CUA Health Insurance

CUA Hospital Cover Health Insurance

CUA Health provides three hospital cover tiers for all budgets, and lets you choose your excess amount.

CUA Health's philosophy to provide affordable cover for everyone, for the protection of you and your family, means its members receive effective hospital cover at reasonable costs.

Explore their range of hospital cover with flexible excess amounts, plus the benefits and limitations you should be aware of.

Top 3 features
  1. Good for choosing your excess for reduced premiums.
  2. Good for honouring waiting periods from other insurers (when moving to a similar policy).
  3. Attractive benefits including opitcal discounts at OPSM and Specsavers.

What CUA Health Hospital Cover policies are available?

CUA Health has three tiers of Hospital Cover policies.

  • Basic and Basic Plus. Insuring you for a range of hospital treatments and services, the Basic tier will cover you for accidents, plus restricted rehabilitation, hospital psychiatric services and palliative care. Basic Plus strikes a balance between the level of cover and affordability, covering you for dental surgery, tonsil or adenoids removal, joint reconstructions and. more.
  • Silver Plus. A higher level of cover, Silver Plus protects you for all of the Basic services, plus cardiac-related services, diabetes management, cancer treatment and more.
  • Gold. CUA Health's top hospital policy, this covers a wide range of treatments and services including pregnancy (including childbirth), IVF and weight loss surgery.

Within each tier, you can further choose which policy best suits what you anticipate you could need, should you head to hospital.

ServiceAccident Only Hospital (Basic)Healthy Start Package (Basic Plus)Basic Plus HospitalStandard Hospital (Silver Plus)Premium Hospital Non-Obstetrics (Silver Plus)Premium Hospital (Gold)
Rehabilitation Palliative CareRestrictedRestrictedRestricted
Psychiatric Hospital servicesRestrictedRestrictedRestrictedRestrictedRestricted
Eye
Cataracts
Ear, nose and throat
Tonsils, adenoids and grommets
Bone, joint and muscle
Joint reconstruction
Hernia and appendix, Gastrointestinal endoscopy
Gynaecology
Male reproductive system
Dental surgery
Sleep study
Miscarriage and termination of pregnancy
Kidney and bladder
Digestive system
Skin
Breast surgery
Brain and nervous system
Lung and chest blood
Podiatric surgery
Diabetes management
Insulin pumps
Chemotherapy, radiotherapy and immunotherapy for cancer Pain management Heart and vascular system
Implantation of hearing devices
Back, neck and spine
Plastic and reconstructive surgery
Joint replacements
Dialysis for chronic kidney failure
Pregnancy and birth
Assisted reproductive services
Weight loss surgery
Available without extras cover

Other benefits of CUA Health Hospital Cover

Even the most basic CUA Health Hospital Cover 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 Access Gap Cover Scheme to reduce or eliminate your out-of-pocket expenses, and help keep your medical costs manageable and predictable.

Other benefits include:

  • Cover for kids until the age of 23. Your children are covered on family or single-parent policies until the age of 23 or 25 if they're studying full time.
  • Choose your own provider. CUA does not have any preferred providers, so you are free to choose any registered health care provider you want.
  • Up to 20% off at OPSM. CUA Health members can take advantage of 20% off lenses and lens extras, 15% off non-prescription sunglasses, 10% off contact lenses purchased in-store and 5% off contact lenses purchased online.
  • Up to 25% off at Specsavers. CUA Health Insurance members can enjoy 25% off a single pair of glasses from the Specsavers $149 or above range plus 20% off lens options and free digital retinal photography.
  • Discount for CUA members. CUA offers a 4% discount on health insurance if you pay your premiums via direct debit from a CUA transaction account.
  • Discounts for CUA home loan customers. If you also have a CUA Rate Breaker Home Loan, you're entitled to enjoy one month of free CUA Health insurance premiums each year.
  • Range of excess options. CUA Health offers hospital cover policies with a range of excess options available. By choosing a policy with an excess you can enjoy lower premiums.
  • Competitions. CUA Health members can also access exclusive competitions.

How do the costs work?

With the exception of the Healthy Start Package in the Basic Plus tier, all of CUA's Hospital Cover policies require you nominate an excess amount of your choice, to be paid on the first hospital visit you make each year.

  • Basic and Basic Plus. Flexible excess options apply, starting at $250.
  • Silver Plus. An excess applies of your choice, either $250, $500 or $750.
  • Gold. You can choose between an excess amount of $0, $250 or $500.

The Healthy Start Package (Basic Plus) requires you to pay a co-payment of a maximum $50 per night, as well as a $250 excess per admission.

CUA Health has agreements with the majority of private hospitals and day surgeries in Australia. If your chosen hospital or day surgery doesn't have an agreement with CUA Health, you may be subject to large out-of-pocket expenses, in addition to any excess payment. Check with your doctor or hospital prior to admission whether there will be out of pocket costs for you. These could include;

  • 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 Access Gap Cover scheme. It will reduce or in some instances remove your out-of-pocket expenses for specialist care you receive while in hospital, too.
  • 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.

Waiting periods and limitations

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.

Most policies will include an excess, which is an amount that you will need to pay for your first hospital visit per year. CUA gives you the choice of excess.

  • Basic. $500 excess applies.
  • Basic Plus. A choice of $250, $500 or $750 excess applies.
  • Silver Plus. A choice of $250, $500 or $750 excess applies.
  • Gold. A choice of $0, $250, $500 or $750 excess applies.

Your excess is capped at a single payment per person per calendar year and opting for a higher amount reduces your premiums.

However, if you know you'll be going to hospital for something like 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.

If you served part or all of your waiting period at your previous provider, CUA Health will honour it so long as it was for a similar level of cover and was valid within 2 months of joining CUA Health.

How to make a claim

There are several ways you can lodge an extras claim with CUA Health:

  • In person. If the health care provider supports the HICAPS system, you can swipe your CUA Health membership card on the spot to claim instantly.
  • Via the CUA Health app. You can submit your claim via the CUA Health Mobile Claiming app by uploading a photo of your receipt. Claims of under $300 will be assessed immediately and the funds transferred to your bank account.
  • Online. You can log into the CUA Health Online Services portal to upload a photo of your receipt and submit your claim. Claims of under $300 will be assessed immediately, and the funds transferred to your bank account.
  • At a CUA branch. You can lodge your claim in person at your nearest CUA branch.
  • By fax or mail. You can also complete a claim form and then return it, along with your receipt, to CUA Health by fax or post.
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