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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Renee Tan made the process simple.
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Tanya 17/10/2019
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Renee Tan made the process simple. She very clearly explained all the options and changes and how that would and could impact our health insurance. Renee gave great service, which makes me want to recommend your services to my family and friends.
Responded very quickly to my email for…
Responded very quickly to my email for…
Shirley 17/10/2019
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Responded very quickly to my email for help on finding a medical fund. Mark that I spoke to was great at helping and explaining everything to me that I needed to know. went through every step in detail and always asked if I had any question during the course of our conversation
Excellent service
Excellent service
Kristine 16/10/2019
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Excellent service. Daniel is really good in explaining everything and very patient.
Daniel listened to what I wanted
Daniel listened to what I wanted
Lorraine 16/10/2019
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Daniel listened to what I wanted , sent me email to review and called back when he said he would , also saved me $50+ per month , and kept adult kids on policy for a bit longer .
Wasn’t pushy
Wasn’t pushy
Shaylee 01/10/2019
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Wasn’t pushy, asked what I required gave me adequate thinking time and I got off the phone a happy customer
This team and in particular Daniel
This team and in particular Daniel
Peter 20/09/2019
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This team and in particular , Daniel was very helpful , took the time to explain in detail all aspects , and was very understanding and patient Highly recommend them
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