Important updates to private hospital benefits

Australian Unity's contract with Gastro Medicine & Endoscopy Group (VIC) effective from midnight 4th January 2025. This means Gastro Medicine & Endoscopy Group will no longer be an Australian Unity Agreement Hospital from this date. 

Australian Unity's contract with Genea Hospital Group (ACT/NSW) effective from midnight 13th December 2024. This means Genea Hospital Group will no longer be an Australian Unity Agreement Hospital from this date.

Last updated: 8 November 2024

Healthscope has announced it intends to terminate its hospital agreements with 22 small-to-medium private health insurers, including Australian Unity, from 4 March 2025. 

We're still working with Healthscope to try and reach an agreement. We strive to treat all contracted hospitals fairly and take great care during negotiations to ensure we balance the needs of hospitals providers while maintaining affordability and value for money for our health insurance members. 

To find out more, visit our dedicated information page.

Last updated: 13 January 2025

Each health fund enters into agreements with individual private hospitals (including overnight-stay hospitals and day clinics) helping to reduce or eliminate any out-of-pocket expenses you may have to pay towards your hospital admission. These are called 'agreement private hospital'.

These agreements cover things like:

• Hospital fees for accommodation, operating theatre charges and other charges directly related to your admission (including dressings and other consumables, plus most diagnostic test)
• The costs of certain approved medications and prostheses required for treatment of your admitted condition. 

If you attend a non-agreement hospital, even if you have private health insurance, you may still have to pay out-of-pocket costs to the hospital. 

This means that the current contract will apply to admissions until it terminates. For admissions after termination, members with hospital cover may face higher out-of-pocket costs. We aim to work closely with affected members to ensure they can continue to receive pre-booked and ongoing courses of treatments without additional out-of-pocket costs. To find out more read our FAQ on 'transitional arrangements'.

There are two major things to consider when you go to hospital:

• Where does your preferred doctor or specialist work? If the specialist you want to see doesn't work at a hospital we have an agreement with, you will face large out-of-pocket costs. Because of this, you may need to consider choosing a new specialist or switching to a health fund that does have an agreement with the hospital you want. 
• Are there agreement hospitals close to your home? If you prefer a hospital that's in a convenient location and close to family and friends, it's worth using our Find Agreement Hospitals tool to check if any agreement hospitals are near to you.

If you have treatment pre-booked at a hospital where an agreement is terminated, you will be covered by the transitional arrangements, meaning you'll continue to be covered under the current contract after the effective termination date, in the following circumstances:

• If your treatment commenced prior to effective termination date and you've discharged after the effective termination date
• If you require an emergency admission within 3 months after the termination date
• If you have pre-booked a procedure for an admission within 6 months after the termination date
• Patients who are already undergoing a course of treatment prior to the effective termination date for up to 6 months after the termination date
• If you have pre-booked pregnancy treatment for an admission within 9 months after the termination date

You'll still be covered if you attend a hospital that we don't have a contract with, however there may be substantial out-of-pocket costs. If you're in this situation you should contact your treating hospital directly to obtain Informed Financial Consent in advance of you admission to understand the costs. 

We will communicate directly with impacted members through their preferred method of contact, providing reasonable prior notice. Additionally, we will keep this page updated with the latest information for our members.