General help centre: for PHI

If you’re covered for a procedure (that is, your Fact Sheet indicates the treatment is “Covered”) and you’ve served any relevant waiting periods, Australian Unity will contribute to your costs. But the benefit you get back will depend on which type of hospital you go to.

Agreement private hospitals

Australian Unity has agreements with more than 500 private hospitals and day surgeries across Australia. We call these “agreement private hospitals”. These agreements mean that, depending on your level of cover, you should be covered for most in-hospital charges—minus any excess or co-payment you’re required to pay. Check which private hospitals we have an agreement with.

Non-agreement private hospitals

If you’re admitted to a private hospital that is not one of our agreement hospitals, the amount we pay may not cover the full cost of your stay. You may incur large out-of-pocket costs, in addition to any excess (or co-payment) that applies.

Public hospitals

If you’re admitted to a public hospital, you can choose to be treated as a public or private patient. As a public patient, you’ll receive treatment by a hospital-appointed doctor and Medicare will cover the whole cost of your treatment and accommodation.

If you choose to be treated as a private patient in a public hospital, you’ll be asked to sign a form noting all the costs relating to hospital and medical fees you will incur, including your excess. There may be very little difference in the care you will be provided (compared to being a public patient), but you may be able to elect a doctor of your choice.

Note—all our covers pay benefits towards shared room accommodation in a public hospital for services included on your cover. If you’re admitted to a private room of a public hospital, you may experience large out-of-pocket costs.

Please check your Fact Sheet to learn more.

Cancelling your old cover

When you make the switch to Australian Unity, we’ll ask for your permission to contact your old health fund to cancel your cover.

We’ll ask them for a transfer certificate, which includes information about any waiting periods you’ve already served, your recent claims, and if Lifetime Health Cover (LHC) loading applies.

Your old fund will usually contact you to arrange any refunds they might owe you. And if you’re paying them by direct debit, it’s a good idea to let your bank know you want to cancel this deduction.

Impact on your new cover

Waiting periods

If you transfer to Australian Unity within 30 days of leaving your previous fund and choose an equal (or lower) level of cover, you won’t have to re-serve any waiting periods you’ve already completed on services that were covered under your old cover and continue to be on your new cover.

If you upgrade your level of cover, or add different services, you may have to serve some waiting periods.

Yearly limits

If you change funds part way through the calendar year, and have made claims with your old fund, it will affect the claim limits you’ll have for the remainder of the year.

For example, if you’ve made $400 worth of preventative dental claims with your old fund, and your new Australian Unity policy has a $600 limit, $400 will be deducted from your new policy to reflect your true limit for the rest of that year.

All your yearly limits will reset on 1 January.

Lifetime limits

Your old fund will provide information to Australian Unity about any claims you’ve made for orthodontics (or anything else with a lifetime limit). Lifetime limits do not reset when you change health insurers.