SCHEDULE OF BENEFITS - nib

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| MediGap 2010 28 Item No Benefit Item No Benefit Item No Benefit Item No Benefit 48209 $1,039.50 48648 $1,552.45 49115 $1,619.80 49517 $1,729.80 48212 $810.75 48651 $2,160.05 49116 $2,138.15 49518 $1,889.60 48215 $1,039.50 48654 $1,552.45 49117 $2,565.75 49519 $3,319.95 48218 $810.75 48657 $2,160.05 49118 $391.35 49521 $2,295.15 48221 $1,080.05 48660 $1,552.45 49121 $877.45 49524 $2,699.95 48224 $539.95 48663 $1,160.75 49200 $1,174.30 49527 $2,295.15 48227 $701.95 48666 $701.95 49203 $877.45 49530 $2,835.10 48230 $607.60 48669 $2,092.30 49206 $809.90 49533 $3,240.05 48233 $877.45 48672 $1,566.20 49209 $1,080.05 49534 $644.55 48236 $1,147.40 48675 $945.10 49210 $1,425.65 49536 $1,349.95 48239 $634.45 48678 $810.75 49211 $1,710.85 49539 $1,349.95 48242 $877.45 48681 $1,349.95 49212 $337.60 49542 $1,889.60 48400 $472.55 48684 $1,349.95 49215 $931.60 49545 $1,080.05 48403 $742.50 48687 $1,889.60 49218 $391.35 49548 $1,349.95 48406 $472.55 48690 $2,160.05 49221 $877.45 49551 $1,889.60 48409 $742.50 48691 $2,571.90 49224 $1,012.40 49554 $2,699.95 48412 $904.25 48692 $1,733.50 49227 $1,012.40 49557 $391.35 48415 $1,147.40 48693 $838.40 49300 $747.40 49558 $391.35 48418 $904.25 48900 $404.85 49303 $782.85 49559 $586.05 48421 $1,147.40 48903 $809.90 49306 $1,552.45 49560 $790.90 48424 $1,080.05 48906 $809.90 49309 $1,080.05 49561 $966.50 48427 $1,309.50 48909 $1,080.05 49312 $1,349.95 49562 $1,054.65 48500 $472.55 48912 $472.55 49315 $1,215.00 49563 $1,142.35 48503 $472.55 48915 $1,080.05 49318 $1,889.60 49564 $1,317.75 48506 $701.95 48918 $2,160.05 49319 $3,319.95 49566 $1,080.05 48509 $337.60 48921 $2,227.40 49321 $2,295.15 49569 $1,080.05 48512 $1,282.45 48924 $2,565.05 49324 $2,699.95 49700 $391.35 48600 $134.80 48927 $526.30 49327 $3,104.95 49703 $877.45 48603 $202.50 48930 $1,080.05 49330 $3,104.95 49706 $472.55 48606 $1,889.60 48933 $1,417.45 49333 $3,509.95 49709 $1,012.40 48612 $3,509.95 48936 $1,080.05 49336 $512.90 49712 $1,080.05 48613 $4,992.60 48939 $1,552.45 49339 $3,982.35 49715 $1,619.80 48615 $634.45 48942 $2,024.95 49342 $3,982.35 49716 $2,138.15 48618 $3,509.95 48945 $391.35 49345 $4,724.85 49717 $2,565.75 48621 $2,295.15 48948 $877.45 49346 $1,215.00 49718 $539.95 48624 $2,835.10 48951 $1,282.45 49360 $493.20 49721 $337.60 48627 $3,644.75 48954 $1,349.95 49363 $593.95 49724 $945.10 48630 $4,049.85 48957 $1,552.45 49366 $877.45 49727 $404.85 48632 $2,238.75 48960 $1,349.95 49500 $539.95 49728 $809.70 48636 $1,160.75 49100 $472.55 49503 $701.95 49800 $189.05 48639 $1,957.30 49103 $1,012.40 49506 $1,053.00 49803 $243.05 48640 $4,992.60 49106 $1,349.95 49509 $1,080.05 49806 $189.05 48642 $1,147.40 49109 $1,012.40 49512 $1,552.45 49809 $310.40 48645 $1,552.45 49112 $1,012.40 49515 $1,215.00 49812 $620.80 48209 to 49812
Item No Benefit Item No Benefit Item No Benefit Item No Benefit 49815 $1,080.05 50230 $2,429.90 50408 $1,431.40 50608 $4,913.90 49818 $391.35 50233 $3,104.95 50411 $1,878.60 50612 $6,989.55 49821 $620.80 50236 $2,429.90 50414 $2,534.60 50616 $888.10 49824 $1,086.75 50239 $1,619.80 50417 $1,878.60 50620 $4,913.90 49827 $674.90 50300 $1,659.95 50420 $1,550.55 50624 $4,913.90 49830 $1,181.15 50303 $2,266.45 50423 $1,431.40 50628 $6,070.00 49833 $742.50 50306 $3,538.75 50426 $666.10 50632 $5,102.75 49836 $1,282.45 50309 $437.40 50450 $1,759.20 50636 $5,669.75 49837 $928.10 50312 $1,003.90 50451 $1,759.20 50640 $3,134.25 49838 $1,602.75 50315 $994.05 50455 $1,992.25 50644 $3,024.05 49839 $742.50 50318 $994.05 50456 $1,992.25 50650 $594.65 49842 $1,282.45 50321 $1,331.95 50460 $2,974.55 50654 $712.15 49845 $674.90 50324 $1,898.65 50461 $2,974.55 50658 $283.50 49848 $229.40 50327 $2,315.95 50465 $4,189.60 51300 $121.95 49851 $296.80 50330 $327.95 50466 $4,189.60 51303 DERIVED 49854 $539.95 50333 $884.50 50470 $5,313.40 51306 $176.15 49857 $499.50 50336 $1,322.10 50471 $5,313.40 51309 DERIVED 49860 $404.85 50339 $805.25 50475 $6,131.10 51312 DERIVED 49863 $607.60 50342 $934.30 50476 $6,131.10 51315 $384.85 49866 $431.65 50345 $497.10 50500 $396.70 51318 $254.00 49878 $81.00 50348 $327.95 50504 $529.15 51700 $92.75 50100 $391.35 50349 $459.10 50508 $566.75 51703 $46.60 50102 $877.45 50351 $2,290.25 50512 $756.05 51800 $120.80 50103 $472.55 50352 $81.00 50516 $510.20 51803 DERIVED 50104 $447.85 50353 $508.70 50520 $680.20 51900 $415.55 50106 $674.90 50354 $1,878.60 50524 $585.75 51902 $94.15 50109 $674.90 50357 $805.25 50528 $944.85 51904 $579.70 50112 $517.65 50360 $934.30 50532 $822.15 51906 $881.70 50115 $205.00 50363 $715.60 50536 $1,096.05 52000 $105.10 50118 $620.80 50366 $1,252.40 50540 $756.05 52003 $149.80 50121 $1,215.00 50369 $934.30 50544 $378.00 52006 $149.80 50127 $1,007.30 50372 $1,640.05 50548 $756.05 52009 $236.60 50130 $447.85 50375 $715.60 50552 $652.00 52010 $323.70 50200 $269.90 50378 $1,252.40 50556 $869.25 52012 $29.90 50201 $472.40 50381 $934.30 50560 $680.20 52015 $140.05 50203 $594.05 50384 $1,640.05 50564 $907.15 52018 $352.75 50206 $877.45 50387 $934.30 50568 $793.80 52021 $37.55 50209 $1,080.05 50390 $327.95 50572 $1,058.35 52024 $66.55 50212 $2,362.45 50393 $1,212.55 50576 $869.25 52025 $234.35 50215 $2,969.90 50394 $3,982.35 50580 $907.15 52027 $190.80 50218 $3,914.95 50396 $666.10 50584 $869.25 52030 $114.65 50221 $3,644.75 50399 $1,322.10 50588 $1,133.80 52033 $234.35 50224 $4,049.85 50402 $606.40 50600 $623.35 52034 $54.75 50227 $4,724.85 50405 $825.05 50604 $2,645.60 52035 $606.80 49815 to 52035 | MediGap 2010 29
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 27: Item No Benefit Item No Benefit Ite
Page 33: 1300 853 530 nib.com.au nib health

SCHEDULE OF BENEFITS - nib

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