Hospital cover

If you find yourself needing treatment in a hospital, Hospital cover can help cover costs like doctor’s fees and your hospital stay. Not only that, but having hospital cover gives you greater choice and control when it comes to your healthcare: 

• Choice of specialists: With hospital cover, you get to choose your specialist when you go to a private hospital, which can feel much more comfortable. 

• Timely care: You won’t have to wait as long for treatment as you would in the public system. Once your waiting periods are finished, you can get care as soon as you and your specialist are ready. 

• You could pay less at tax time: If you earn over a certain income threshold, having hospital cover can help you avoid the Medicare Levy Surcharge (MLS). Plus, it helps you avoid paying Lifetime Health Cover (LHC) loading if you take out hospital insurance before your 31st birthday.

nib Hospital cover helps pay for your treatment based on your level of cover and the type of hospital you choose. Generally, you'll be covered for: 

• Hospital accommodation (i.e. your bed and a private room if one is available) 

• Operating theatre fees 

• Intensive care fees 

• Labour ward fees 

• Meals 

• Common treatments and support treatments* 

• Associated treatment for complications and associated unplanned treatment^ 

However, there are some things that aren't covered, such as luxury room upgrades, non-essential services and Outpatient services performed by a doctor or specialist 

Learn more about what nib does and doesn’t cover for your hospital stay and always check your Policy Booklet or Fact Sheet for more information. 

You can still be covered if you have a pre-existing condition, as long as the procedure is included in your Hospital cover. However, you'll need to serve a longer waiting period before you can claim any treatment for it. 

If your condition falls under the pre-existing category, a 12-month waiting period typically applies from the date you join or upgrade your hospital cover. This means we won't cover any hospital expenses related to that condition during this waiting period. 

Learn more about pre-existing conditions.

Going to the hospital can come with some costs, even if you have cover. While nib helps with expenses for services included in your plan, you might still face out of pocket costs if your treatment exceeds what nib and Medicare cover. 

To help minimise these costs, nib has No Gap and Known Gap agreements with certain specialists in select locations across Australia. If your procedure qualifies and is covered by your policy, your only expense could be a hospital excess. 

To better manage your expenses, make sure you have the right cover, consult with nib before your hospital visit, choose a participating specialist and request written fee estimates from your doctors and hospital. 

Learn how to reduce your out of pocket hospital costs.