Nurse and Midwives Health Review
Overview
Nurses and Midwives Health is a not-for-profit, industry-based fund open to the public and private nursing and midwifery community and members of the Australian Nursing and Midwifery Federation. The fund was established 3 years ago by Teacher’s Health Fund who are Australia’s largest industry-based health fund.
Since then, nurses and midwives across Australia have been able to enjoy the benefits and convenience of having their own personal health care insurance provider.
Nurse and Midwives Health Key Facts
Founded: 2016
For-Profit or Not-For-Profit? Not-For-Profit
Private Hospital Agreements Nationwide: 281
Day Hospital Agreements Nationwide: 268
Health Deal Represented? No
Headquarters: Sydney, NSW
Nurses and Midwives Health Hospital Cover
Nurses and Midwives Health has 5 hospital covers that range from basic to comprehensive cover. The hospital policies currently available with NMH are:
- Basic Hospital (Basic Plus)
- Mid Hospital (Basic Plus)
- Mid Silver Plus
- Top Hospital (Gold)
- Gold Hospital
Nurses and Midwives 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 the current extras covers available:
- Essential Extras
- Top Extras
Nurses and Midwives Health Combined Cover
Nurses and Midwives Health has 1 available combined policy and this is:
- StarterPak (Basic Plus)
Nurses and Midwives Health Waiting Periods
NMH 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 Nurses and Midwives Health?
Nurses and Midwives Health offer 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 member claiming app by submitting a photo of your receipt.
Online: You can log into https://online.nmhealth.com.au/ and lodge your claim by providing the details on your receipt.
By Mail: You can lodge your claim by posting relevant accounts and receipts to:
Nurses and Midwives Health
GPO BOX 3874,
Sydney, NSW
2001
Nurses and Midwives Health Gap Cover
NMH gap cover is called Access Gap Cover. 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. Access Gap 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.
Nurses and Midwives medical services with No Gap: 76.5%
Industry Average: 79.1%
Nurses and Midwives medical Services with No or Known Gap: 96.1%
Industry Average: 90.5%
Nurses and Midwives medical services with No Gap: 85.1%
Industry Average: 89.5%
Nurses and Midwives medical Services with No or Known Gap: 95.9%
Industry Average: 95.7%
Nurses and Midwives medical services with No Gap: 84.3%
Industry Average: 86.7%
Nurses and Midwives medical Services with No or Known Gap: 96.5%
Industry Average: 95.1%
Nurses and Midwives medical services with No Gap: 90.7%
Industry Average: 89.2%
Nurses and Midwives medical Services with No or Known Gap: 96%
Industry Average: 94.5%
Nurses and Midwives medical services with No Gap: 86.9%
Industry Average: 89.5%
Nurses and Midwives medical Services with No or Known Gap: 97%
Industry Average: 96.6%
Nurses and Midwives medical services with No Gap: 86.9%
Industry Average: 84.4%
Nurses and Midwives medical Services with No or Known Gap: 95.4%
Industry Average: 96.2%
Nurses and Midwives medical services with No Gap: 80.3%
Industry Average: 90.2%
Nurses and Midwives medical Services with No or Known Gap: 91.5%
Industry Average: 96.7%
Nurses and Midwives medical services with No Gap: –
Industry Average: 84.2%
Nurses and Midwives medical Services with No or Known Gap: –
Industry Average: 93.8%
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