SCHEDULE OF BENEFITS - nib

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| MediGap 2010 22 Item No Benefit Item No Benefit Item No Benefit Item No Benefit 39703 $743.35 40331 $1,367.95 41542 $1,687.45 41662 $116.50 39706 $1,594.10 40332 $2,232.15 41545 $736.50 41665 $243.75 39709 $2,272.85 40333 $1,141.80 41548 $977.45 41668 $310.75 39712 $4,103.95 40334 $1,509.60 41551 $2,250.95 41671 $682.80 39715 $2,843.85 40335 $2,772.60 41554 $2,652.10 41672 $851.80 39718 $1,249.50 40336 $452.45 41557 $1,540.05 41674 $142.00 39721 $1,141.80 40339 $2,272.85 41560 $1,687.45 41677 $127.10 39800 $4,093.20 40342 $2,100.40 41563 $2,088.95 41680 $230.20 39803 $4,093.20 40345 $1,955.30 41564 $2,701.30 41683 $165.55 39806 $1,841.75 40348 $2,482.55 41566 $1,540.05 41686 $101.60 39812 $904.90 40351 $2,482.55 41569 $1,687.45 41689 $192.80 39815 $2,617.45 40600 $1,367.95 41572 $1,459.85 41692 $251.55 39818 $2,617.45 40700 $2,499.10 41575 $3,441.65 41695 $141.35 39821 $3,108.05 40703 $2,100.40 41576 $5,162.50 41698 $45.95 39900 $743.35 40706 $3,069.85 41578 $3,441.65 41701 $129.90 39903 $2,272.85 40709 $743.35 41579 $2,581.20 41704 $51.25 39906 $1,141.80 40712 $1,497.15 41581 $3,958.55 41707 $633.75 40000 $1,314.10 40800 $914.80 41584 $2,716.65 41710 $736.50 40003 $1,314.10 40801 $2,500.75 41587 $3,700.00 41713 $857.00 40006 $1,034.15 40803 $1,712.75 41590 $1,687.45 41716 $417.80 40009 $754.00 40850 $3,243.75 41593 $2,199.35 41719 $166.10 40012 $1,475.75 40851 $5,676.75 41596 $2,457.90 41722 $830.25 40015 $914.80 40852 $487.85 41599 $2,457.90 41725 $633.75 40018 $228.35 40854 $754.00 41603 $711.90 41728 $1,267.85 40100 $990.90 40856 $365.95 41604 $263.45 41729 $803.45 40103 $1,454.20 40858 $754.00 41608 $1,540.05 41731 $1,098.00 40106 $1,475.75 40860 $2,897.45 41611 $990.85 41734 $1,432.85 40109 $1,594.10 40862 $271.70 41614 $1,540.05 41737 $682.80 40112 $2,046.55 40903 $794.35 41615 $1,540.05 41740 $83.05 40115 $1,034.15 40905 $861.85 41617 $2,677.90 41743 $476.75 40118 $1,367.95 41500 $116.50 41620 $1,165.10 41746 $1,098.00 40300 $1,367.95 41503 $337.40 41623 $1,687.45 41749 $857.00 40301 $1,372.25 41506 $203.45 41626 $203.45 41752 $417.80 40303 $1,561.80 41509 $230.20 41629 $736.50 41755 $65.70 40306 $2,057.35 41512 $827.90 41632 $337.40 41758 $166.10 40309 $1,561.80 41515 $543.35 41635 $1,616.85 41761 $173.55 40312 $2,100.40 41518 $1,312.35 41638 $2,018.15 41764 $173.55 40315 $2,272.85 41521 $1,397.15 41641 $67.00 41767 $1,041.30 40316 $2,979.10 41524 $403.65 41644 $201.75 41770 $990.85 40318 $2,843.85 41527 $830.25 41647 $155.30 41773 $830.25 40321 $1,561.80 41530 $1,352.65 41650 $155.30 41776 $827.90 40324 $915.60 41533 $1,616.85 41653 $101.60 41779 $990.85 40327 $915.60 41536 $1,811.00 41656 $173.55 41782 $1,345.30 40330 $1,367.95 41539 $1,540.05 41659 $109.55 41785 $1,668.95 39703 to 41785
Item No Benefit Item No Benefit Item No Benefit Item No Benefit 41786 $1,041.30 41889 $251.55 42599 $860.50 42704 $634.90 41787 $803.45 41892 $332.10 42602 $860.50 42707 $1,085.75 41788 $310.75 41895 $519.60 42605 $634.90 42710 $1,229.10 41789 $417.80 41898 $363.00 42608 $409.65 42713 $512.15 41792 $391.05 41901 $853.85 42610 $131.10 42716 $1,628.75 41793 $524.85 41904 $348.25 42611 $196.55 42719 $706.90 41796 $160.65 41905 $640.60 42614 $65.75 42722 $773.20 41797 $203.45 41907 $173.55 42615 $98.35 42725 $1,823.20 41800 $166.10 41910 $551.35 42617 $186.50 42728 $307.40 41801 $230.20 42503 $139.65 42620 $71.70 42731 $2,069.10 41804 $127.10 42506 $655.55 42621 $71.70 42734 $409.65 41807 $99.05 42509 $829.65 42622 $112.65 42737 $409.65 41810 $50.30 42510 $956.30 42623 $952.75 42740 $409.65 41813 $503.50 42512 $655.55 42626 $1,536.55 42741 $409.65 41816 $262.25 42515 $829.65 42629 $1,157.40 42743 $860.50 41819 $493.05 42518 $481.30 42632 $159.80 42744 $409.35 41820 $591.70 42521 $1,638.95 42635 $409.65 42746 $1,300.85 41822 $337.40 42524 $278.70 42638 $512.15 42749 $1,628.75 41825 $503.50 42527 $553.15 42641 $665.75 42752 $1,823.20 41828 $73.75 42530 $860.50 42644 $98.25 42755 $225.30 41831 $504.45 42533 $553.15 42647 $278.70 42758 $952.75 41832 $322.85 42536 $1,136.90 42650 $98.25 42761 $706.90 41834 $1,821.50 42539 $1,618.55 42651 $219.00 42764 $706.90 41837 $1,746.50 42542 $686.30 42653 $1,823.20 42767 $1,485.15 41840 $2,147.40 42543 $1,203.90 42656 $2,274.05 42770 $401.55 41843 $1,888.40 42545 $1,741.30 42659 $1,229.10 42771 $395.40 41846 $262.25 42548 $1,034.45 42662 $1,229.10 42773 $1,229.10 41849 $385.55 42551 $860.50 42665 $819.50 42776 $1,823.20 41852 $417.80 42554 $1,003.85 42667 $193.30 42779 $2,274.05 41855 $407.25 42557 $1,403.35 42668 $102.55 42782 $614.45 41858 $698.25 42560 $553.15 42672 $1,229.10 42783 $614.45 41861 $853.85 42563 $706.90 42673 $614.45 42785 $481.30 41864 $575.75 42566 $1,003.85 42676 $157.55 42786 $481.30 41867 $866.70 42569 $1,403.35 42677 $83.00 42788 $481.30 41868 $549.15 42572 $159.80 42680 $409.65 42789 $481.30 41870 $642.65 42573 $309.75 42683 $163.95 42791 $481.30 41873 $830.25 42574 $658.25 42686 $372.75 42792 $481.30 41876 $830.25 42575 $112.65 42689 $159.80 42794 $92.15 41879 $1,345.30 42581 $159.80 42692 $377.00 42797 $92.15 41880 $359.05 42584 $377.00 42695 $614.45 42801 $1,429.90 41881 $567.60 42587 $70.75 42698 $810.10 42802 $714.70 41884 $128.65 42590 $460.90 42701 $451.75 42805 $798.85 41885 $406.80 42593 $278.70 42702 $1,036.05 42806 $481.30 41886 $251.55 42596 $686.30 42703 $779.25 42807 $484.60 41786 to 42807 | MediGap 2010 23
Page 1 and 2: SCHEDULE OF BENEFITS RULES AND GENE
Page 3 and 4: RULES FOR PARTICIPATION IN nib’s
Page 5 and 6: Making Claims for MediGap Benefits
Page 7 and 8: for any of the reasons set out abov
Page 9 and 10: Item No Benefit Item No Benefit Ite
Page 21: Item No Benefit Item No Benefit Ite
Page 33: 1300 853 530 nib.com.au nib health

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