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Insurance claim made

Medi-gap scheme is a rort

1 out of 5, reviewed on Feb 18, 2018

NIB health insurance is worthless- we were warned by multiple doctors but didn't listen. Our mistake and we have finally woken up to warn others. Our surgeon told us nib were terrible but he would use their medigap scheme for us due to our circumstances, however insisted we pay upfront because nib will go to lengths to avoid paying fees - we had no choice, as surgury was necessary. We checked with nib to ensure everything was covered in the procedure and checked the doctor was medigap provider etc then paid upfront, feeling confident nib would pay after they told us we were covered. Surgeon was absolutely right! We now have a huge out of pocket because they wont honour their medigap scheme. Doctors are right NIB are trouble. Dont use them. You are better off without insurance over nib.

Was this review helpful? Yes

Customer Service

1 out of 5, reviewed on Feb 16, 2018

Customer service is awful, they don't have the full information about their procedure.
There is no email available to send any mails, the links at their website is not working.

Was this review helpful? Yes

Comments
NIB Official

Hi Vincent, sorry to hear about your experience with nib. Could you please contact us via email at nib@nib.com.au or phone 13 16 42 and we can look into this for you? Thanks, Paige

Insurance claim made

Out of Pocket expense for day surgery $2500!!!! after being a member for over 20 years.

1 out of 5, reviewed on Feb 14, 2018

I was shocked when as a NIB top table client, I had to pay $500 excess to surgeon and $500 excess to anaesthetist plus the expected hospital excess and prior admission tests cost.

NIB say as I had an out of pocket with provider no matter how small, they technically don't pay anything to provider.

All providers, have recommended I get a better fund.

Appears with NIB if I don't use recommended NIB provider who is in Medigap scheme, I pay the Gap myself.

Was this review helpful? Yes

Sydney

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Surgery

1 out of 5, reviewed on Feb 07, 2018

Hospital after doing fund check on my insurance to check if Ill have to pay for surgery they came back saying no but now the insurance is claiming that the insurance doesn't cover that.

1 person found this helpful, do you? Yes

Adelaide

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Digusted

1 out of 5, reviewed on Feb 06, 2018

I had knee surgery in December 2017 Which was NOT a pre existing injury, I checked that this simple procedure was covered and it was as well as the chosen hospital. Instantly out of pocket over $5000 What a shock, I made a complaint and am still waiting for my money after being told I would get it in writing . I hope your listening NIB I’ve reported my case to the ombudsman and will be seeking legal advice. This has been a disgusting experience and i will defiantly be dropping my private health insurance. Please don’t do it an DEFIANTLY don’t go with NIB it’s a Rort they should be ashamed of, since they made 120 million dollars and here they are ripping off average hard working Australins

Regards

Michael

1 person found this helpful, do you? Yes

  • 9 reviews
  • 1 comment
  • 1 answer
  • 10 helpful votes
Private message

Disgusting business

1 out of 5, reviewed on Feb 05, 2018

I had purchased a policy due to knowing down the track I would need surgery on my back. My policy was constantly increasing it went from $60.00 per month to 80.00 per fortnight in 3 years. I made a call to cancel and was convinced by the consultant that I could have a more suited policy for less cost so I agreed.
I have been booked in for back surgery for three months and in the days before I was told by the surgeons office it would not be covered by NIB. They had lowered my cover so as not to include back surgery without my knowing. I am in severe disabling pain and was told I would have to wait another 12 months before I could get the operation. There was no care or compassion NIB and there rules and there hefty premiums are not worth it please take my advice and save your money and don’t give it away to NIB for nothing! They are thieves in cahoots with the government.

1 person found this helpful, do you? Yes

  • 1 review
  • 1 helpful vote
Private message

Terrible service they tell you your covered then when it's time to go give them the claim number you

1 out of 5, reviewed on Jan 26, 2018

Rubbish you are paying for there web site that all. Provider is very hard to get things through.
Never again. (nib) I went to get glasses what the I still have to pay more money come on what this crap.

1 person found this helpful, do you? Yes

Perth

  • 4 reviews
  • 1 helpful vote
Private message

Insurance claim made

Terrible service! Avoid nib at all costs! Medibank and bupa all the way!

1 out of 5, reviewed on Jan 24, 2018

This policy was the biggest waste of money. I had rather pay a few dollars extra for medibank or bupa. This is the first and last time i shall use nib! Zero satisfaction! Policy holds no value! I haven't been able to make a single claim so far, cannot wait to get over and done with nib.

1 person found this helpful, do you? Yes

Comments
NIB Official

Hi Kosh, i'm sorry to hear about your experience. Can you please contact us directly on 13 16 42 so we can investigate this further for you? Thanks, Paige

  • 5 reviews
  • 1 question
  • 2 helpful votes
Private message

Insurance claim made

Time to leave

2 out of 5, reviewed on Jan 15, 2018

My hubby and I have both held NIB membership for years as singles and more recently as a family. Over nearly 15 years our premiums have sky rocketed. We both managed to avoid the lifetime loading by signing up at the right age but our premiums and the reduced extras caps have encouraged us to shop around.
We made a decision to protect our toddler from illness where we can (we're pro vaccination), and had our son vaccinated with Bexsero...what do you know NIB don't cover this script.
Yep, time to leave NIB. Hello Teachers Health.

1 person found this helpful, do you? Yes

melbourne

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Hiding Changes so paymernts don't need to be made

1 out of 5, reviewed on Jan 04, 2018

I have the highest level extras and hospital cover with NIB. I Have been regularly claiming a non pbs script that my son has to have.Without the rebate it would cost me $70 per script. The last claim I submitted was rejected. I followed up with them and they said it is no longer covered because it is not on the MIMs list. They went onto say that I'm lucky that they are not asking to be repaid for previous claims!! The person on the phone suggested I get my child to take the prescribed product by a different method as that would be covered. I didn't know call centre staff can now give medical advice!
When i asked where the information regarding the MIMs list could be found i was informed that it couldn't be clearly put as part the product information as it would become to detailed for people to understand. It is in the T & C's.
This is definitely not the first time NIB have changed what they will pay for or the % they will reimburse without informing the member.
At least it has motivated me to change companies today!

1 person found this helpful, do you? Yes

Comments
NIB Official

Hi SMR, sorry to hear about your experience. Can you please contact us directly on 13 16 42 so we can investigate this further for you? Thanks, Paige

Sydney

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Incorrect statements

1 out of 5, reviewed on Jan 04, 2018

We have realised that NIB are adding the medicare claimed amounts on their statements for hospital cover which is illegal. For my wife's operation it states they paid $1800 towards one of her surgeries but really only paid $646. However it was medicare that paid $1154, yet NIB statement shows the full $1800. Overall when we review the other statements we have found further discrepancies. The intentional act is misleading. After being informed by clinics we are visiting for my wife's recovery we were told NIB are the worst health insurance company to be with. We are now looking elsewhere. Support and service is shocking at not worth the effort in dealing with. Have tried talking to them face to face but they tell you it's standard.

1 person found this helpful, do you? Yes

Comments
NIB Official

Hi there, i'm sorry to hear about your experience. Can you please contact us directly on 13 16 42 so we can investigate this further for you? Thanks, Paige

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Disappointed

1 out of 5, reviewed on Jan 03, 2018

I've been with NIB for MANY years. Very disappointed that when it came to claim for a simple health improvement receipt, it was made exceptionally difficult for me. First needed the health management program form, fine. (sort of, though joining a gym is really a health improvement no brainer) then was rejected again, due to the 'yoga' box being ticked - which is of course one of the services that the gym offers. (the only one I utilise) I'm sorry, but this truly just wasting everyones time with bureaucratical red tape. Clearly being a long term customer doesn't count for a thing. Maybe its time to start shopping around for a new provider...

1 person found this helpful, do you? Yes

sydney

  • 20 reviews
  • 3 comments
  • 1 answer
  • 18 helpful votes
Private message

Insurance claim made

**Warning !!!***Going Downhill Really Fast ***Warning***

1 out of 5, reviewed on Dec 21, 2017

WOW been with them for MANY years, but NIB is going downhill so fast.
This is how they rip people off;
1) You make a claim via the app.
2) You check its clear and readable & submit
3) They don't pay the claim.
4) If you remember to call by phone and follow up they lie outright and say they emailed you to say its ineligible. You check your email and NOTHING not even in spam.
5) Did the claim again making sure its 100% perfect, they did the same trick again!!

I checked to see my email was working by emailing nib@nib.com.au and it si working 100%.

They are liars and no doubt ripping off customers like me that have valid claims...Where a certain percentage of claims will fall through the cracks and never get paid.

The call center has moved overseas to become a huge NIGHTMARE.

But they know how to take your monthly payment automatically!!

3 people found this helpful, do you? Yes

  • 1 review
  • 2 helpful votes
Private message

Insurance claim made

Worst Health Provider Ever

1 out of 5, reviewed on Dec 14, 2017

Unfortunately it isn't possible to give zero stars but that is what this company deserves. I have been advised by consultant that 60% of dental bill for my partner will be covered, individually went item by item on the quote and wrote down what was said on the phone.
Once it came to the surgery NIB paid less than half of amount what I was advised by consultant previously.
After numerous phone calls with management I have been confirmed from management that the consultant gave me wrong information and that I was right (this was all after they made idiot out of me- saying that I have misunderstood the consultant and that the information provided to me was correct).
At the moment I am requesting voice conversation recording and will take matter further as nobody is getting back to me to form NIB.
Also at initial registration with NIB it took 6 attempts to send us the right cards at first place, misspelled name 6x. Seriously I guess that should have ring the alarm bell that they are just useless.

2 people found this helpful, do you? Yes

  • 1 review
  • 2 helpful votes
Private message

Feedback and complaint

1 out of 5, reviewed on Dec 14, 2017

Am writing this regarding my issue a case am speaking with nib every day i apply for my refund last month on 17th November up to now i didn't receive my money.

I need to make complaint this is serious action am taking you people playing with me every time while am calling. As you said that you gone do investigation.
I don't know what you people doing so am going to give serious complaint am going to the court regarding this issue.

Guys because of you am fully disappointed this is the crazy insurance company that am notice. Even the response is very stupid giving crazy answers even their no higher people to speak with me this what your company even i suggest my friends that this is the waste insurance.

At least if you don't want to give my money let me know please.
Because am doing my time waste with you by calling every day with my money enjoy your self guys.
If you need any money ask me i will provide for your insurance company.
I think you doing this stuff for every Clint ya.
k keep on going like this k doing good job, even you will receive good award as well and you can earn, get more money you do like this carry on guys.
See how am frustrated to write this mail.
To develop your company let me know i will provide you money so that you can't do same like this stuff with others, atleast they gone save their money.

2 people found this helpful, do you? Yes

Comments
NIB Official

Hi Lucky, I am sorry to hear about your experience. Could you please contact us directly on 13 16 43 to discuss this with you further?
Thanks, Paige

Canberra

  • 1 review
  • 1 helpful vote
Private message

Insurance claim made

Do NOT use them if you are planning a BABY!

1 out of 5, reviewed on Dec 11, 2017

I just joined ProductReview to caution other young parents from joining NIB if they want to have a baby.We have the TOP Private health cover for both my wife and our newborn baby from Day#1 which $354 per month.

1) The doctor performed some tests while in operation-theatre to deliver the baby which were not covered. I have a letter from Capital Pathology that NIB has no 'no-gap' cover unlike Bupa, CUA, PeopleCare, etc. Yes, they sent me a list of all providers who would pay for these and that NIB won't cover. What kind of top private insurance won't cover tests requested by the surgeon while in surgery? I would be happy to upload the letter if there is an option to upload a document here.

2) I have another $840 bill from Anaesthetist ! Again the same reason, NIB won't cover this. I called NIB and they say the surgeon over charged. How could a top health cover not pay for the Anaesthetist ?

In a nut shell, if you have a baby while being on NIB's top health cover which they say is specifically for Babies you may end up in bills like us. This was the ONLY hospital admittance and claim we had and we paid our $500 gap.

1 person found this helpful, do you? Yes

  • 1 review
  • 2 helpful votes
Private message

Insurance claim made

Worst hospital Cover

1 out of 5, reviewed on Dec 01, 2017

Changed from Bupa to NIB 6 months ago and just had day surgery - up to $1000 out of pocket (not including the $500 excess). They have poor financial arrangements with hospitals and doctors, with out of pocket costs of $500 for pathology and $420 anaesthetist. With Bupa, I would not be out of pocket after paying the excess. Was a no brainer to go back to Bupa! They hide their contributions by rolling them in with Medicare which is extremely misleading. I phoned prior to my hospital visit and despite having the item numbers, they could not give me an indication of my out of pocket costs. Big mistake. If you are planning a hospital visit, switch from NIB!

2 people found this helpful, do you? Yes

  • 1 review
  • 1 helpful vote
Private message

Don't even consider NIB. they are the worst of the lot

1 out of 5, reviewed on Nov 29, 2017

If there is negative stars i would give them 100. worth for nothing.
I paid 180 dollars a month for basic cover _ extras for 6 years at straight without a claim only to realise that the cover doesn't actually cover anything for hospitals. That is not the mistake of nib but my bad to not look at the fineprints but when i want to switch to a better cover they wouldn't consider my existing customer relationship and wouldn't give any discounts. Their premiums are way too high than other bunch of competitors...NIB sorry you're not worth it to be considered. You're worth it to be ignored for life for sure.
My honest opinion stay away from this day light thieves anytime.

1 person found this helpful, do you? Yes

Myocum

  • 3 reviews
  • 4 helpful votes
Private message

Liars and evaders of a direct answer

1 out of 5, reviewed on Nov 23, 2017

I have been paying into NIB since 1996 and have made very few claims. I recently had to have cataract surgery and when I checked, NIB said I was "not fully covered". In all those years I was never made aware of that by NIB.When I asked "what not fully covered meant" the person in their Sydney office face- to- face told me she couldn't tell me and I needed to check with the hospital. The hospital told me I was not covered at all for hospital costs or the anaesthetist. To get a reimbursement for the doctor I had to pay a $200 excess. The hospital told me of all health funds NIB is the worst to deal with. I will be finding a new fund immediately and telling everyone I know to DUMP NIB!

1 person found this helpful, do you? Yes

Comments
NIB Official

Hi Chris, I'm sorry to hear about your experience. Would you mind calling us on 13 16 42 and we can look into this further for you? Thanks, Paige

  • 1 review
  • 1 helpful vote
Private message

Extremely slow

2 out of 5, reviewed on Nov 18, 2017

They are unbelievably slow. It took close to three months to process my payment request. When I complained they made that process slow and cumbersome. Not impressed. They didn't seem to think there was a problem. Looking for another insurer.

1 person found this helpful, do you? Yes

1 of 16 pages


Questions & Answers

I'm an international student. I get my OSHC covered through nib. I want to get my card. n visit the office too. can you please assist me?

Vinay asked on Feb 22, 2018

Can I claim for an iron infusion?

Susu asked on Oct 12, 2017

Answer this

Hi Susu,

This depends on your individual level of cover. Please contact us at 13 16 42 and we would be happy to look into this for you.

Thanks,
Paige

hi there..does NIB cover a partial discount for ray ban sunglasses...not prescription glasses at OPSM or sunglasses hut?

Debra R asked on Aug 30, 2017

Answer this

Actually I just bought a pair of Ray Ban, from Sunglasses hut and asked the sales person for a discount, she said the store doesn't give discount, but if am a member of a private health fund they offer a discount. doesn't matter which health fund! Cheers

Hi Debra, thank you for your enquiry. I can advise that we do not pay any benefits towards non-prescription sunglasses. Kind regards, Jess.

See all 26 questions about NIB Health Insurance