Choose from three levels of hospital cover with Credit Union Australia
Credit Union Australia (CUA) has made its name as a members-first financial services provider, and also offers affordable and effective hospital cover to its members. The CUA health philosophy is affordable cover for everyone, for the protection of yourself and your family, at reasonable costs.
This review will explore what is covered by each of the three levels of cover and the benefits and limitations you should be aware of.
What hospital cover plans does CUA offer?
All CUA hospital plans let you access public and private hospitals, although the procedures covered can vary widely.
Your three options are essential, standard and premium cover. With premium, you can also choose whether or not you’d like to include pregnancy-related cover, as well as a zero excess option.
|Cardiac and related|
|Tonsil or adenoid removal|
|Joint arthroscopy and meniscectomy|
|Pregnancy||With optional pregnancy cover only|
|Assisted reproduction||With optional pregnancy cover only|
|Gastric banding||With optional pregnancy cover only|
|Joint replacements and revisions||Hip, knee, shoulder and elbow|
|Non-cosmetic plastic surgery|
|Psychiatric||Restricted||24-month restriction. Fully restricted with optional pregnancy cover.|
|Other non-Medicare services|
|All other Medicare services|
With restricted benefits, the amount you can claim is limited to public hospital rates when treated in a private hospital.
Are there any other benefits?
CUA only offers obstetrics and pregnancy-related cover as an optional type of premium policy, meaning you can still find a high level of hospital cover without paying for benefits that you might not need or want.
Meanwhile, even the most basic policy options will still entitle you to private hospital cover for select procedures so you have the option of bypassing extensive waiting lists, choosing your doctor and staying in a private room at a private hospital without necessarily picking up a comprehensive, high-level policy.
You can also access the gap cover scheme to reduce or eliminate your out-of-pocket expenses, and help keep your medical costs manageable and predictable.
What are the limitations, costs and waiting periods?
When you join CUA, pre-existing conditions are subject to a 12-month exclusion, followed by 12 months of restricted benefits. You will not be able to claim full benefits for the treatment of pre-existing conditions until 2 years after joining.
It’s also important to note that some policies will include an excess. This is an amount that you will need to pay for your first hospital visit per year.
- Essential: $500 excess applies.
- Standard: $500 excess applies.
- Premium: If you forego pregnancy cover a $500 excess applies. If you include pregnancy cover you may choose from a $500, $250 or $0 excess.
Your excess is capped at a single payment per person per calendar year. Opting for a higher amount reduces your premiums, but if you know you’ll be going to hospital, such as if you took out cover specifically for childbirth, it might be worth opting for a lower excess even at the cost of higher premiums.
Note that a 12-month waiting period applies to obstetrics, so you will need to take out cover at least 12 months prior to giving birth in order to claim the hospitalisation expenses.
You cannot make any claims for certain procedures within the waiting periods.
- None: Accidents resulting in hospitalisation and requiring immediate medical treatment.
- 2 months: Psychiatric care, and all procedures not otherwise specified.
- 12 months: Obstetrics and pre-existing conditions.
What isn't covered?
You cannot make claims for:
- Hospital procedures for which Medicare pays no benefits, such as purely cosmetic procedures
- Any gap expenses. These arise when practitioners charge more than the Medicare benefit amount for a treatment. To minimise or avoid this, you can check ahead of time what the gap expenses will be, and use only funds that participate in the CUA Health Gap scheme
- Personal hospital expenses, such as TV rental costs, phone calls and similar
- Additional costs involved in “nursing home-type” patient admissions to a public or private hospital
- Certain experimental or high cost drugs
- Any outpatient treatments
- Products or services purchased or undertaken overseas, or from an overseas fund