Onemedifund Health Insurance Review

Onemedifund is a relatively recent entrant into the health insurance market. The for-profit fund was established in 2007 and is owned by National Health Benefits Australia. It operates across Australia, and prides itself on high member retention.

I’d like health insurance cover for:

Which humans

  I'm  

  looking for  

cover type

  cover and I live in  

.

  I am currently with  

select fund

by Gary Andrews

Last update 15 Apr 2021

Overview

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.

Key Points

Offers only one top tier hospital and extras policy.
Access gap agreements with 36,000 doctors across Australia.
Optical discounts with many of Australia's best known eyecare specialists.

Onemedifund 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.

COMPARE & SAVE

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.

With one top-level Gold plan, Onemedifund is suitable for people who want top health cover, without having to choose between policies.

Essentials 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

Emergency ambulance cover is included with a 1 day waiting period.

This includes land, sea and air ambulance with no annual limits.

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.

Like hospital cover, Onemedifund only offers one comprehensive extras policy that covers a full range of services.

You can combine this with their Gold Hospital policy.

Comprehensive Extras

This policy comes with unlimited general dental treatment and many services that allow you to claim back up to 80% -- 100% on treatment.

A number of annual limits increase after five years of membership.

COMPARE & SAVE

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.

Gold Hospital $250 Excess

  • 1 day -- ambulance
  • 2 months -- rehabilitation, psychiatric and palliative care (including where the condition is pre-existing)
  • 2 months -- all other hospital treatments
  • 2 months -- health programs
  • 12 months -- all other pre-existing conditions
  • 12 months -- pregnancy and birth, and assisted reproductive services

Member benefits

Members can access hospital substitution programs, including Hospital at Home, Rehab at Home and Chemo at Home.

There's also a range of programs available to members, including mental health coaching, diabetes management, and chronic disease management.

Members can also get optical discounts at Specsavers, OPSM and other opticians.

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 complaints from 1 January to 30 March 2020.

That's pretty impressive, and indicates customer service is outstanding.

COMPARE & SAVE

FAQs

Is Onemedifund a not-for-profit fund?

No, Onemedifund is for-profit.

Who can apply? Are there any restrictions?

Onemedifund has no restrictions on membership.

Is it easy to switch to Onemedifund?

Onemedifund 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?

No, providing you transfer to Onemedifund within 30 days of leaving your old fund on an equivalent or lower level of cover.

Can I change my level of cover?

Yes, when you switch to Onemedifund you can join their top level cover even if it is higher than your previous cover.

However, you will need to serve waiting periods for the extras 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?

If you're 31 or over, you usually need to pay 2% loading for each year you've gone without health cover since the 1st July following your 31st birthday.

You can find out more here.

When do extras reset?

Extras reset on 1 July each year.

What age are children covered up to?

Onemedifund allows dependent children on a family policy up to the age of 18.

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.

Read our guide to learn more.

How do I contact Onemedifund?

Visit onemedifund.com.au or call 1800 148 626

COMPARE & SAVE

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