Medibank Essentials OSHC

You pay a AUD 30 contribution towards each eligible prescription medicine; Medibank then pays up to AUD 70 per item, up to AUD 500 per member per calendar year (AUD 1,000 per couple or family membership). If the medicine costs more, you pay the difference. ahm OSHC and nib OSHC Core pay up to AUD 50 per item, also with a AUD 500 annual limit for singles, and nib pays only for medicines listed on the Pharmaceutical Benefits Scheme (PBS). Medibank's Comprehensive OSHC, sold only through selected universities and schools, pays up to 100% of the item cost after the AUD 30 contribution, up to AUD 1,000 per member per year.

If you go to the accident and emergency department of a public or private hospital, Medibank pays 100% of any facility fee the hospital charges, whether or not you are admitted; doctors' fees, x-rays and blood tests can still leave out-of-pocket costs. ahm OSHC has the same rule. If you are admitted, Medibank pays accommodation, theatre and intensive-care costs at its Members' Choice private hospitals (arrangements with most private hospitals and day surgeries) and when you are a private patient in a public hospital; at other private hospitals it pays lower benefits and you may face significant out-of-pocket costs. By comparison, nib OSHC Core lists public-hospital emergency department fees only when they lead to an admission or are certified as emergency treatment.

No. Essentials OSHC has no waiting period for hospital psychiatric services, including treatment for pre-existing conditions. Psychology and other allied health services are covered only when billed with an MBS item number (for example under a mental health treatment plan), at 85% of the MBS fee. ahm and nib OSHC Core have a 2-month waiting period for pre-existing psychiatric conditions.

ahm OSHC is a business of Medibank Private Ltd — the same company, sold under a separate brand. Both brands have arrangements with most private hospitals and day surgeries in Australia and pay A&E facility fees at public and private hospitals. Medibank Essentials costs AUD 47 a year more for a single (AUD 719 vs AUD 672) and pays up to AUD 70 per medicine item instead of AUD 50; both have a AUD 500 annual medicine limit for singles. Medibank has no waiting period for pre-existing psychiatric hospital care; ahm has a 2-month wait.

Essentials OSHC includes no extras. Medibank sells separate extras policies (for example Healthy Start Extras or Essential Extras) that Medibank OSHC and ahm OSHC members can add for dental, optical and physio; they cost extra, waiting periods apply, and members without Medicare are generally not eligible for the Australian Government Rebate on them. Medibank's Comprehensive OSHC, sold only through selected universities and schools, adds private psychology, counselling and repatriation benefits, but no dental or optical cover.