How to use your nib health insurance

Congratulations on purchasing health cover! You’ve taken the first step in protecting your health, but at nib, we’re more than a health insurer, we’re your health partner – giving you access to tools and benefits to keep you looking and feeling your best. 

So now that you’re an nib member, you might be wondering: what’s next? 

We’ve put together a little step-by-step guide to make sure you feel confident about your chosen cover and benefits – that way, you can start getting the most out of your cover quicker! 

Once you’ve signed up to be an nib member, we’ll send a welcome pack to your email address. This will include information on your chosen policy and information on the Government’s health insurance rebates and the Lifetime Health Cover loading. 

We know it’s a lot of information to digest, but the Australian Government has several initiatives in place to encourage Aussies to take up private health cover – so it’s good to understand what you’re eligible for.  

It’s important to double-check the inclusions listed on your policy to make sure you’re covered for all of the services you might need. For example, if you’re looking to access pregnancy benefits or dialysis services, you may need to opt for one of our higher levels of cover.  

Regardless of what level or type of cover you’ve chosen, you can rest easy knowing that nib offers unlimited emergency ambulance on most health covers^1. We also provide members with nib Hospital cover access to our Accidental Injury Benefit. If you have an accident and present for treatment with a medical practitioner at the emergency department within 72 hours of the accident, you can receive benefits related to the accident in line with our Gold Hospital cover within 90 days after an accident if you end up being admitted to hospital². 

You’ll also be able to double check what annual limits apply on your Extras policy. You’ll either have a policy that allows 60% or 75% of the cost back on Extras like dental and optical every time you claim with a recognised provider, until you reach your annual limit. For example, if you visit your dentist for a filling and it costs $200, you know you’ll get 60% back with Core Extras — that’s $120 back in your wallet³. For more information, check out our article, When do private health insurance annual limits reset? 

All new nib members will receive a standard card, sent out to your postal address. But, you can also download your nib card to your Apple Wallet or Android device. Having your nib member card on your phone allows you to tap your phone or smart device (like your Apple watch) to automatically claim your benefits after an appointment.  

A ‘gap’ is the difference between what your health insurer (and the government) pays for and what a specialist or a hospital charges for their service when you go to hospital. To help you minimise this gap (or ‘out-of-pocket expense’), we’ve developed agreements with most Australian private hospitals and specialists. These agreements mean we can reduce or eliminate out-of-pocket expenses for our members when they need hospital treatment. Use our online hospital search tool to find private hospitals and specialists we have agreements with.  

For more information, visit our dedicated article: Why do I have to pay a gap when being treated in hospital?

If you think you might need to head to hospital in the near future, it’s important to note any waiting periods your policy might have before claiming. The best bet? Contact nib to get advice on your hospital admission. That way we can make sure you’re covered for the procedure, help you find an nib agreement hospital and even search for a local nib MediGap specialist to reduce any out-of-pockets. 

Related: Going to hospital? Here's why you should contact nib first.

Contact us first so we can help reduce any out-of-pockets

Now that you’ve got a good understanding of your policy, it’s time to start claiming! The simplest way to make a claim is to download the nib app, which is available on iPhone, iPad and Android. Open your app, take a photo of your official receipt and hit ‘claim now’. For more detailed instructions, check out our nib app claiming guide.  

Looking for a local health professional for your next dental, physio or optical appointment? The nib First Choice network is a must-visit. It’s our community of specially selected health providers, who have promised they will deliver quality care and value for money. 

Another perk of being an nib member is that you’ll unlock access to nib Rewards – our portal of exclusive benefits and offers with more than 100 retailers – so you’ll be able to save on everything from groceries to gym memberships⁴.   

If you have any questions about your policy, we’re here for you. Feel free to give one of our health insurance experts a call on 13 14 63.

¹1 day waiting period applies. Not available to: (i) QLD residents who have ambulance services provided by their State ambulance schemes; (ii) TAS residents who are covered under state ambulance schemes in TAS and when travelling in mainland Australia except SA and QLD; or (iii) pension and health care card holders who have ambulance services provided by State ambulance schemes (check entitlements with Centrelink if unsure).

²Excludes consult at an Emergency Department or with a Medical Practitioner (e.g. GP). Accidental Injury Benefit criteria must be met for approval.

³Annual limits and waiting periods may apply.

⁴T&Cs apply. Some offers may vary or be available for a limited time. For members with private health insurance, nib Rewards are available to new health insurance members after 30 days of membership, provided premium payments are up to date.