Do you work for a university or a higher education institution? Discover if UniHealth is the fund for you.
Restricted health funds are exclusive health insurance providers that are typically run as not-for-profit organisations for the benefit of their members. Because the health funds are restricted, it often means more similarities between members, which can help restricted funds offer more focused products to deliver better value for money. This guide goes through the different UniHealth cover types available and looks at how it compares to other health funds and the fine print to consider before signing up.
What are the key features of UniHealth policies?
- Comprehensive ambulance cover with all policies. It’s generally unusual to find a health fund that includes cover for non-emergency ambulance services in its hospital policies, especially at its most basic level of cover. UniHealth includes a $3,000 annual limit for non-emergency ambulance services and unlimited cover for emergency ambulance services.
- Full private room cover. You will receive cover for private hospital accommodation when available for all eligible in-hospital procedures. For restricted procedures you can still get covered for a private room in a public hospital. Many other health funds will only cover a shared room in a public hospital.
- No outright excluded treatments. The services covered by the Basic Hospital policy are similar to what you’ll find with many other health funds, but it doesn’t outright exclude cover for any specific procedures. Although out-of-pocket costs may be incurred as a private patient (regardless of whether you’re in a public or private hospital) it still gives you more flexibility if you do need any of those procedures.
What policies does UniHealth offer?
You can take out either hospital or extras cover alone. If you want both, you can also take out both hospital and extras, either by picking your own cover level for each or picking the package option:
- Hospital. Covers you for Medicare services in private hospitals and delivers other benefits. The three levels of hospital cover are Basic, Mid and Top.
- Extras. Covers a range of ancillary health services that aren’t covered by Medicare, like dental work, optical, physiotherapy and many other out-of-hospital health services. The two levels of extras cover are Essential and Top.
- Package. UniHealth has a single package option known as the StarterPak, designed for those who want basic value-for-money cover for more commonly used services.
What’s covered by each level of hospital cover?
- Covered in private hospitals
- Minimally covered in private hospitals, largely covered as a private patient in a public hospital
- Not covered
How many members does UniHealth service?
Along with Teachers Health, UniHealth provides health insurance policies to over 290,000 people. This gives Teachers Health a market share of 2.2%.
Is UniHealth nonprofit?
Does UniHealth get many complaints?
Teachers Health, the not-for-profit fund that runs UniHealth accounts for:
- 2.2% of the Australian health insurance market
- 2.2% of all complaints about benefit payments
- 1.2% of all complaints about service
- 0.9% of all complaints that require investigation
Source: Private Health Insurance Ombudsman, State of the Health Fund Report 2016
How many hospital agreements does UniHealth have in my state and in total?
There are two important factors that determine the benefit your health fund pays for hospital services:
- The level of hospital cover you purchase
- Whether your health fund has an agreement with the hospital where you are treated
The table below details the number of hospital agreements Teachers Health (UniHealth’s parent fund) has in place across each Australian state and territory. You can check this figure against the industry maximum for all health funds to see how UniHealth compares.
|Private hospital agreements||Day hospital agreements|
|NSW||97 (industry maximum: 101)||90 (industry maximum: 96)|
|ACT||6 (industry maximum: 7)||7 (industry maximum: 9)|
|VIC||78 (industry maximum: 84)||75 (industry maximum: 75)|
|QLD||53 (industry maximum: 57)||45 (industry maximum: 51)|
|SA||26 (industry maximum: 29)||25 (industry maximum: 27)|
|WA||21 (industry maximum: 23)||23 (industry maximum: 26)|
|TAS||6 (industry maximum: 8)||3 (industry maximum: 5)|
|NT||2 (industry maximum: 2)||1 (industry maximum: 1)|
Are there any additional benefits to being a member?
- Access Gap Cover. All UniHealth policies include Access Gap Cover. This billing scheme helps reduce your out-of-pocket expenses for hospital treatments with participating doctors.
- QBE home and car insurance discounts. Members receive a multi-policy discount with QBE home and car insurance.
- Allianz Global Assistance travel insurance discounts. They also get 10% off Allianz Global Assistance travel insurance
- New family program. Practical information and support for early parenting matters.
- Rehabilitation at home. Professional rehabilitation services in the comfort and privacy of your own home.
- Weight loss and management. Assistance in reaching and then maintaining your weight goals.
- Chronic disease management. Professional, evidence-based support and assistance for a range of chronic diseases.
- Diabetes management. Assistance for members with diabetes or pre-diabetes.
- Residential care support. Receive assistance in making well-informed decisions on residential aged care facilities.
- Hospital care at home. Early discharge and hospital care in your own home to help reduce the chance of hospital-acquired infections and to get home sooner.
Paying your UniHealth premiums
Premiums for your UniHealth health insurance policy can be paid using the following methods:
- BPAY. Contact your bank and quote UniHealth’s BPAY reference number (266155) and your BPAY member reference number.
- Phone. You can make an over-the-phone credit card payment by calling 1300 345 876, or (02) 8072 9282 if calling from a mobile phone or from overseas.
- Credit card. You can log into your UniHealth account and pay your premium by credit card through the UniHealth Online Member Services area.
- Direct debit. You can also set up a direct debit from your nominated bank account or credit card for premiums to be automatically paid at your desired frequency.
Premiums can be paid fortnightly, monthly, quarterly, half-yearly or yearly.
How do I lodge a UniHealth claim?
There are several ways you can lodge a health insurance extras claim with UniHealth:
- On the spot. Simply swipe your UniHealth membership card on the spot when you visit your health care provider to claim your benefit instantly.
- Via mobile app. The UniHealth member app makes it easy to submit extras claims by uploading a photo of your receipt. The app is available for Apple and Android devices.
- Online. You can lodge a claim for the following extras services through the UniHealth Online Member Services area: Acupuncture, chiropractic, complementary therapies, remedial massage, optical, physiotherapy and podiatry.
- By mail. You can download a claim form from the UniHealth website. Once the form has been completed, you can send it along with your invoice or receipt to UniHealth, GPO Box 9812, Sydney NSW 2001.
- In person. Completed claim forms and invoices or receipts can be lodged in person at a Member Care Centre located at a Teachers Health Centre.
- Via email. Finally, you can also send your completed claim form and invoice via email to firstname.lastname@example.org
If you receive a bill for hospital services from your doctor or specialist:
- If the doctor or specialist participates in UniHealth’s Access Gap Cover scheme, the bill will be sent directly to UniHealth
- If the doctor or specialist does not participate in the Access Gap Cover scheme, you will need to take the bill to Medicare for processing before UniHealth can pay a benefit.
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