Your Health Cover

Advantage Visitor Cover

Hospital Inpatient Benefits
What’s Covered In-Hospital
When you’re admitted to hospital we will pay 100% of the cost for the following
services that relate to procedures included on Advantage Visitor Cover.
Á Doctors’ surgical fees and in-hospital Á Operating theatre, intensive care and
consultations ward fees Waiting periods apply
Á Hospital accommodation for overnight Á Pharmaceuticals required for specific
and same day stays treatment when in hospital
Á Government approved prosthetic devices See below
There may be services that attract lower benefits and will incur out-of-pocket expenses. You should request Informed Financial Consent
from your medical provider to confirm any out-of-pocket expenses that may apply. Please refer to the nib OVHC Fund Rules or call
1800 775 204 for more information.

Examples of Inclusions
Á Accidents Á Hernia surgery Á Removal of appendix
Á All eye surgery (e.g. cataracts, squints, Á Kidney stone and gall stone removal Á Removal of tonsils and adenoids
pterygiums) Á Knee and shoulder surgery Á Upper gastrointestinal investigations
Á Back surgery (e.g. slipped disc) Á Knee, hip and shoulder investigations Á All other Medicare recognised services
Á Colonoscopies and bowel surgery Á Rehabilitation programs not listed
Á Grommets in ears
Exclusions
The following is a list of services NOT covered by this policy:
˜ Assisted reproductive services ˜ Infertility investigations ˜ Outpatient psychology services
˜ Bone marrow and organ transplant ˜ Outpatient psychiatric services ˜ Services not covered by Medicare
˜ Cosmetic surgery
Please refer to the nib OVHC Fund Rules for a full list of Exclusions and Limitations.

Lower Benefits
If you’re admitted to hospital for the below services, benefits may be reduced to the rate determined by the relevant state and territory
health authorities, and inpatient medical expenses are reduced to the Medicare Benefit Schedule (MBS) fee (known as Lower Benefits).
This may result in significant out-of-pocket expenses. To understand what your out-of-pocket expenses may be, please call 1800 775 204.
For more information about Lower Benefits, please refer to the nib OVHC Fund Rules.
„ Obesity/weight loss surgery „ Pregnancy and birth related services
„ Palliative care „ Psychiatric treatment

Standard Waiting Periods

„ 12 months - Pre-existing conditions „ 2 months - Inpatient psychiatric,
except psychiatric, rehabilitation or rehabilitation or palliative care services
palliative care services (whether pre-existing or not)
„ 12 months - Pregnancy and birth „ No waiting period -
related services Ambulance services

nib.com.au 1800 775 204

Your Health Cover - Advantage Visitor Cover 1/3
Issued by nib health funds limited ABN 83 000 124 381 (nib), a registered private health insurer. The information contained in
this document is current as at 1 December 2023 and is intended as a summary only. This document should be read in
conjunction with the nib OVHC Fund Rules. Rules and benefits may change from time to time.
Your Health Cover
Advantage Visitor Cover
Hospital Excess
A hospital excess is the amount you pay towards the cost of a hospital stay
before any benefits are payable by nib. A higher excess means your premiums
with nib will be lower.
You only pay an excess if you or someone (other than a dependant child under
Excess options
21 years of age) on your policy goes to hospital. The excess applies per person on this cover:
per calendar year and is payable directly to the hospital prior to your admission.
The excess level for couples and families is capped at twice the chosen level of
excess in any calendar year. NIL | $500
Please note: If you’ve recently switched hospital covers your previous level of per person per calendar year
excess may apply for up to 12 months for pre-existing conditions. Refer to the
nib OVHC Fund Rules for more information.

Medical Outpatient Benefits

When you see a doctor while you are not admitted to a hospital, this is called an outpatient service. We will pay towards the following
services listed under the MBS on Advantage Visitor Cover.

Benefits Covered Benefit Waiting Period

Applies if you are new to health
insurance or if you have recently
increased your level of Extras cover

Doctor/General practitioner consultations 100% MBS No wait

Specialist/Surgeon consultations 100% MBS No wait

Specialist services (including pathology and radiology) 100% MBS No wait

Emergency facilities Gazetted rates1 No wait

Outpatient continuing treatment

100% Cost No wait
following hospitalisation

Pregnancy and birth related consultations

100% MBS 12 months
and services (excluding antenatal and postnatal services)

Call us on 1800 775 204

To understand treatment and costs before you

go to hospital and if out-of-pocket expenses apply

1 This is the amount determined by the state and territory health authorities to be the minimum benefit payable under a hospital product for a particular treatment
in a public hospital or a private hospital.

nib.com.au 1800 775 204

Your Health Cover - Advantage Visitor Cover 2/3
Issued by nib health funds limited ABN 83 000 124 381 (nib), a registered private health insurer. The information contained in
this document is current as at 1 December 2023 and is intended as a summary only. This document should be read in
conjunction with the nib OVHC Fund Rules. Rules and benefits may change from time to time.
Your Health Cover
Advantage Visitor Cover
Additional Benefits
Benefits Covered Waiting Period
Ambulance cover No wait
(where medically necessary and provided by a state and territory ambulance service)

Medical repatriation to home country

(where deemed medically necessary by a medical practitioner appointed by nib, up to a limit No wait2
of $100,000)

Extras
Extras cover is for services you can use every day.

Benefits Covered Annual Limit Waiting Period

(100% of the costs up to annual limits) Maximum amount claimable per Applies if you are new to health
person per membership year insurance or if you have recently
increased your level of Extras cover

Pharmaceutical prescriptions $500 2 months

(PBS listed only)

2 Please note there is a 12 month wait for any claims relating to pre-existing conditions.

nib.com.au 1800 775 204

Your Health Cover - Advantage Visitor Cover 3/3
nib384408_28112023

Issued by nib health funds limited ABN 83 000 124 381 (nib), a registered private health insurer. The information contained in
this document is current as at 1 December 2023 and is intended as a summary only. This document should be read in
conjunction with the nib OVHC Fund Rules. Rules and benefits may change from time to time.