Nurses & Midwives Health is the only health fund exclusively serving the Australian nursing and midwifery community. It offers a suite of hospital and extras covers that can be selected individually or combined into a package to provide cover that suits your unique needs.
It's an arm of Teachers Health which, along with UniHealth, makes Nurses & Midwives part of the largest restricted health cover provider in Australia. Also, this particular block has the highest member retention of any other health fund, so members are sticking around for something.
Pros
A competitive option for families who want access to pregnancy and childhood support services.
Good for people with health issues who want access to healthy lifestyle programs to help them get back on track.
The highest member retention of any health fund (along with Teachers and UniHealth).
Basic Hospital (Basic Plus). This goes beyond the government's minimum requirement for Basic cover by not only offering restricted cover for psychiatry, rehabilitation and palliative care but also offering full cover for dental surgery, joint reconstructions and hernia/appendix, and ambulance rides (including non-emergency). It also offers restricted cover for most other clinical categories except insulin pumps.
Mid Hospital (Basic Plus). This policy covers a wide range of services and has no exclusions. Instead, it provides restricted cover for 11 clinical categories like pregnancy, joint replacements and kidney dialysis. It also covers emergency and non-emergency ambulance rides.
Mid Silver Plus. This provides cover for all services required for a silver rating, plus excludes pregnancy and joint replacements, so saves money for those who don't want cover for these services.
Top Silver Plus. This product gives you comprehensive cover with only one restriction: hospital psychiatric services. It includes cover for services including pregnancy, heart procedures, and hip or knee joint replacements.
Gold Hospital. This offers full cover for all 38 clinical categories required for a Gold policy including pregnancy, insulin pumps, in-hospital psychiatry, heart issues and more. It also covers emergency and non-emergency ambulance rides.
Combined
StarterPak (Basic Plus) This pre-made package covers both hospital and extras. It's designed for the young and active so comes with a fairly basic level of cover. You'll find cover for common surgeries such as ACL surgery in here as well as benefits for dental.
Extras coverage
Extras
Essential Extras. Essential Extras Cover is designed to offer an affordable level of cover for common, everyday services not covered by Medicare. These include general and major dental, optical, acupuncture, remedial massage, chiro, osteo, physio, and non-PBS pharmaceuticals. Emergency ambulance cover is also included, as are Healthy Lifestyle benefits for expenses like gym memberships and health screening services.
Top Extras. Top Extras cover from Nurses & Midwives Health provides generous benefit limits for a wide range of general treatments, including general and major dental, orthodontics, optical, acupuncture, myotherapy, chiro, osteo, physio, speech therapy, podiatry, non-PBS pharmaceuticals, medical appliances and hearing aids. Emergency ambulance cover is also included, as are Healthy Lifestyle benefits for expenses like gym memberships and health screening services.
Transport from the scene of an accident or medical event to a hospital
Treatment at the scene by a qualified ambulance officer
Air ambulance services
Australia-wide coverage
What's not covered
Inter-hospital transfers
Transfers from a medical facility to a hospital and vice versa
Transport from the hospital to home
Transport to a hospital for routine management of an ongoing illness
Nurses & Midwives frequently asked questions
Membership of Nurses & Midwives Health is open to Australian nurses, midwives and their families. To be eligible for membership you will need to be, or have been in the past, any of the following:
A registered nurse
A registered midwife
An enrolled nurse
A nurse practitioner
A psychiatric nurse
A mothercraft nurse
An assistant in nursing
An assistant in midwifery
A nursing student undergoing training, a student nurse or a trainee enrolled nurse
An employee whose job is to provide nursing care or services, or to assist in the provision of nursing care or services
You will also need to be a current or former member of a state or territory based nursing/midwifery union approved by the fund.
If you meet the above criteria, membership of Nurses & Midwives Health is also open to your family members, including your spouse, children, siblings, parents and grandchildren.
Members can then choose from a range of hospital and extras cover options, which can be combined together or purchased as standalone cover.
If you need to make a hospital claim, the process differs depending on whether or not your doctor participates in Nurses & Midwives' Access Gap Cover Scheme. If the doctor does participate, they'll send your bill to Nurses & Midwives for payment. If your doctor is not part of the scheme, you'll need to take the bill to Medicare, who will process the claim. Then you'll send your bill to Nurses & Midwives who will pay their share.
There are several ways to make extras claims:
On the spot by swiping your membership card at the provider's HICAPS terminal (if they have one)
Via the Nurses & Midwives mobile app
By submitting a claim form via post or email.
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To make sure you get accurate and helpful information, this guide has been edited by Tim Bennett as part of our fact-checking process.
Gary Ross Hunter was an editor at Finder, specialising in insurance. He’s been writing about life, travel, home, car, pet and health insurance for over 6 years and regularly appears as an insurance expert in publications including The Sydney Morning Herald, The Guardian and news.com.au. Gary holds a Kaplan Tier 2 General Advice General Insurance certification which meets the requirements of ASIC Regulatory Guide 146 (RG146). See full bio
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Gary Ross has written 648 Finder guides across topics including:
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