Tell us your experience with Medibank

Do you have something to say about Medibank Private health insurance? Tell us your good experiences, bad experiences or otherwise and help inform the CHOICE Community.

Read our Medibank Private health insurance review

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Our daughter has health insurance with Medibank Private. Approx three years ago she had bariatric weight loss surgery. At the time of her surgery she was covered by Medibank Private. Since her surgery Medibank Private has restricted Weight Loss surgery to members who have top tier cover. Our daughter was able to get this surgery when she had basic health insurance albeit there was about a $3000 gap to be paid. She has been told that the band is in all probability causing her severe health issues and will have to be removed if this is confirmed by Endoscopy. My question is this since she is no longer covered for Bariatric surgery with basic health insurance cover will she be covered if she has to have the lap band removed? The weight loss surgery for her has been very successful. Her band might have to be removed because of an immune condition she has that is causing her body to reject it.

I find it interesting that Medibank Private is not the only fund to change the rules so that you have to have top insurance to be able to be claim on this procedure. Weight loss surgery has the potential to save people’s lives. I think Medibank Private are a greedy company & they only care about their shareholders. We had insurance with them for decades but spat the dummy when they decided to not cover blood tests and radiology if you were an inpatient no matter what your level of cover was.

If the band is causing problems your daughter may very well be able to get the surgery for free through the Public system and not pay a cent. Have her get her GP to send a referral to the Public Hospital and if she has any problems with her illness get her to attend the emergency department of the Hospital as this will help speed up her access to surgery.

You have eloquently stated what capitalism and private enterprise are about, eg profits. While many [conservatives] rail loudly about ‘red tape’ impeding business the purpose of that ‘red tape’ is usually to overlay integrity and public responsibility into activities where it otherwise would not exist.

Yet many people continue to vote in favour of less ‘red tape’, less government, and more private enterprise, but bleat when the reality sets in that capitalism is for the benefit of capitalists not of ‘the public’ unless ‘the public’ is congruent with ‘their customers’. When the latter holds, the common outcome is to charge the most and deliver the least, also referred to as ‘what the market will bear pricing’ to maximise profits and thus dividends and thus support a high share price, noting executive options are part of their compensation and are favourably taxed as capital gains events – eg the executives have a vested interest in pumping up the share price any way they can.

One need only survey the societal outcomes of the many ‘public-private’ partnerships across Australia that mostly privatise profits and socialise losses. Since Medibank Private had its IPO the beneficiaries appear to be the shareholders and executives in 2016 and more in 1H2017, rather than their policy holders (customers).

In the case of health funds there is anecdotal evidence that Medibank, as an historic market maker, will be a leader for customers’ costs while delivering as little as possible in return, and the competitors take the cue and follow along. All the while government constrains Medicare to make a ‘vibrant and profitable’ capitalistic health insurance industry - eg follow the money.

Health funds are insurance companies and can be expected to work chapter and verse to a policy as it is at the time. Only Medibank can answer that question, and get it in writing (or email) as that usually encourages a more rigorous response as they can be held accountable more easily.

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Our family uses Medibank Private (Hospital and Extras) and have been happy with them for many years. I recently had a heart attack and as soon as the public hospital found I had Medibank Private they transferred me to their private hospital area and called my Cardiologist. Handy as they had no public beds and had suggested that I should go home and call my Cardiologist. One week in Private hospital and I never saw a bill, including for the stent inserted while there. Medibank Private followed me up to ensure I was happy with the service and treatment received. The wife has just had a hip replacement at a private hospital ( 12 - 18 mths wait if public, 1 month prelim tests then the operation in Private Hospital). We were out of pocket $1,000 but this was worth not waiting for the extended public wait. In summary, yes you pay many $ for Medibank Private, but we have found the cost was more than justified.

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thank for your message. the gap you paid sounds very reasonable. do you have top hospital cover?

I went to a dentist aligned with medibank private, whilst it was fantastic having no out of pocket fees, the caliber of dental service was atrocious, they’re just basically a money-making machine. Taking X-rays on every visit and you are seen by a dental hygienist who checks and cleans then the actual dentist steps in for a 2 minute run down and disappears. What a wrought. I did complain to medibank but they didn’t do anything. I now go to a very caring and professional dental practice run by husband and wife dentists. I am out of pocket but it’s worth it to just get a proper dental check without all the whohaa of the more “business “ run practices.

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If anyone has had experience with the Medibank Accident and Ambulance Cover policy, please let me know.

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I am just wondering if anyone else has found themselves in the position I currently find myself in. I have been a Medibank or as it was called when I joined Medibank Private. We have been with this company for over 20 years. When we took out this policy we went to a Medibank Private office in Adelaide (This was back in the day offices with face to face contact was common place) we specifically asked for the policy to include joint replacement as my wife had hip issues. The rep told us this certainly could be included but would only be eligible after a 12 month waiting period, which we believed to be fair & reasonable. I now need to have a knee replacement & believing the policy covered this so went ahead with the process of having the surgery which was scheduled for 11/10/21. I was contacted today by the hospital were the procedure was scheduled indicating they tried to process the payment to Medibank but they indicated I was not covered for this procedure. After a long process on the phone to Medibank (I must admit the Medibank Rep treated my rather well) I was informed that yes originally the policy did cover this procedure but apparently in 2019 the Government changed the categories to a Gold, Silver & Bronze classification which apparently reduced what I was covered for. I do remember receiving a letter from Medibank at some stage indicating as part of the Australian Government private health insurance reforms some natural therapy services would be removed from the policy. Just to rub salt into the wound this come after a price increase on 01/04, the charges apparently took effect later in April. Perhaps I should have taken much more notice but I assumed that because my policy costs hadn’t reduced I must be still receiving the same level of cover, I did not use natural therapies so was not concerned about it Just very poor form to have a reduction in services covered but still pay the same price. I have no interest in how the Government mandates categories but this should have no impact on a current policy & what is covered under the policy. The Medibank rep has raised a case to have the decision review but will take 2 business days to file & then another 10 Business days to review before a decision is made, this will conveniently push the decision past the surgery date. Am I missing something complaining about this sort of treatment? I implore all to regularly check what their policy covers. This in a system the Government forces citizens to join or have to pay a tax surcharge.

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That is an interesting story, with many issues. One that everyone should be aware of is to never make assumptions and always confirm cover prior to making arrangements for treatment. If there are surprises they can be dealt with and decisions made without the time pressures you face.

As for government, no comment other than be it insurances or super, they seem little more than toys at times, even when they improve, or pretend to improve the products on offer.

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As with electricity retailers, and insurers obfuscated offerings, it was almost impossible for the average consumer to work out which health fund gave them the best deal.

The Government sold this change as a way to make it a level playing field so it will be easier for consumers to compare and contrast the health fund offerings. The plethora of health insurance policies required additions and/or removals to bring them into line with the new ‘standard’.

You should/would have received correspondence from Medibank detailing the changes to your cover. If you were sent this information you would be very very lucky if Medibank decide to pay for your knee replacement.

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