Medibank
Medibank Gold Ultra Health Cover
Medibank
How $477.98 is worked out
- Premium as filed - $629.90 a month (hospital share $1.00)
- Government rebate - 24.1% of the premium (never of the loading): -$151.92
- A month - $477.98
Go to insurer no commission on this policy
Hospital: what is covered
Covered (38)
- Assisted reproductive services
- Back, neck and spine
- Blood
- Bone, joint and muscle
- Brain and nervous system
- Breast surgery (medically necessary)
- Cataracts
- Chemotherapy, radiotherapy and immunotherapy for cancer
- Dental surgery
- Diabetes management (excluding insulin pumps)
- Dialysis for chronic kidney failure
- Digestive system
- Ear, nose and throat
- Eye (not cataracts)
- Gastrointestinal endoscopy
- Gynaecology
- Heart and vascular system
- Hernia and appendix
- Hospital psychiatric services
- Implantation of hearing devices
- Insulin pumps
- Joint reconstructions
- Joint replacements
- Kidney and bladder
- Lung and chest
- Male reproductive system
- Miscarriage and termination of pregnancy
- Pain management
- Pain management with device
- Palliative care
- Plastic and reconstructive surgery (medically necessary)
- Podiatric surgery (provided by a registered podiatric surgeon)
- Pregnancy and birth
- Rehabilitation
- Skin
- Sleep studies
- Tonsils, adenoids and grommets
- Weight loss surgery
Restricted (0)
None.
Not covered (0)
None.
Restricted means partially covered for hospital costs as a private patient in a public hospital; in a private room or private hospital you may face significant expenses.
Excess, waiting periods and hospital
- Tier - Gold
- Hospital - Private or public hospital
- Excess - No excess.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Offered for 18 to 29 year olds
- Accident cover - Yes
- Travel and accommodation benefits - Yes
Waiting periods
- Most treatments - 2 months
- Existing conditions - 12 months
- Pregnancy and birth - 12 months
- Rehabilitation, psychiatric and palliative care - 2 months
As filed by the insurer: Medibank's most comprehensive cover. Gap bonus to use towards out-of-pocket costs in hospital. Private Room Priority for pre-booked admissions at a Members' Choice hospital. Where a two month waiting period applies to a service on your hospital cover, it may be waived for claims resulting from an Accident that occurred during this time, please contact Medibank for further information.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental * | 2 months | Check-up (item 012): $47.30; Scale and clean (item 114): $79.40; Fluoride treatment (item 121): $25.90; Tooth extraction (item 322): $196.50 | no yearly limit |
| Major dental | 12 months | Crown (item 615): $1222.30 | $1,600 per policy a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): $227.70 | $1,600 per policy a year (shared with other services) |
| Braces * | 12 months | Braces, upper and lower, with a retainer (item 881): 100% back | $1,500 per policy a year, $3,500 lifetime |
| Glasses and contact lenses | 6 months | Single vision glasses: 100% back; Multifocal glasses: 100% back | $300 per policy a year |
| Prescriptions not on the PBS | 2 months | Prescription: $51.00 | $800 per policy a year |
| Physiotherapy | 2 months | First visit: $68.30; Follow-up visit: $58.10 | $1,000 per policy a year |
| Chiropractic | 2 months | First visit: $67.40; Follow-up visit: $50.60 | $750 per policy a year (shared with other services) |
| Podiatry | 2 months | First visit: $59.00; Follow-up visit: $47.40 | $600 per policy a year (shared with other services) |
| Psychology | none | First visit: $132.98; Follow-up visit: $115.63 | $600 per policy a year |
| Acupuncture | 2 months | First visit: $59.80; Follow-up visit: $46.40 | $500 per policy a year (shared with other services) |
| Remedial massage | 2 months | First visit: $64.30; Follow-up visit: $46.40 | $500 per policy a year (shared with other services) |
| Hearing aids | 36 months | Hearing aid: 100% back | $1,600 per policy a year, 1 appliance every 5 years |
| Blood glucose monitors | 24 months | Blood: 100% back | $300 per policy a year, 1 appliance every 3 years |
| Chinese herbal medicine | 2 months | First visit: $32.50; Follow-up visit: $32.50 | $500 per policy a year (shared with other services) |
| Dietitian | 2 months | First visit: $83.80; Follow-up visit: $46.30 | $600 per policy a year |
| Exercise physiology | 2 months | First visit: $32.50; Follow-up visit: $32.50 | $500 per policy a year (shared with other services) |
| Eye therapy (orthoptics) | 2 months | First visit: $60.00; Follow-up visit: $50.00 | $600 per policy a year |
| Home nursing * | 2 months | First visit: 100% back; Follow-up visit: 100% back | $500 per policy a year |
| Occupational therapy | 2 months | First visit: $91.40; Follow-up visit: $66.90 | $600 per policy a year |
| Orthotics | 2 months | Benefit: 100% back | $600 per policy a year (shared with other services) |
| Osteopathy | 2 months | First visit: $67.40; Follow-up visit: $50.60 | $750 per policy a year (shared with other services) |
| Speech therapy | 2 months | First visit: $87.70; Follow-up visit: $59.10 | $600 per policy a year |
Not covered: Audiology, Antenatal and postnatal, Health management programs, Vaccinations.
* A 12 month waiting period applies to surgical tooth extraction. Orthodontics has a $1500 opening balance then a top up of $500 per year up to a $3500 lifetime limit. Home nursing not available in NT or TAS.
Other services, as filed: - Health appliance and external prostheses, (contact Medibank for further information) $600 per annum, 2 mth waiting period, fixed amount back per item up to annual limit. - Laser Eye Surgery (where no Medicare benefit is payable) $3,500 per lifetime limit, 36 mth waiting period, 100% back up to lifetime imit. - Blood pressure monitor (24 mth waiting period) and Breathing appliances (12 mth waiting period) included with Blood glucose monitors. - Health subscriptions (refer to Medibank for approved organisations) $100 per annum, 2 mth waiting period, 100% per subscription up to annual limit. - Health screening tests (where no Medicare benefit is payable) $200 per annum, 2 mth waiting period, 100% per test up to annual limit. Refer to Medibank for approved screening tests. - Private hospital accident and emergency facility fees, $250 per annum, 2 mth waiting period, 100% back up to annual limit. - Teeth whitening (must be provided by recognised dentist), $250 per annum, 2 mth waiting period, fixed amount payable. - Counselling (no waiting period) shares an annual limit with Psychology. Please contact Medibank for more information.
Comprehensive hospital and extras cover in one convenient package. Widest range of extras services including laser eye surgery, teeth whitening and much more. Our highest annual limits. Easy online and electronic claiming.
Ambulance
Emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.
Agreement hospitals in ACT
Medibank has agreements with 12 private hospitals here, as filed with the Ombudsman.
The list
- ACT Endoscopy - Deakin (day hospital)
- Act Day Hospital - Deakin (day hospital)
- Barton Private Hospital - Barton
- Brindabella Endoscopy Centre - Garran (day hospital)
- Calvary Bruce Private Hospital - Bruce
- Calvary John James Hospital - Deakin
- Canberra Microsurgery - Phillip (day hospital)
- Canberra Private Hospital - Deakin
- Canberra Surgicentre - Braddon (day hospital)
- Icon Cancer Centre Canberra - Bruce (day hospital)
- Mugga Wara Endoscopy Centre - Deakin (day hospital)
- National Capital Private Hospital - Garran
This policy's other options
Every state, household and excess the insurer filed for this policy, with the premium before the rebate.
Member retention (hospital cover)
85.4% is the Commonwealth Ombudsman's figure for Medibank in its State of the Health Funds Report 2024-25 (Table 1, page 15; data at 30 June 2025).
The Ombudsman describes it as one measure of the comparative effectiveness of insurers and of their level of member satisfaction: the percentage of members, hospital memberships only, who have remained with the insurer for 2 years or more (page 12). It is published for the insurer, not for this policy, and is not adjusted for policies that lapse when a member dies. The Ombudsman cautions that no single indicator shows an insurer's overall performance (page 27).
It is shown as published. The list is not sorted, filtered or ranked by it.
Member retention is the Commonwealth Ombudsman's figure, from its State of the Health Funds Report 2024-25. Source: Licensed from the Commonwealth Ombudsman under a Creative Commons 4.0 licence. This report is available from the Commonwealth Ombudsman website at www.ombudsman.gov.au.
Where this comes from
Policy details come from the PrivateHealth.gov.au dataset published by the Private Health Insurance Ombudsman on data.gov.au (release of 1 Oct 2026), licensed under Creative Commons Attribution 3.0 Australia. Statement J20/TCFF10, filed by Medibank Private Limited, issued 1 Apr 2026.
† Monthly premium: the premium the insurer filed with the Private Health Insurance Ombudsman for this state, household and excess, before the Australian Government rebate. Answer the income and age questions and every figure becomes the premium after your rebate, with any Lifetime Health Cover loading added to the hospital share (the rebate never applies to the loading) and the age-based discount taken off it where the policy offers one. Insurers may quote a different payment frequency and round each step; check the figure with the insurer before you join.
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