Australian Unity Hospital and Extras Insurance

Get combined hospital and extras cover in one simple package with Australian Unity

When you’re looking for health insurance, you can create your own cover by picking separate hospital and extras policies. You can then choose to either get both policies from the same fund or each one from a different fund. Another option is to get a hospital and extras policy for complete health cover.

These health packages can be cost effective, but might not have the cover you need. Check out the features of Australian Unity combined health plans and see if they are right for you.

Receive quotes for Australian Unity hospital and extras insurance

What do Australian Unity combined health plans cover?

There are four options, ranging from basic cover to comprehensive, to choose from when picking an Australian Unity combined health plan. Each level of cover has different limits and benefits for both hospital and extras cover.

Australian Unity hospital cover is largely geared towards public hospital procedures and can cover a broad range of procedures, although you will need to share a ward in a public hospital to access restricted treatments.

Care ‘n RepairBasic StarterSmart StartSmart EssentialsSmart Combination
Hospital CoverPrivate hospital cover for accidents onlyAccidents and select procedures at private hospitalsPrivate hospital accommodation and theatre fees, select private day-hospital proceduresFull cover of applicable services at private and public hospitalsFull cover of applicable services at private and public hospitals
Excess$500$500$100$500$250 or $500
Gap cover scheme
  • no
  • no
  • no
  • yes
  • yes
Joint reconstructions and investigationsRestricted
  • yes
Restricted
  • yes
  • yes
Surgical prostheses
  • yes
Except insulin pumps and cochlear implants
  • yes
  • yes
  • yes
Hip and knee replacements or revisions
  • no
  • no
  • no
  • no
  • yes
RehabilitationRestrictedRestricted
  • yes
  • yes
  • yes
PsychiatricRestrictedRestrictedRestrictedRestrictedRestricted
SterilisationsRestricted
  • no
  • yes
  • yes
  • yes
Heart relatedRestricted
  • no
Restricted
  • yes
  • yes
Eye procedures
  • no
  • no
Restricted
  • no
  • yes
Renal dialysis
  • no
  • no
Restricted
  • no
  • yes
Pregnancy
  • no
  • no
  • no
  • no
Restricted
Fertility related
  • no
  • no
  • no
  • no
  • no
Gastric reductions and weight loss
  • no
  • no
RestrictedRestrictedRestricted
Hospital at home, rehabilitation at home
  • yes
  • yes
  • yes
  • yes
  • yes
Extras$1,205 total annual per person limit$1,000 total annual per person limit$1,300 total annual per person limit$2,150 total annual per person limit$2,750 total annual per person limit
General and preventative dental
  • yes
  • yes
  • yes
  • yes
  • yes
Root canal, gum disease and surgical extractions
  • no
  • yes
  • yes
  • yes
  • yes
Crowns, bridges and dentures
  • no
  • no
  • no
  • yes
  • yes
Orthodontics
  • no
  • no
  • no
  • no
  • no
No gap dental network access
  • no
  • no
  • yes
  • yes
  • yes
Optical
  • no
  • no
$150$200$200
Physiotherapy
  • yes
  • yes
  • yes
  • yes
  • yes
Chiropractic and osteopathy
  • no
  • yes
  • yes
  • yes
  • yes
Natural therapies
  • yes
  • yes
  • yes
  • yes
  • yes
Remedial massage
  • yes
  • yes
  • no
  • yes
  • yes
Dietetics
  • yes
  • yes
  • no
  • no
  • no
Speech, eye and occupational therapyOccupational therapy only
  • no
  • no
  • no
  • no
Podiatry
  • no
  • yes
  • no
  • no
  • no
Psychology
  • no
  • no
  • no
  • no
  • no
Pharmacy
  • no
  • no
  • no
  • no
  • no
Travel vaccinations
  • no
  • no
$150$150$150
Hearing aids and health devicesBraces, splints, wheelchairs, crutches and compression garments up to $150
  • no
  • no
  • no
  • no

Are there any other benefits to joining Australian Unity?

You can get a 4% discount by paying premiums with direct debit to help keep costs down. Certain plans also let you access the Australian Unity no gap dental network, so you can get the right dental care while keeping out-of-pocket expenses to a minimum.

This lets you get up to 100% back on preventative dental services, including examinations, scale and clean, fluoride treatment, x-rays and even custom-fitted mouthguards. With all plans, except the Care ‘n Repair, you can start accessing these right away without a waiting period.

The hospital excess is predictable and limited to once per year for singles and twice per year for couples and family policies.

  • The Care ‘n Repair policy, Basic Starter and Smart Starter policies, which give you health maintenance plus general cover in the event of the unexpected, have an excess waiver in the event of an accident resulting in hospitalisation.
  • The Smart Starter and Smart Essentials policies, which let you take full advantage of the healthcare system, also have an excess waiver for day surgery procedures.

By signing up for Australian Unity health insurance, you can also get further discounts on other products like home, car and travel cover.

What are the limitations and waiting periods?

Sub-limits apply to extras services, and depending on the plan there may be combined sublimits. It’s important to note that many private hospital procedures are not covered with the less-comprehensive combined health plans. You will generally need to make use of the public hospital system, although you’ll still get the benefits of being able to choose your own doctor and, in some cases, a private room.

The following waiting periods apply:

  • 1 day for accidents resulting in hospitalisation. For accidents, you are also covered in both private and public agreement hospitals.
  • 2 months for psychiatric, palliative care and rehabilitation services.
  • 12 months for pre-existing conditions.
  • 24 months for gastric reduction and other obesity procedures.

Extras waiting periods may vary depending on the plan, but are generally as follows:

  • None for preventative dental with select plans.
  • 2 months for specified general dental services and therapies.
  • 6 months for optical and lifestyle benefits.
  • 12 months for dental crowns where applicable with higher level plans.

How to make a claim

For extras, you have several ways to claim:

  • At the time. If the provider has a HICAPA or CSC machine, just swipe your Australian Unity membership card.
  • Online. You can claim later by logging in to your online account.
  • Over the phone. You cancall 1800 807 144 to make a claim or get assistance with paying claims.
  • Sending in a claim form. You can complete a claims form, attach the receipts and then mail, email or fax it to Australian Unity at the addresses listed on the form.

For hospital cover, you can generally make a claim at agreement hospitals by having doctors contact Australian Unity directly.

At non-agreement hospitals, you can follow these steps after receiving a bill:

  1. Take your paperwork to Medicare and get a Medicare cheque for the doctor and a medical statement for Australian Unity.
  2. Complete a health cover claim form and attach the medical statement.
  3. Mail the form and medical statement to the reply paid address on the claim form. You will then receive an Australian Unity cheque for the doctor.
  4. Send the Medicare and Australian Unity cheques, together with any amount still owing, to the doctor.

Andrew Munro

Andrew writes for finder.com.au, comparing products, writing guides, sniffing out deals and looking for new ways to help people get the most out of their money.

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