Why should I keep my private health insurance during the COVID-19 pandemic?

Two young men laughing and eating a healthy breakfast together

Here are some of the many benefits of keeping your cover

14 September 2020 7 minute read

Since we first heard about the outbreak of COVID-19 (the novel coronavirus), all of us have changed the way we go about our everyday lives to help prevent the spread of the virus.

During these uncertain times, it’s even more important that we continue to focus on staying mentally and physically healthy.

If you find yourself asking, ‘Why should I keep my private health insurance?’, we're here to help.

We’ve put together some of the benefits of keeping your nib health insurance throughout the COVID-19 pandemic.

You’ll receive coverage for COVID-19

To support our members, we've temporarily expanded coverage for chest, lung, kidney or other treatment related to COVID-19 across all levels of Hospital cover at no additional cost, even on Basic and Bronze Hospital covers where these treatments are currently excluded, until 30 September 2021. You'll just need to have served the standard two-month waiting period before requiring treatment¹.

Along with other health insurers across Australia, any treatment for COVID-19 as an outpatient that is covered by Medicare will not be covered by nib.

For more information, see our FAQs about COVID-19 and your cover.

You’ll receive cover for psychology regardless of your Extras policy

Looking after your mental health and wellbeing is essential; that’s why at nib, until 30 June 2021, all members with Extras cover will be covered for psychology up to a limit of $300 at no additional cost (claimable as a one-time benefit only)².

To be eligible, you'll need to be an Australian resident member, currently holding Extras cover and have already served your two-month waiting period. If you currently have psychology cover over $300 or are on a mental health care plan set by Medicare, you’re unable to claim the temporary cover.

For more information, call 13 14 63 or visit our COVID-19 mental health support page.

You’ll be able to claim on telehealth services

To ensure our members continue to stay as healthy as possible while social distancing, nib will cover appropriate treatment using telehealth for eligible members.

This means that you’ll still be able to use your cover to claim on telehealth appointments (like video calls or Skype appointments) for services including psychology, physiotherapy, dietetics, speech pathology and occupational therapy³. A service will only be provided by telehealth where it is safe and clinically appropriate, so not all providers will be able to make it available. Please check with your provider if this is something they’re able to do.

For a full list of telehealth services, as well as claiming criteria, check out our telehealth FAQs.

You’ll have unlimited emergency ambulance cover

nib offers unlimited emergency ambulance cover regardless of your level of Hospital cover⁴. So by keeping your policy, you’ll get the emergency help you need, when and as often as you need it without having to worry about an expensive bill.
If you don’t have private health insurance, you might have to pay a hefty fee.

You’ll have accidental injury cover

Although public hospitals provide free health treatment in the emergency department, if you need further treatment after your initial admission, the costs (and the waiting times) can add up quickly. That’s why we offer nib’s Accidental Injury Benefit on the majority of nib Hospital covers. This benefit provides you with the peace of mind that you have extra protection if you do receive an injury as a result of an accident.

How does it work? If you’re an nib member and you seek treatment with a medical practitioner or attend a hospital emergency department within 72 hours of an accident, you’ll receive benefits in line with our top Hospital cover for the following 90 days if you are then admitted to hospital. So if you require further treatment as a result of your accident as an inpatient in hospital, you can rest assured you’ll be covered. This includes admission to a private hospital, or as a private patient in a public hospital.

A mum and son pulling a tray out of the oven

You can access mental health services, regardless of Hospital cover level

Thanks to the mental health waiver, eligible nib members⁶ on a lower level of Hospital cover can upgrade their policy and immediately access the full benefits for psychiatric treatment without serving the usual two month waiting period. For more information, head to our Restrictions and Waivers page.

You could avoid the Medicare Levy Surcharge

If you’re single and earn more than $90,000 or you’re part of a family that earns more than $180,000⁷, and you haven’t held private hospital cover for the full financial year, you may be charged the Medicare Levy Surcharge come tax time. This government-initiated payment is an extra 1% to 1.5% tax on top of the Medicare Levy we all have to pay.

Find out more with our article: Do I have to pay the Medicare Levy Surcharge at tax time?

You could access our range of Health Management Programs

At nib, we want you to be at your healthiest all the time, but with the current restrictions, we understand it can be tough. That’s why we encourage all our members to look into our range of Health Management Programs. Designed by qualified health professionals, offered free of charge to eligible members⁸ and tailored to your individual needs, the programs are designed to help get you in shape, keep you out of hospital and aid a quicker recovery post-hospitalisation.

For more information, or to register your interest, head to our Health Management Programs page.

You’ll avoid re-serving waiting periods

If you decide to cancel your private health insurance policy and then open a new one in six or 12 months’ time, you’ll be required to re-serve your waiting period. A waiting period is the time-frame you have to wait before you can start claiming benefits on your cover, and it applies to both Hospital and Extras cover.

The government is responsible for setting the maximum hospital wait periods that health funds can have, so that it’s as fair as possible for all Aussies.

You won’t lose your financial incentives

If you cancel your private health insurance and you’ve been getting the benefit of government financial incentives (such as avoiding the Lifetime Health Cover loading and receiving the age-based discount), if you do decide to take out private health insurance in the future, you may not be eligible for the same discounts and loading exemptions you had initially.

Still not sure whether keeping your private health insurance is the right decision for you and your family? We encourage you to do a cover review; head to our article, Everything you need to know about reviewing your cover for more information or call 13 16 42.

¹Pre-Existing Conditions have a waiting period of 12 months.

²The minimum benefit of $300 for psychology on Extras products is claimable once only by an eligible member. This benefit did not reset with other Extras limits on 1 January 2021.

³Subject to: level of Extras cover, policy exclusions, waiting periods & limits. Other T&Cs apply.

⁴Not 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 NSW, SA or QLD; or (iii) pension and health care card holders who have ambulance services provided by State ambulance schemes (check entitlements with Centrelink if unsure).

⁵One-day waiting period applies.

⁶This waiver is only available to members who have held Hospital cover for at least the previous two months, have not previously used their waiver with us or any other fund, have been admitted to a hospital and are under the care of an addiction medicine specialist or consultant psychiatrist.

⁷Visit the Australian Tax Office website for specific rules for calculating income for MLS purposes.

⁸T&Cs and eligibility criteria apply to each program.