative dental

• Physiotherapy

Core and Wellbeing Extras

This extras plan offers 60% back on each visit and covers chiropractic and psychology.

Key inclusions:

• Physiotherapy

• Chiropractic and osteopathy

• Psychology

Top Extras

This is nib's top tier extras plan, giving you 75% back on a full range of services and higher annual limits.

Key inclusions:

• Antenatal and postnatal services

• Orthodontics

• Podiatry

Waiting periods

To stop people signing up, claiming, then cancelling their health insurance, all insurers apply waiting periods.

Generally, the more expensive the treatment, the longer you'll wait.

But keep an eye out for special deals with waiting periods reduced or waived.

Hospital waiting periods

• 12 months for pre-existing conditions, pregnancy, and birth

• 2 months for hospital psychiatric services, rehabilitation, and palliative care as well as health programs, hospital substitution programs, and all other services

• 1 day for ambulance and accidental injury benefit

Extra waiting periods

• 36 months for hearing aids

• 12 months for major dental, artificial aids, and orthodontics

• 6 months for optical and health management programs

• 2 months for all other services

• 1 day for ambulance services

Member benefits

All nib members have access to 100% back on optical and dental when you visit a nib eye care or dental care centre.

There are also discounts and offers available through nib Rewards at over 150 retailers.

Members can also benefit from reduced out-of-pocket costs if you see a dentist or optician in their First Choice provider network.

How to claim

Claim on the spot through the HICAPS payment system at your provider.

You can also claim through the nib app or online, or email, fax or post your claim form.

Hospital agreements

nib has agreements with most private hospitals and day clinics across Australia.

When comparing policies, it's worth checking if your local hospitals and clinics are covered.

Our specialists at Compare Club can do this for you.

Customer service

nib received 8.1% of complaints in 2021, and has a market share of 9.2%^.

FAQs

1. Is nib a not-for-profit fund?

No, nib is a for-profit fund.

2. Who can apply? Are there restrictions?

Dependent children, adult dependents and student dependents of policy holders must be unmarried and not in a de facto relationship.

To claim, all those listed on the policy must be Australian citizens, permanent residents or registered for Medicare.

Unless otherwise approved by nib, a person under 16 years of age is not eligible to be a policy holder.

3. Is it easy to switch to nib?

Yes, you can sign up right here, right now. We’ll take care of the paperwork.

4. Do I need to re-serve waiting periods?

If you switch to an equivalent or lower level of cover, you won’t have to serve new waiting periods. However, you may need to serve new waiting periods if your new policy includes additional services or higher benefits

5. Can I change my level of cover?

Yes, you can choose a lower or higher level of cover.

If you move to a higher level of cover, you will usually need to serve waiting periods on the extra services/higher benefits.

6. Do I get the government rebate?

For every dollar of private health insurance premiums, the Australian Government provides eligible Australians with a rebate of up to 33.4% (depending on your age and income). To learn what you’re entitled to, read our rebate guide.

7. Do I have to pay the Lifetime Health Cover loading?

If you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover since the 1st July following your 31st birthday. You can find out more here.

8. Up to what age are children covered?

Generally, people up to 23 years old are covered by hospital policies. If they’re studying full time, dependents can be covered as a student under a family policy up to the age of 25.

Children must not be married or living in a de facto relationship.

This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions.

^Private Health Ombudsman, nib, accessed 13 January 2022.