NIB Health Insurance Review
Overview
The Newcastle Industrial Benefits (NIB) health fund was established 60 years ago for BHP Steelwork employees in the NSW Hunter region. Today the health fund provides quality and affordable cover to over 1 million Australians. nib also operates in New Zealand and offers health cover to Australian expats studying and working abroad.
NIB Health has dental and eye care centres in Victoria and New South Wales that offer 100% back on preventative dental, selected contact lenses and single vision glasses depending on what policy you hold.
NIB is the 4th largest health insurance provider in Australia.
NIB Health Insurance Key Facts
Founded: 1952
For-Profit or Not-For-Profit? For-Profit
Private Hospital Agreements Nationwide: 288
Day Hospital Agreements Nationwide: 275
Health Deal Represented? Yes
Headquarters: Newcastle, NSW
NIB Health Hospital Cover
nib Health has hospital policies to suit every age and medical need. These range from Basic Essentials Hospital Plus all the way up to Gold Top Hospital. Here is a list of some of the hospital covers currently available from nib:
- Basic Essentials Hospital Plus
- Bronze Hospital Plus
- Silver Hospital
- Silver Advantage Hospital Plus
- Gold Top Hospital
NIB Health Extras Cover
Extras Cover takes care of the everyday healthcare service expenses that are not covered under Medicare such as dental services, prescription glasses, and physiotherapy. Here is a list of some of the current extras covers available:
- Core Extras
- Core and Wellbeing Extras
- Core and Young at Heart Extras
- Core, Family and Young at Heart Extras
- Dental Boost
- Core Boost
- Core, Wellbeing and Young at Heart
- Top Extras
- Premium Extras
NIB Health Combined Cover
Nib has 8 combined covers and these are:
- Basic Kickstarter
- Basic Plus
- Basic Saver – Basic Plus
- Bronze Kickstarter Plus
- Everyday Saver – Basic Plus
- Mid Plus-Silver Plus
- Top Cover – Gold
- Young at Heart Top – Silver Plus
NIB Health Waiting Periods
nib recognises the waiting periods you have already served with a previous health fund if you switch, this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:
Hospital waiting periods
- Ambulance services: 1 day
- Accidental Injury: None
- New Conditions: 2 Months
- Pregnancy and birth-related services: 12 months
- Pre-existing conditions: 12 months
- Rehabilitation & Palliative care: 2 months
- Weight Loss Surgery: 12 months
How Do You Claim Extras With NIB Health?
NIB offers 4 quick and easy ways to claim on your extras. This can be done in the following ways:
On the spot: Swipe your membership card at a health provider that uses the HICAPS system to have your claim processed immediately.
Via a mobile app: You can lodge a claim using the nib App by submitting a photo of your receipt.
Online: You can log into nib’s Online Services and lodge your claim by providing the details on your receipt.
By Mail: You can lodge your claim by posting a completed claim form with the relevant accounts and receipts to:
Locked Bag 2010,
Newcastle, NSW
2300
NIB Health Gap Cover
NIB’s gap cover is called MediGap. If your doctor charges you more than the standard MBS fee, this is known as the ‘gap’ and can leave you with an out-of-pocket expense. MediGap can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.
Gap Cover Ratings By State
To determine how beneficial a gap scheme will be, we suggest comparing health funds in the same state or territory to show which of the funds offer a greater proportion of medical services covered with no gap. While it is more likely that a medical service covered under your health fund can be utilized at no personal cost to you, it is entirely the choice of the physician whether or not to participate in the gap cover scheme.
Medical Services with No Gaps — The percentage of claims that were fully refunded.
Medical Services with No or Known Gaps — The percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed.
The information below outlines the percentages of services covered under no-gap and known-gap.
NIB Health Fund medical services with No Gap: 66.2%
Industry Average: 79.1%
NIB Health Fund medical Services with No or Known Gap: 66.2%
Industry Average: 90.5%
NIB Health Fund medical services with No Gap: 92.6%
Industry Average: 89.5%
NIB Health Fund medical Services with No or Known Gap: 92.6%
Industry Average: 95.7%
NIB Health Fund medical services with No Gap: 91.4%
Industry Average: 86.7%
NIB Health Fund medical Services with No or Known Gap: 91.4%
Industry Average: 95.1%
NIB Health Fund medical services with No Gap: 85.9%
Industry Average: 89.2%
NIB Health Fund medical Services with No or Known Gap: 85.9%
Industry Average: 94.5%
NIB Health Fund medical services with No Gap: 93.6%
Industry Average: 89.5%
NIB Health Fund medical Services with No or Known Gap 93.6%
Industry Average: 96.6%
NIB Health Fund medical services with No Gap: 81.8%
Industry Average: 84.4%
NIB Health Fund medical Services with No or Known Gap: 81.8%
Industry Average 96.2%:
NIB Health Fund medical services with No Gap: 85.3%
Industry Average: 90.2%
NIB Health Fund medical Services with No or Known Gap: 85.3%
Industry Average: 96.7%
NIB Health Fund medical services with No Gap: 77.2%
Industry Average: 84.2%
NIB Health Fund medical Services with No or Known Gap: 77.2%
Industry Average: 93.8%
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General Manager
Chris is the General Manager of Health Deal, one of Australia's biggest health insurance comparison services. He has been with Health Deal since the very beginning. Started as a sales agent and made the first ever sale for Health Deal, Chris has worked his way up to General Manager in 2020. He's seen it all through team leadership and campaign management.