onemedifund
Gold Hospital $250 Excess & Comprehensive Extras
onemedifund
How $676.12 is worked out
- Premium as filed - $891.02 a month (hospital share $652.60)
- Government rebate - 24.1% of the premium (never of the loading): -$214.90
- A month - $676.12
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. $500 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 person 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 person a year, $2,100 lifetime |
| Glasses and contact lenses | 6 months | Single vision glasses: $275.00; Multifocal glasses: $275.00 | $275 per person a year |
| Prescriptions not on the PBS | 2 months | Prescription: $65.00 | $500 per person a year, $1,000 per policy a year (shared with other services) |
| Physiotherapy | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $550 per person a year, $1,100 per policy a year (shared with other services) |
| Chiropractic | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per person a year, $1,500 per policy a year (shared with other services) |
| Podiatry | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per person a year, $1,500 per policy a year (shared with other services) |
| Psychology | 2 months | First visit: $120.00; Follow-up visit: $80.00 | $500 per person a year, $650 per policy a year |
| Acupuncture | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per person a year, $1,500 per policy a year (shared with other services) |
| Remedial massage | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per person a year, $1,500 per policy a year (shared with other services) |
| Hearing aids | 24 months | Hearing aid: $1500.00 | $1,500 per person a year, 1 appliance every 5 years |
| Blood glucose monitors | 12 months | Blood: $130.00 | $130 per person a year, 1 appliance every 3 years |
| Antenatal and postnatal | 12 months | First visit: 80% back; Follow-up visit: 80% back | $150 per person a year |
| Dietitian | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per person a year, $1,500 per policy a year (shared with other services) |
| Exercise physiology | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $550 per person a year, $1,100 per policy a year (shared with other services) |
| Eye therapy (orthoptics) | 2 months | First visit: $90.00; Follow-up visit: $75.00 | $550 per person a year, $1,100 per policy a year (shared with other services) |
| Health management programs | 6 months | Benefit: $150.00 | $150 per person a year, $300 per policy a year |
| Home nursing | 2 months | First visit: $45.00; Follow-up visit: $45.00 | $1,000 per person a year |
| Occupational therapy | 2 months | First visit: $60.00; Follow-up visit: $40.00 | $550 per person a year, $1,100 per policy a year (shared with other services) |
| Orthotics | 2 months | Benefit: 80% back | $250 per person a year, $500 per policy a year |
| Osteopathy | 2 months | First visit: $40.00; Follow-up visit: $30.00 | $750 per person a year, $1,500 per policy a year (shared with other services) |
| Speech therapy | 2 months | First visit: 80% back; Follow-up visit: 80% back | $800 per person a year |
| Vaccinations | 2 months | Vaccination: $65.00 | $500 per person a year, $1,000 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 Victoria
onemedifund has agreements with 126 private hospitals here, as filed with the Ombudsman.
The list
- Adeney Private Hospital - Kew
- Anam Cara House Geelong - Waurn Ponds
- Ballarat Day Procedure Centre - Wendouree (day hospital)
- Ballarat Surgicentre - Soldiers Hill (day hospital)
- Bayside Day Procedure and Specialist Centre - Frankston (day hospital)
- Beleura Private Hospital - Mornington
- Bendigo Day Surgery - Bendigo (day hospital)
- Bentleigh Surgicentre - Bentleigh (day hospital)
- Boroondara Day Surgery - Hawthorn (day hospital)
- Brunswick Private Hospital - Brunswick
- Cabrini Brighton - Brighton
- Cabrini Malvern - Malvern
- Camberwell Day Surgery - Hawthorn East (day hospital)
- Casey Day Hospital - Narre Warren (day hospital)
- Chelsea Heights Day Surgery and Endoscopy - Chelsea Heights (day hospital)
- Chesterville Day Hospital - Cheltenham (day hospital)
- Coburg Endoscopy Centre - Coburg (day hospital)
- Corymbia Day Hospital - Dandenong (day hospital)
- Delmont Private Hospital - Glen Iris
- Diamond Valley Renal Care Centre - Greensborough (day hospital)
- Donvale Rehabilitation Hospital - Donvale
- Dorset Rehabilitation Centre - Pascoe Vale
- Dr Scope - Sunshine (day hospital)
- Eastside Endoscopy Centre - Ringwood (day hospital)
- Epworth Camberwell - Camberwell
- Epworth Eastern - Box Hill
- Epworth Freemasons - East Melbourne
- Epworth Geelong - Waurn Ponds
- Epworth Hawthorn - Hawthorn
- Epworth Richmond - Richmond
- Essendon Day Procedure Centre - Moonee Ponds (day hospital)
- Essendon Private Clinic - Essendon West
- Fertility Control Clinic - East Melbourne (day hospital)
- Footscray Day Surgery - Footscray (day hospital)
- Forest Hill Dialysis Clinic - Forest Hill (day hospital)
- Frances Perry House - Parkville
- Glen Eira Day Surgery - Caulfield South (day hospital)
- Glen Iris Private - Glen Iris (day hospital)
- Goonawarra Day Hospital - Sunbury (day hospital)
- Hampton Day Hospital - Hampton East (day hospital)
- Heyfield Hospital Inc - Heyfield
- Hobson Healthcare Sydenham - Sydenham (day hospital)
- Hobson Healthcare Werribee - Werribee (day hospital)
- Holmesglen Private Hospital - Moorabbin
- Imaging @ Olympic Park - Melbourne (day hospital)
- Ivanhoe Endoscopy Centre - Ivanhoe (day hospital)
- Jessie McPherson Private Hospital - Clayton
- John Fawkner Private Hospital - Coburg
- Keilor Private - Keilor (day hospital)
- Kew Endoscopy Centre - Kew East (day hospital)
- Knox Day Hospital - Bayswater (day hospital)
- Knox Private Hospital - Wantirna
- La Trobe Private Hospital - Bundoora
- Linacre Private Hospital - Hampton
- Malvern Dialysis Clinic - Malvern (day hospital)
- Malvern Private Hospital - Malvern East
- Manningham Private Hospital - Templestowe Lower (day hospital)
- Maryvale Private Hospital - Morwell
- Masada Private Hospital - East St Kilda
- Melbourne IVF Procedure Centre - Collingwood (day hospital)
- Melbourne Private Hospital - Parkville
- Mildura Health Private Hospital - Mildura
- Mitcham Private Hospital - Mitcham
- Monash Heart Private Operated By Jessie Mcpherson Private Hospital - Clayton
- Monash House Private Hospital - Clayton
- Monash Surgical Private Hospital - Clayton (day hospital)
- Mulgrave Private Hospital - Mulgrave
- Neerim Health - Neerim South
- Noble Park Endoscopy Centre - Noble Park (day hospital)
- North Eastern Rehabilitation Centre - Ivanhoe
- North Melbourne Renal Care Centre - North Melbourne
- North West Day Hospital - Ascot Vale (day hospital)
- Northern Private Hospital - Epping
- Northpark Private Hospital - Bundoora
- Panch Day Surgery Centre - Preston (day hospital)
- Paso Infusion Centre - Frankston (day hospital)
- Peninsula Private Hospital (Vic) - Langwarrin
- Ramsay Clinic Albert Road - Melbourne
- Ringwood Private Hospital - East Ringwood
- Rosebud Day Hospital - Rosebud (day hospital)
- Shepparton Private Hospital - Shepparton
- Sir John Monash Private Hospital - Clayton (day hospital)
- Skin Cancer Day Surgery - Ashwood (day hospital)
- Skin Health Institute - Carlton (day hospital)
- South Eastern Private Hospital - Noble Park
- Southern Eye Centre Day Surgery - Frankston (day hospital)
- Specialist Surgicentre Docklands - Docklands (day hospital)
- Specialist Surgicentre Geelong - Geelong (day hospital)
- Springvale Endoscopy Centre and Day Hospital - Springvale (day hospital)
- St Albans Endoscopy Centre - St Albans (day hospital)
- St John Of God Berwick Hospital - Berwick
- St John Of God Frankston Rehabilitation Hospital - Frankston
- St John Of God Geelong Hospital - Geelong
- St John Of God Langmore Centre - Berwick
- St John of God Ballarat Hospital - Ballarat
- St John of God Bendigo Hospital - Bendigo
- St John of God Berwick Day Oncology Centre - Berwick (day hospital)
- St John of God Warrnambool Hospital - Warrnambool
- St Vincent's Private Hospital East Melbourne - East Melbourne
- St Vincent's Private Hospital Fitzroy - Fitzroy
- St Vincent's Private Hospital Kew - Kew
- St Vincents Private Hospital Werribee - Werribee
- Stonnington Day Surgery - Malvern (day hospital)
- Sunshine Dialysis Clinic - St Albans (day hospital)
- The Avenue Private Hospital - Windsor
- The Bays Healthcare Group Inc - Mornington
- The Digestive Health Centre - Dandenong (day hospital)
- The Geelong Clinic - St Albans Park
- The Glen Endoscopy Centre - Glen Waverley (day hospital)
- The Melbourne Clinic - Richmond
- The Melbourne Eastern Private Hospital - Boronia
- The Victoria Clinic - Prahran
- The Victorian Rehabilitation Centre - Glen Waverley
- Vermont Private Hospital - Vermont South
- Victoria Parade Surgery Centre - East Melbourne (day hospital)
- Victorian Gut Centre Bundoora - Bundoora (day hospital)
- Wangaratta Private Hospital - Wangaratta
- Warringal Private Hospital - Heidelberg
- Waverley Endoscopy - Mount Waverley (day hospital)
- Waverley Private Hospital - Mount Waverley
- WestPoint Endoscopy Day Hospital - Werribee (day hospital)
- Western Gastroenterology Services - Footscray (day hospital)
- Western Private Hospital - Footscray
- Whitehorse Day Surgery - Box Hill (day hospital)
- Windsor Private Hospital - Windsor
- Wyndham Clinic Private Hospital - Werribee
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/AABD20, 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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