Gold Advanced Cover $750 Excess
nib
How $1,471.69 is worked out
- Premium as filed - $1,939.44 a month (hospital share $1,357.61)
- Government rebate - 24.1% of the premium (never of the loading): -$467.75
- A month - $1,471.69
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 - Capped per person and per policy per year. $750 per admission. $750 per person a year. $1,500 per policy a year. No excess for dependants.
- 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 - No
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: Our Going to Hospital Pack provides more ways to reduce out-of-pockets, ask us for your copy.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental | 2 months | Check-up (item 012): $35.20; Scale and clean (item 114): $66.85; Fluoride treatment (item 121): $21.85 | $1,000 per person a year |
| Major dental | 12 months | Tooth extraction (item 322): $168.55; Crown (item 615): $1079.10 | $1,300 per person a year (shared with other services) |
| Root canal | 12 months | Root canal (item 417): $178.10 | $1,300 per person a year (shared with other services) |
| Braces | 12 months | Braces, upper and lower, with a retainer (item 881): 75% back | $800 per person a year, $2,600 lifetime |
| Glasses and contact lenses | 6 months | Single vision glasses: 75% back; Multifocal glasses: 75% back | $350 per person a year |
| Prescriptions not on the PBS | 2 months | Prescription: 75% back | $500 per person a year |
| Physiotherapy | 2 months | First visit: 75% back; Follow-up visit: 75% back | $600 per person a year |
| Chiropractic | 2 months | First visit: 75% back; Follow-up visit: 75% back | $500 per person a year (shared with other services) |
| Podiatry | 2 months | First visit: 75% back; Follow-up visit: 75% back | $400 per person a year (shared with other services) |
| Psychology | 2 months | First visit: 75% back; Follow-up visit: 75% back | $500 per person a year |
| Acupuncture | 2 months | First visit: 75% back; Follow-up visit: 75% back | $450 per person a year (shared with other services) |
| Remedial massage | 2 months | First visit: 75% back; Follow-up visit: 75% back | $450 per person a year (shared with other services) |
| Hearing aids | 36 months | Hearing aid: 75% back | $1,200 per person a year, 2 appliances every 5 years |
| Blood glucose monitors | 12 months | Blood: 75% back | $500 per person a year, 1 appliance every year |
| Antenatal and postnatal * | 2 months | First visit: 100% back; Follow-up visit: 100% back | $300 per person a year |
| Chinese herbal medicine | 2 months | First visit: 75% back; Follow-up visit: 75% back | $450 per person a year (shared with other services) |
| Dietitian | 2 months | First visit: 75% back; Follow-up visit: 75% back | $700 per person a year |
| Exercise physiology | 2 months | First visit: 75% back; Follow-up visit: 75% back | $400 per person a year |
| Eye therapy (orthoptics) | 2 months | First visit: 75% back; Follow-up visit: 75% back | $300 per person a year |
| Health management programs | 6 months | Benefit: 75% back | $200 per person a year |
| Home nursing | 2 months | First visit: 75% back; Follow-up visit: 75% back | $200 per person a year |
| Occupational therapy | 2 months | First visit: 75% back; Follow-up visit: 75% back | $550 per person a year |
| Orthotics | 2 months | Benefit: 75% back | $400 per person a year (shared with other services) |
| Osteopathy | 2 months | First visit: 75% back; Follow-up visit: 75% back | $500 per person a year (shared with other services) |
| Speech therapy | 2 months | First visit: 75% back; Follow-up visit: 75% back | $450 per person a year |
Not covered: Audiology, Vaccinations.
Other services, as filed: Preventative Tests ($200) e.g. thin prep, bone density testing, bowel screening (Service limits apply). Health Aids ($500) e.g. spacer, peak flow meter, nebuliser, Irlen lens. Myotherapy: combined limit of $450 with acupuncture, remedial massage and Chinese herbalism. Sublimit of $250 for Remedial Message. Psychology has a sublimit of $150 for Digital Cognitive Behavioural Therapy (CBT). Healthier Lifestyle ($200) includes nib approved weight management, quit smoking and health management programs (gym, personal trainer) and more. Use nib Rewards to access a range of rewards and discounts on services like groceries, petrol, entertainment, health, wellbeing and more! For Preventative dental service limits apply. Non-PBS pharmaceuticals have a sub limit of $150 for Weight Management Medication.
By choosing an nib First Choice provider it means you could pay less on dental treatment, physiotherapy and optical. Service limit apply to Preventative dental, Optical, Orthotics, Hearing Aids & Hearing Aids Repair, Health Aids and Preventative Test.
No yearly limit on preventative dental.
Ambulance
Emergency ambulance. Call-out fees covered. Waiting period for emergency transport: 1 day. No limit on emergency transport.
Agreement hospitals in Northern Territory
nib has agreements with 3 private hospitals here, as filed with the Ombudsman.
The list
- Darwin Day Surgery - Wanguri (day hospital)
- Darwin Private Hospital - Tiwi
- NT Medical Specialist - Wanguri (day hospital)
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)
79.0% is the Commonwealth Ombudsman's figure for NIB 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 J115/NWHI2Y, filed by nib Health Funds Ltd., issued 1 Oct 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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