Onemedifund Health Insurance Reviews 2024

Onemedifund's name reflects that this is a slightly unusual fund in that it only offers one top-level hospital policy and one comprehensive extras plan. Customers are entitled to increased limits on the Comprehensive Extras plan after five years with Onemedifund.

All members can also access a range of free health programs. Onemedifund isn't on our panel but we're confident we can get you a great deal on your health cover.

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, appropriate hospital cover can help you avoid paying the Medicare Levy Surcharge for the period of your cover.

Onemedifund offers one top-level Gold hospital plan.

Gold Hospital 250 Excess

Onemedifund's only hospital plan is top-tier gold cover that includes most public and private hospital services.

You'll only pay a maximum of $250 excess per person per year, capped at $500 on a family policy, no matter how many times you need hospital treatment.

50% of the excess is payable for day surgery.

Key inclusions:

• Pregnancy and birth

• Weight loss surgery

• Cataracts

• Hospital psychiatric services

Ambulance cover

Ambulance cover is included with a 1 day waiting period, which includes land, sea and air ambulance with no annual limits. Ambulance cover differs from state to state, so if you’re confused, read our guide here.

Extras cover

Onemedifund’s extras reset on July 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 onemedifund’s extras cover below, it’s always worth taking a closer look at potential 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.

Onemedifund lives up to its name and offers one comprehensive extras policy to members.

Comprehensive Extras

Comprehensive Extras comes with unlimited dental and other services that allow you to claim back up to 80 to 100% back.

 Key inclusions:

• Hearing aids

• Major dental

• Speech therapy

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

Extra waiting periods

• 24 months for laser eye surgery and hearing aids

• 12 months for major dental, pre and post natal services

• 6 months for optical and health management programs

• 2 months for general dental, physio, chiro, pharmacy, podiatry and natural therapies as well as all other health services

Member benefits

Onemedifund has plenty of benefits to offer their members, including a range of health programs.

Members can also take advantage of Hospital at Home, Rehab at Home and Chemo at Home that allow you to be cared for in your own home instead of going to a hospital for treatment. This is only available as long as your doctor agrees.

There’s a range of optical discounts and special offers across a range of eyecare outlets nationwide. 

How to claim

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

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

Hospital agreements

Onemedifund 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

Onemedifund received 0% of complaints in 2021, and has a market share of 0.5%^.

Frequently Asked Questions

Is onemedifund a not-for-profit fund?

Onemedifund is a for-profit fund.

Who can apply? Are there restrictions?

Onemedifund has no restrictions on membership, which means anyone can join.

Is it easy to switch to onemedifund?

Onemedifund isn’t on our panel so you’ll need to contact them directly to switch. We’re confident the Compare Club team can find you a great deal from the health funds on our panel.

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. 

Can I change my level of cover?

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

If you move to health insurance with a higher level of cover, you will usually need to serve waiting periods on the extra services/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?

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

Up to what age are children covered?

Children under the age of 18 are covered with family cover, as well as full time student dependents or ‘adult kids’ under the age of 25.

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