Nurses & Midwives Health Insurance Review 2024

The Nurses and Midwives Fund (often known as NMW) is a non-profit fund, established in 2016 by Teachers’ Health exclusively for members of nursing and midwifery unions and their families. 

A non-profit fund exclusively for nursing and midwifery union members and their families. 

As the only health fund solely for nurses and midwives, NMW is able to thoroughly tailor their policies for its members, who can also use Teachers Health Centres across Australia.

Hospital cover

Nobody chooses to go to hospital. But when you do, appropriate 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.

e with your budget. If you earn over $90,000 individually or $180,000 as a couple, taking out appropriate hospital cover may avoid paying the Medicare Levy Surcharge.

NMW offers 5 types of hospital cover, ranging from two Basic plans that cover the essentials, to the comprehensive Gold Hospital plan.

All hospital plans include emergency and non-emergency ambulance transport.

Basic Hospital 

Under NMW’s most basic level of cover, you can be treated by a doctor of your choice in any public hospital, plus get access to a few services in a private hospital and a lot of restricted items. This cover has a $300 excess and will help you avoid the Medicare Levy Surcharge.

Key inclusions:

• Dental surgery

• Hernia and appendix

• Joint reconstructions

Mid Hospital (Basic Plus)

NMW’s Mid Hospital package may be classified as a Basic Plus policy but it’s more comprehensive than a lot of Bronze policies and covers a lot of services. There are no exclusions in this plan, however some services are restricted. Excess options are $300 and $500.

Key inclusions:

• Back, neck and spine

• Chemotherapy, radiotherapy and immunotherapy

• Gynaecology 

Mid Silver Plus

Mid Silver Plus covers a wide range of services. There are few key exclusions, such as pregnancy services and cataracts, making this suitable as a good all-round mid-tier policy. You can choose a $300 or $500 excess.

Key inclusions:

• Insulin pumps

• Palliative care

• Pain management

Top Silver Plus

Top Silver Plus covers everything in a private hospital except psychiatric services. It’s one of the most comprehensive Silver Plus plans available and is suitable for both parents-to-be and older Australians.

Key inclusions:

• Cataracts

• Joint replacement

• Pregnancy and birth

Gold Hospital

NMW’s highest tier of cover includes everything Top Silver Plus does, with the addition of hospital psychiatric services. It covers all hospital accommodation and theatre expenses at any public hospital and all agreement private hospitals. This cover has a $500 excess.

Key inclusions:

• Hospital psychiatric services

• Lung and chest

• Weight loss surgery

Ambulance cover 

Emergency ambulance cover is included in all hospital and extras cover. Non-emergency ambulance transport is included in all hospital policies.

Extras cover 

Extras reset for the Nurses and Midwives health fund on 1 January 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 each plan below, it’s always worth digging a little deeper into any gap fees, how much you can claim back, and whether your preferred healthcare provider, such as your local dentist, has an agreement with 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, you can speak to one of our experts who can talk you through what’s included in each extras policy.

NMW offers 2 extra plans which we’ve detailed below. Both plans include 100% benefits for Healthy Lifestyle services, including weight management, eligible gym memberships and health screenings.

Essential Extras

Essential Extras allows you to get set levels of money back on many common health services.

Key inclusions:

• $500 annual limit per person on general dental

• Lifetime limit of $2,500 per person on orthodontics (annual limits apply)

• 100% back on eligible gym membership, up to $150 per person.

Top Extras

Top Extras comes with generous annual limits and covers a broad range of services. Major dental limits increase the longer you stay with the fund.

Key inclusions:

• Unlimited general dental

• Hypnotherapy

• Prenatal and postnatal physiotherapy services

Waiting periods

Waiting periods are there to stop people from signing up, claiming and then cancelling their cover. It means once you take out a new plan, you’ll have to wait a certain amount of time before receiving your benefit.

When you switch to NMW from another provider, you won’t have to re-serve your waiting periods, unless your new policy covers something you didn’t have before or has improved annual extras benefits and/or limits.

Hospital Waiting Periods

• Emergency ambulance transport - 1 day

• Pre-existing conditions - 12 months

• Pregnancy and birth related services - 9 months

• Psychiatric, rehabilitation, palliative care and all other hospital services - 2 months

Extras Waiting Periods

• Emergency ambulance transport - 1 day

• Optical and healthy lifestyle - 6 months

• Orthodontia, Major Dental, medical appliances (including hearing aids) - 12 months

• Wheelchairs - 24 months

• All other services - 2 months

Member benefits

NMW have six dedicated health centres across NSW, VIC and SA, providing dental and optical services to members. You will receive two fully covered preventative dental check-ups each year when you use one of NMW’s health centres. Some of the members-only offers available at these centres include 50% off optical frames, 25% off sunglasses and contact lenses, no gap frame and lens packages and free retinal photo and OCT scans.

You will also have access to a range of support under the Teachers Healthcare Services team, such as mental health support, pregnancy programs, and more.

How to claim

Hospital

Simply tell the hospital you are a member of a NMW policy. Your hospital account will be sent directly to NMW for them to assess on your behalf.

Extras

You can swipe your membership card to claim directly on the spot with your provider’s HICAPS terminal.

You can also claim via the NMW claiming app, or fill out the claim form and send it via email or mail.

Hospital agreements

NMW has agreements with a large number of hospital and day surgery providers across Australia.

When comparing policies, it’s worth checking if your preferred local hospitals and clinics are covered. Our specialists at Compare Club can do this for you.

Customer service

From 1 January to 31 March 2020, the Private Health Ombudsman received just 2 complaints from NMW members. NMW has a market share of 0.1%.

Source: Private Health Ombudsman

Frequently Asked Questions

Is NMW a not-for-profit fund?

Yes - all profits are diverted back into the fund, for increased benefits to members.

Who can apply? Are there restrictions? 

Nurses and Midwives Health is a restricted fund. You can only join NMW if you’re a current or former member of a nursing or midwives union and are currently working, or have previously worked, in any of these roles:

• registered nurse or midwife

• enrolled nurse

• nurse practitioner

• psychiatric nurse

• mothercraft nurse

• assistant in nursing or midwifery

• nursing student undergoing training, student nurse or trainee enrolled nurse

Is it easy to switch to NMW?

Nursing and Midwives Health isn’t on our panel but we’re confident we can find you a great deal on your health insurance. You’ll need to contact the fund directly if you’re interested in switching to one of their policies.

Do I need to re-serve waiting periods? You can switch to an equivalent or lower level of cover without re-serving waiting periods. You will only be required to serve waiting periods if you have upgraded to a higher level of cover.

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 and/or higher benefits.

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.

Do I have to pay the Lifetime Health Cover loading?

Yes - but you can avoid the LHC if you take out hospital cover by July 1st following your 31st birthday.

What age are children covered up to?

Dependent children can be on your plan up to the ages of 23, or up to 25 if they are studying full-time.