GU Health Hospital Cover

See what kind of hospital cover GU Health offers corporate employees.

Grand United (GU) is one of Australia’s leading corporate health specialists, dedicated to helping Australian businesses provide health cover for workers. More than 300 companies are currently using GU and finding tailored solutions for their business and employee healthcare needs.

Instead of choosing a set plan, a business can create a health insurance policy for its employees that balances cost and cover in a way that works for the company. Employees may be able to choose between getting the corporate plan and getting other cover levels from GU. This helps individuals adjust cover in line with their own needs to help keep costs down for everyone. It also makes sure a business isn’t overpaying or getting inadequate cover from its corporate health plan.

This is helped by SplitPay, an advanced system that allows for the management of costs and cover on an individual-employee level as well as on a company-wide scale. Businesses create health plans where the costs are shared to help ensure cover remains individualised and affordable.

How does GU cover hospital stays?

Depending on the individual plan, GU can cover 100% of the accommodation and theatre costs for hospital stays as well as the remaining 25% of medical fees that are not covered by Medicare. These benefits are available for both agreement private hospitals and public hospitals.

Like many other hospital cover policies, GU offers the Access Gap Cover Scheme to help minimise out-of-pocket hospital expenses in the event of a claim and to keep them predictable. The plan may have “no gap” cover or “known gap” cover.

GU cover ensures employers and their employees are covered by effective comprehensive hospital health insurance when needed, for the benefit of all involved. Conditions may apply to specific hospital services or with specific cover types.

  • Emergency admissions. If an emergency admission is the result of a pre-existing condition, benefits may not be payable.
  • Fertility treatment. Benefits are only payable for inpatient hospital treatments with resident (non-overseas visitor) plans.
  • Cosmetic and reconstructive surgery. Depending on the plan, full benefits may be payable for medically necessary reconstructive or cosmetic procedures that are also covered by Medicare. Elective procedures are typically excluded or may carry restricted benefits, such as limiting benefits to a set cost for hospital accommodation.
  • Podiatric surgery. GU does not cover any medical costs associated with podiatric surgery, except minimum benefits payable for accommodation. Theatre fees, podiatric surgeon’s fees and other participating doctor fees, such as anaesthesiologists, are also excluded. Should the procedure involve a prosthesis, it may be covered provided it is on the government’s approved prostheses list.
  • Dental surgery. Only the hospital fees are payable under your hospital cover plan. Any dentist’s medical fees are only claimable under the applicable extras portion of your GU health plan.
  • Psychiatric and rehabilitation care. No benefits are payable for services outside of hospital. Depending on your plan, minimum benefits may be payable for in-hospital services.

What are the pros of getting Grand United hospital cover?

GU can work with businesses to tailor a health plan to the individual industry, to payroll structures, to the budget and to an employee’s profile. This can be a competitive benefit since four out of five current GU members say the availability of private health insurance would influence their decision when deciding on a future employer.

It can also be an effective direct investment in your company. Lost productivity in the workplace has been estimated to cost Australia $6.4 billion per year, largely attributable to factors including attending work when sick, other illness and injuries, and health issues such as obesity.

Businesses can get health and wellness data as well as reports on employee health plans for a clearer understanding of how investing in corporate health care is making a real difference to the business.

In addition, dual-branded membership materials and online portals can effectively showcase a business’s involvement in a corporate health plan and help support employee engagement.

Employees can also take advantage of the GU My Health Space online wellness portal. This provides employees with personalised health information and recommendations to assist them in better managing their health and improving productivity within your business.

Another benefit of GU cover is that it carries the same advantages as other policies, such as qualifying one for the Australian government healthcare rebate and exemption from Lifetime Health Cover loading.

Additional benefits available with GU hospital cover can include the following:

  • Hospital care at home. Employees may be able to get out-of-hospital services from registered practitioners, including physiotherapy, occupational therapy, nursing, personal care attendance, home help and maternity nursing care. The availability of these services depends on the cover level.
  • Chronic disease management programs. The Diabetes Action Program, Healthy Heart Program, Vascular Health Program and Risk Factor Management Program can help individuals who are experiencing temporary or chronic health issues with individualised management and wellness plans.
  • Additional member benefits and discounts. Discounts for cinema tickets, sportswear, travel insurance, day spas and more are an effective perk for your employees.

What are the waiting periods? How about benefit limitations?

The typical waiting periods apply in line with legislation and may vary between cover levels. Pre-existing conditions are typically subject to a 12-month waiting period, with the exception of palliative care, psychiatric treatment and rehabilitation which are only subject to a 2-month waiting period. The typical waiting period for most services is 2 months, while other types of cover such as pregnancy or fertility, where applicable, may be subject to a waiting period of up to 12 months.

Benefit limitation periods, restricted benefits and more may also apply to a policy and can help tailor the costs of a health plan in more detail.

How do I make payments and claims?

When visiting a GU agreement hospital, out-of-pocket expenses will often be limited to the excess and any applicable gap. Typically, the hospital will contact GU directly while the excess and any gaps in cover may be directly payable to the hospital by the individual.

Depending on the corporate healthcare plan being provided and on personal preference, a business may wish to process claims itself on behalf of employees as an added benefit. This is often as simple as sending a two-way claims form to Medicare and following the correct procedures.

Premium payments are largely dependent on the plans chosen. When taking advantage of SplitPay, both individual employees and the corporate body may have premium obligations. In other situations, the company or the employees may be responsible for the complete premium payments payable via direct debit.

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