Nurses & Midwives Health Insurance Review

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.

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by Gary Andrews

Last update 15 Apr 2021

Overview

As the only health fund solely for nurses and midwives, NMW is able to thoroughly tailor their policies for its membership.

Members can also use Teachers Health Centres across Australia.

Key Points

Backed by Teachers Health, Australia's largest industry-based health fund.
Access to programs to assist with chronic conditions, such as obesity.
Discounts on glasses and lenses at Teachers Health Centres.

Nurses and Midwives Health isn't on our panel but we're confident we can get you a great deal on your health insurance.

Click below to get started.

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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.

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
  • Tonsils, adenoids and grommets

Bronze Hospital

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
  • Podiatric surgery
  • 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:

  • Heart and vascular
  • Insulin pumps
  • Palliative care
  • Pain management

Top Silver Plus

Top Silver Plus covers everything in a private hospital except hospital 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:

  • Assisted reproductive services
  • 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 insurance helps cover the bills for routine treatments with rebates of up to 100% and covers out-of-hospital treatments such as dental, optical, to chiro and more.

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 two 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)
  • $200 annual limit per person on optical
  • 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
  • Hearing Aids
  • Hypnotherapy
  • Prenatal and postnatal physiotherapy services
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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

  • 1 day -- Emergency ambulance transport
  • 12 months -- Pre-existing conditions
  • 9 months -- ​Pregnancy and birth related services
  • 2 months -- ​Psychiatric, rehabilitation, palliative care and all other hospital services

Extras Waiting Periods

  • 1 day -- Emergency ambulance transport
  • 6 months -- Optical and healthy lifestyle
  • 12 months -- Orthodontia, Major Dental, medical appliances (including hearing aids)
  • 24 months -- Wheelchairs
  • 2 months -- All other services

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

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FAQs

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 any 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 get you a great deal on your health insurance if you're looking to switch health insurance. 

Click here to get started.

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).

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.

When do extras reset?

Extras reset on 1 July each year.

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.

How do I contact NMW?

Phone: 1300 344 000 Mail: Nurses & Midwives Health, GPO Box 3874, Sydney NSW 2001

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