onemedifund
Gold Hospital $250 Excess & Comprehensive Extras
onemedifund
How $338.06 is worked out
- Premium as filed - $445.51 a month (hospital share $326.30)
- Government rebate - 24.1% of the premium (never of the loading): -$107.45
- A month - $338.06
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. $250 per person a year. $250 per policy a year.
- Co-payments - None.
- Known gap - Yes, with the fund's doctors
- Age-based discount - Not offered
- Accident cover - No
- 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: Ambulance Cover Nationwide. No waiting period applies for hospital treatment resulting from an accident.
Extras: what you get back
| Service | Waiting period | Example benefits, as filed | Limits |
|---|---|---|---|
| General dental | 2 months | Check-up (item 012): $50.00; Scale and clean (item 114): $80.00; Fluoride treatment (item 121): $30.00; Tooth extraction (item 322): $200.00 | no yearly limit |
| Major dental | 12 months | Crown (item 615): $850.00 | $2,650 per policy a year |
| Root canal | 2 months | Root canal (item 417): $200.00 | no yearly limit |
| Braces | 12 months | Braces, upper and lower, with a retainer (item 881): $2100.00 | $2,100 per policy a year, $2,100 lifetime |
| Glasses and contact lenses | 6 months | Single vision glasses: $275.00; Multifocal glasses: $275.00 | $275 per policy a year |
| Prescriptions not on the PBS | 2 months | Prescription: $65.00 | $500 per policy a year (shared with other services) |
| Physiotherapy | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $550 per policy a year (shared with other services) |
| Chiropractic | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per policy a year (shared with other services) |
| Podiatry | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per policy a year (shared with other services) |
| Psychology | 2 months | First visit: $120.00; Follow-up visit: $80.00 | $500 per policy a year |
| Acupuncture | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per policy a year (shared with other services) |
| Remedial massage | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per policy a year (shared with other services) |
| Hearing aids | 24 months | Hearing aid: $1500.00 | $1,500 per policy a year, 1 appliance every 5 years |
| Blood glucose monitors | 12 months | Blood: $130.00 | $130 per policy a year, 1 appliance every 3 years |
| Antenatal and postnatal | 12 months | First visit: 80% back; Follow-up visit: 80% back | $150 per policy a year |
| Dietitian | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per policy a year (shared with other services) |
| Exercise physiology | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $550 per policy a year (shared with other services) |
| Eye therapy (orthoptics) | 2 months | First visit: $90.00; Follow-up visit: $75.00 | $550 per policy a year (shared with other services) |
| Health management programs | 6 months | Benefit: $150.00 | $150 per policy a year |
| Home nursing | 2 months | First visit: $45.00; Follow-up visit: $45.00 | $1,000 per policy a year |
| Occupational therapy | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $550 per policy a year (shared with other services) |
| Orthotics | 2 months | Benefit: 80% back | $250 per policy a year |
| Osteopathy | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per policy a year (shared with other services) |
| Speech therapy | 2 months | First visit: 80% back; Follow-up visit: 80% back | $800 per policy a year |
| Vaccinations | 2 months | Vaccination: $65.00 | $500 per policy a year (shared with other services) |
Not covered: Audiology, Chinese herbal medicine.
Loyalty bonuses apply to Surgical Equipment/Health Aids, Crowns & Bridges, Dentures & Orthodontics after 5yrs continuous cover on this product. Ambulance Cover Nationwide.
Ambulance
Emergency and non-emergency ambulance. Call-out fees covered. Waiting period for emergency transport: none. No limit on emergency transport.
Agreement hospitals in ACT
onemedifund has agreements with 12 private hospitals here, as filed with the Ombudsman.
The list
- ACT Endoscopy - Deakin (day hospital)
- Barton Private Hospital - Barton
- Brindabella Endoscopy Centre - Garran (day hospital)
- Calvary Bruce Private Hospital - Bruce
- Calvary John James Hospital - Deakin
- Canberra Imaging Group - Deakin (day hospital)
- 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.
| State | Who is covered | Excess | A month, as filed |
|---|---|---|---|
| Every state | Me and my partner | $250 | $891.02 |
| Every state | My family | $250 | $891.02 |
| Every state | Just me | $250 | $445.51 |
| Every state | Me and my children | $250 | $891.02 |
Member retention (hospital cover)
93.2% is the Commonwealth Ombudsman's figure for Onemedifund 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 H9/AAAY10, filed by National Health Benefits Australia Pty Ltd (onemedifund), 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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