Mildura Health Fund Review

Overview

Mildura Health is a regional health fund that has been operating in Mildura, Victoria for 90 years. Mildura Health Fund is member owned and not-for-profit, the returns are invested back into its 32,000 members in the form of higher benefits and competitive premiums.

Mildura Health Key Facts

Founded: 1929

For-Profit or Not-For-Profit? Not-For-Profit

Private Hospital Agreements Nationwide: 251

Day Hospital Agreements Nationwide: 182

Health Deal Represented? No

Headquarters: Mildura, VIC

Mildura Health Hospital Cover

Mildura Health has 2 hospital policies to suit every age and medical need. Here is a list of the hospital covers currently available:

Basic Plus – H1
Five Star Gold – H4

Mildura Health Extras Cover

Extras Cover takes care of the everyday healthcare service expenses that are not generally covered under Medicare such as dental services, prescription glasses, and physiotherapy. Here is a list of some of the current extras covers available:

Base Extras – A
Mid Extras – A1
Five Star Extras – E1
Dental – D

Mildura Health Waiting Periods

Mildura Health 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: none
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 Mildura Health?

You can make claims on your extras with Mildura through any of these 3 quick and easy steps:

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 Mildura Health Fund app by submitting a photo of your receipt.

In person: You can visit the Mildura fund office to submit your claim in person.

Mildura Health Gap Cover

Mildura Health Fund have no gap agreements with a number of specialists, doctors and surgeons who operate at Mildura Health Private Hospital (MHPH). 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. Mildura Health’s gap scheme may assist in minimising or eliminating 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.

ACT

Mildura Health medical services with No Gap: 28.6%

Industry Average: 79.1%

Mildura Health medical services with No or Known Gap: 53.1%

Industry Average: 90.5%

NSW

Mildura Health medical services with No Gap: 84.1%

Industry Average: 89.5%

Mildura Health medical services with No or Known Gap: 97.7%

Industry Average: 95.7%

VIC

Mildura Health medical services with No Gap: 82.6%

Industry Average: 86.7%

Mildura Health medical services with No or Known Gap: 98.8%

Industry Average: 95.1%

QLD

Mildura Health medical services with No Gap: 80.1%

Industry Average: 89.2%

Mildura Health medical services with No or Known Gap: 93.8%

Industry Average: 94.5%

Mildura Health medical services with No Gap: 79.7%

Industry Average: 89.5%

Mildura Health medical services with No or Known Gap: 95.8%

Industry Average: 96.6%

Mildura Health medical services with No Gap: 76.7%

Industry Average: 84.4%

Mildura Health medical services with No or Known Gap: 93.0%

Industry Average: 96.2%

TAS

Mildura Health medical services with No Gap: 88.3%

Industry Average: 90.2%

Mildura Health medical services with No or Known Gap: 100%

Industry Average: 96.7%

Mildura Health medical services with No Gap: 75.7%

Industry Average: 84.2%

Mildura Health medical services with No or Known Gap: 100%

Industry Average: 93.8%

Mildura Health Fund Review

Mildura Health Fund Review

Overview

Mildura Health Key Facts

Mildura Health Hospital Cover

Mildura Health Extras Cover

Mildura Health Waiting Periods

How Do You Claim Extras with Mildura Health?

Mildura Health Gap Cover

Gap Cover Ratings By State

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