UniHealth

• Dental extras
• Other extras

• Hospital
• Extras

A restricted service offers you a lot more options than an outright excluded service. For example, if you’ve taken out a Basic Hospital policy with UniHealth and you need knee surgery, you can receive time and cost estimates for how long you will have to wait and how much it will cost you to have the surgery done either under Medicare as a public patient or as a partially-covered private patient in a public or private hospital.

In many cases, you might be able to get a considerable portion of the costs covered for a restricted treatment as a private patient in a public hospital.

With restricted treatments, you’re in a position to consider all of the available treatment options, balancing the out-of-pocket costs and the benefits of each. If the treatment was simply excluded rather than restricted, as it typically is with most basic hospital policies, you’d have no choice but to get it done as a public patient or pay potentially extreme out-of-pocket costs as a private patient.

In general, the Basic Hospital policy delivers a higher level of cover than you might find with many equivalent basic policies, while the Top Hospital policy is generally equivalent to most comprehensive hospital policies, but at a more competitive price. And don’t forget about the exclusive UniHealth bonuses.

The Mid Hospital policy is also noteworthy. With a $500 excess option and private hospital cover for a practical range of services, it could be a suitable choice for people who want more than the  Basic cover but don’t feel the need to get the full range of services included in the Top cover.

UniHealth’s set dental benefits are fairly generous compared to other health funds and the benefits are the same for all general, and even some major, dental treatments under both the Essential and the Top Extras plans. Essential Extras is a suitable option for people who want cost-effective access to major dental cover, especially compared to the many health funds that won’t offer any major dental cover under a basic extras policy.

Most of the benefits are prescribed as a set amount that is reimbursed, which varies depending on the type of service you receive. This means you can receive exceptionally cost-effective ancillary health services even with the most basic extras policy. For example, you might only be a few dollars out of pocket for a chiropractic visit. By contrast, a more typical basic extras policy might see you paying a flat 40-50% of the cost out-of-pocket.

The services covered by Essential Extras are limited and may not be as varied as many other providers. However, it’s worth noting that Essential Extras does cover useful services that are not always available at a basic cover level, including non-PBS pharmaceuticals and healthy living benefits. This means you may be able to get cover for the cost of non-PBS prescription medications, gym memberships, weight management programs, pilates and yoga classes, disease management programs and health screening services.

You are not covered for orthodontics with the Essential Extras policy or the StarterPak combined package, but the Top Extras policy does include a lifetime orthodontics limit that grows over time. This is typical of most health insurance providers. A lifetime limit is the most you can ever claim under that policy, in contrast to the usual annual limits.

When you first join, there is a 24-month waiting period for orthodontics. However, once your cover begins in the third year, you will receive a $1,500 lifetime limit. This limit grows by $500 each year, up to $2,500 in the fifth year. For example, you might be able to claim $1,500 on orthodontics in your third year of cover and then a further $1,000 in the fifth year of your cover. Between these two claims, you will have used up the $2,500 lifetime limit. Note that the growing limit only applies to years of continuous cover.

The lower benefit amount is for wisdom teeth removal that requires the removal of bone alone. The higher benefit amount is for wisdom teeth removal that requires the removal of bone and tooth division. The latter procedure is more intensive and may be more likely to require anaesthetic or incur other costs. As such, higher benefits are payable.

Although costs can vary widely between different dentists (and depending on the situation), the $240 benefit payable towards this procedure should typically be enough to cover most of the costs of this procedure.

Switching is generally as easy as signing up with a new provider and leaving your old policy behind. The health funds are able to handle the transfer of information between themselves and you can access the appropriate cover right away, depending on the applicable waiting periods.

If you the policy you switch to includes equivalent cover for the same services as your previous policy, any waiting periods already served will be recognised.

The excess is an amount payable if you are admitted to hospital. It generally needs to be paid directly to the hospital. By picking a higher excess, you can get lower premiums, but you may have larger out-of-pocket expenses in the event of hospitalisation.

The excess payable per year is limited, although these limits can vary between health funds. With UniHealth, the excess is payable up to once per year for a singles policy and up to twice per year for couples and family policies.

The excess you choose is entirely your choice. Generally, however, someone who has no reason to expect hospitalisation in the near future might favour a higher excess and lower premiums, while someone who is more likely to experience serious health issues may want to opt for no-excess hospital cover. As such, it can be useful to look for a policy that offers a range of different excess options.