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onemedifund

Reviewed and updated 1 June 2024

About onemedifund

What is onemedifund?

onemedifund is a private health insurer that operates as an open health fund.

Background

In 2007, not-for-profit insurer Peoplecare helped establish National Health Benefits Australia Pty Ltd, which trades under the brand onemedifund. Peoplecare manages onemedifund on behalf of its parent company.

Who can join onemedifund?

Anyone can join onemedifund because it is an open health fund.

What products does onemedifund offer?

onemedifund offers:

Hospital Cover
Extras Cover
Combined Hospital and Extras Cover.

Do onemedifund policies include Ambulance Cover?

onemedifund includes emergency Ambulance Cover with:

Hospital Cover
Extras Cover
Combined Hospital and Extras Cover.

Is onemedifund a not-for-profit health insurer?

No. onemedifund is a for-profit health insurer.

Does onemedifund operate in all Australian states and territories?

Yes. onemedifund operates in all Australian states and territories.

How does onemedifund Hospital Cover compare with other insurers?

Benchmarks	onemedifund	Industry average
Member retention for Hospital Cover	93.8%	86.9%
% hospital-related charges covered	92.5%	89.9%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

Does onemedifund have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

Yes. onemedifund has agreements with a few private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:

Location	Number of private Agreement Hospitals	Industry maximum
ACT	5	6
NSW	97	98
NT	2	2
QLD	51	60
SA	20	23
TAS	5	9
VIC	74	76
WA	22	24

onemedifund also has agreements with a few day hospitals so it can provide services at low cost or with no out-of-pocket costs:

Location	Number of day Agreement Hospitals	Industry maximum
ACT	8	9
NSW	87	103
NT	1	2
QLD	48	57
SA	25	30
TAS	6	8
VIC	67	79
WA	19	24

Source: onemedifund: performance

How does onemedifund Extras Cover compare with other insurers?

Benchmark	onemedifund	Industry average
% of Extras Cover charges covered	48.6%	51.1%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

How does onemedifund compare with other private health insurers?

Benchmarks	onemedifund	Industry average
Market share	0.1%	–
% of services with no gap	89.6%	88.3%
% of services with no gap or where known gap payment made	97.7%	97.2%
Market share of complaints to the PHIO	0.0%	3.1%
% complaints investigated by the PHIO	0.0%	3.1%
Benefits as a % of contributions	73.7%	80.5%
Management expenses as a % of contribution income	9.8%	13.1%
Management expenses per average policy	$629	$592

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

Is onemedifund a member of any industry organisations?

No. onemedifund is not a member of any industry organisations.

Does onemedifund let me claim online or via an app?

Yes. onemedifund allows you to make a claim through the onemedifund app or online. You can also claim on the spot through the HICAPS payment system at your provider.

How to contact onemedifund

Phone:

1800 148 626

Website:

https://www.onemedifund.com.au/

Email:

info@onemedifund.com.au

Address:

The ‘Precinct’
Level 6
10 Herb Elliot Avenue
SYDNEY OLYMPIC PARK NSW 2127

Postal address:

Locked Bag 25
WOLLONGONG NSW 2500

Compare onemedifund with other private health insurers

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onemedifund

About onemedifund

What is onemedifund?

Background

Who can join onemedifund?

What products does onemedifund offer?

Do onemedifund policies include Ambulance Cover?

Is onemedifund a not-for-profit health insurer?

Does onemedifund operate in all Australian states and territories?

How does onemedifund Hospital Cover compare with other insurers?

Does onemedifund have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

How does onemedifund Extras Cover compare with other insurers?

How does onemedifund compare with other private health insurers?

Is onemedifund a member of any industry organisations?

Does onemedifund let me claim online or via an app?

How to contact onemedifund

Compare onemedifund with other private health insurers

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