Private Health Information Statement - Combined policy

Top Choice (Silver Plus)

Monthly Premium

$734.20 #

(before any rebate, loading or discount)

Covers two adults & dependants (3 or more people, only 2 of whom are adults)

Available in NSW & ACT

# You may be entitled to an Australian Government rebate on the above premium. Your premium may also include a Lifetime Health Cover loading or an insurer discount. Check with your insurer for details.

This policy covers children and other dependants up to and including the age of 22, students up to and including the age of 30, as well as persons with a disability who qualify as a child or other dependant or student in these age ranges.

Hospital cover

This policy exempts you from the Medicare Levy Surcharge.

This policy provides accident cover - check with your insurer for details.

This policy does not provide benefits for travel or accommodation (outside of hospital).

This policy includes cover for

Hospital Cover Legend
Back, neck and spineEye (not cataracts)Miscarriage and termination of pregnancy
BloodGastrointestinal endoscopyPain management
Bone, joint and muscleGynaecologyPain management with device
Brain and nervous systemHeart and vascular systemPalliative care
Breast surgery (medically necessary)Hernia and appendixPlastic and reconstructive surgery (medically necessary)
CataractsImplantation of hearing devicesPodiatric surgery (provided by a registered podiatric surgeon – limited benefits)
Chemotherapy, radiotherapy and immunotherapy for cancerInsulin pumpsRehabilitation
Dental surgeryJoint reconstructionsSkin
Diabetes management (excluding insulin pumps)Joint replacementsSleep studies
Dialysis for chronic kidney failureKidney and bladderTonsils, adenoids and grommets
Digestive systemLung and chestHospital psychiatric services
Ear, nose and throatMale reproductive system

This policy does not include cover for

Hospital Cover Legend
Assisted reproductive servicesPregnancy and birthWeight loss surgery

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess on admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Excess payments do not apply to hospital admissions for dependants.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product.

The Medical Costs Finder lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Day surgery excess is limited to half the total per person excess (where no overnight stay). If the total per person excess isn’t paid after your first hospital admission you will pay the balance on any subsequent admission(s) within the calendar year. Additional Benefits of the cover: Hospital Substitution Programs, Preventative Health Services and Health Support Programs. Waiting periods may apply. Please refer to the product Fact Sheet or contact Australian Unity for further details.

General Treatment Cover

Using a preferred provider means you may have lower out of pocket costs and can access more No Gap treatments on dental, plus discounts on some optical purchases. A preferred providers list is available from Australian Unity.

This policy includes General treatment (Extras) cover for

General treatment legend
Note, for items marked with an asterisk *: 1) No waiting period for preventative dental and selected diagnostic services. A 12-month waiting period applies for surgical tooth extractions and treatments of gum disease. 2) Crowns and bridges combined sub-limit is $600 per person, Dentures sub-limit is $600 per person. A Full Denture replacement is limited to once every three years.
TreatmentWaiting period (months)Benefit limits (per 12 months unless otherwise stated)Examples of maximum benefits
General dental*2$700 per person
(combined limit for general dental, endodontic & other services)
Periodic oral examination - $33.00
Scale & clean - $52.00
Fluoride treatment - $25.50
Surgical tooth extraction - $105.00
Major dental*12$1,000 per person
(Sub-limits apply)
Full crown veneered - $600.00
Endodontic12Combined limit - see General dentalFilling of one root canal - $123.00
Optical6$250 per personSingle vision lenses & frames - 100% of charge
Multi-focal lenses & frames - 100% of charge
Physiotherapy2$500 per personInitial visit - $40.00
Subsequent visit - $40.00
Chiropractic2$300 per person
(combined limit for chiropractic & osteopathy)
Initial visit - $40.00
Subsequent visit - $30.00
Podiatry2$400 per personInitial visit - $40.00
Subsequent visit - $30.00
Acupuncture2$300 per person
(combined limit for acupuncture, remedial massage & other services)
Initial visit - $30.00
Subsequent visit - $30.00
Remedial massage2Initial visit - $30.00
Subsequent visit - $30.00
Osteopathy2Combined limit - see ChiropracticInitial visit - $40.00
Subsequent visit - $30.00
Annual benefit limits apply per calendar year. Myotherapy - $30 per consultation, Maximum of $300 per person (Combined limit - see Acupuncture), 2 month waiting period. There are Preventative Health Services and Health Support Programs available on this cover. Please refer to the product Fact Sheet or contact Australian Unity for further details.

This policy does not include General treatment (Extras) cover for

General treatment legend
Blood glucose monitorsNon PBS pharmaceuticalsPsychology
Hearing aidsOrthodonticOther treatments - check with your insurer

Ambulance cover

In NSW & ACT this policy provides:

Emergency: Unlimited with no waiting period.

Call-out fees:  will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover

Despite the above, call-out fees where you're not taken to hospital are limited to 2 ambulance attendances per-person per-calendar year. Please note: This cover doesn't include non-emergency ambulance transportation. Emergency ambulance transportation to hospital is only covered if transport is coded and invoiced as emergency transport by a state/territory ambulance service/authority. Some authorities provide certain ambulance services at no cost to eligible residents. Refer to your local ambulance provider for more information. Australian Unity won't pay a Benefit if you're eligible to claim from, or are covered by, another source. Australian Unity doesn't pay a benefit towards ambulance subscription services.

Disclaimer

The information contained in this Private Health Information Statement was provided by the insurer and is intended as general information. It may not take into account your particular circumstances. For information please contact the insurer.

Covered

For information on what is covered under each category, see https://www.privatehealth.gov.au/categories

Restricted

Restricted categories partially cover your hospital costs as a private patient in a public hospital. You may incur significant expenses in a private room or private hospital.

Not Covered

These categories are not covered by this policy.