(before any rebate, loading or discount)
Covers one adult & dependants, including non-student dependants (2 or more people, only one of whom is an adult)
Available in South Australia
# 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, students up to and including the age of 30 and non-students up to and including the age of 30, as well as persons with a disability who qualify as a child, student or non-student in these age ranges.
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).
| Blood | Eye (not cataracts) | Pain management |
| Bone, joint and muscle | Gastrointestinal endoscopy | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Brain and nervous system | Gynaecology | Skin |
| Breast surgery (medically necessary) | Hernia and appendix | Sleep studies |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Joint reconstructions | Tonsils, adenoids and grommets |
| Dental surgery | Kidney and bladder | Hospital psychiatric services |
| Diabetes management (excluding insulin pumps) | Lung and chest | Palliative care |
| Digestive system | Male reproductive system | Rehabilitation |
| Ear, nose and throat | Miscarriage and termination of pregnancy |
| Assisted reproductive services | Heart and vascular system | Pain management with device |
| Back, neck and spine | Implantation of hearing devices | Plastic and reconstructive surgery (medically necessary) |
| Cataracts | Insulin pumps | Pregnancy and birth |
| Dialysis for chronic kidney failure | Joint replacements | Weight 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.
Excess: You will have to pay an excess on admission. This is limited to a maximum of $750 per person and $1500 per policy per year.
Excess payments do not apply to hospital admissions for dependants.
Co-payments: No co-payments
Waiting periods:
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.
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.
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.
| Note, for items marked with an asterisk *: 1) No waiting-period for preventative dental and selected diagnostic services.T reatments claimed as No Gap Dental benefits (where available) do not count to yearly limit. 2) A full denture replacement is limited to once every three years. 3) Surgical tooth extractions and treatment of gum disease have a 12-month waiting period. 4) Limit of one chiropractic x-ray per person per calendar year. 5) Travel Vaccinations only. | |||
|---|---|---|---|
| Treatment | Waiting 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, major dental, endodontic & other services) | Periodic oral examination - 60% of charge Scale & clean - 60% of charge Fluoride treatment - 60% of charge |
| Major dental* | 12 | Surgical tooth extraction - 60% of charge Full crown veneered - 60% of charge | |
| Endodontic | 12 | Filling of one root canal - 60% of charge | |
| Optical | 6 | $200 per person | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Physiotherapy | 2 | $350 per person (combined limit for physiotherapy & exercise physiology) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Chiropractic* | 2 | $250 per person (combined limit for chiropractic & osteopathy) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Podiatry | 2 | $200 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Psychology | 2 | $100 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Acupuncture | 2 | $200 per person (combined limit for acupuncture, remedial massage & other services) | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Remedial massage | 2 | Initial visit - 60% of charge Subsequent visit - 60% of charge | |
| Dietetics/dietary advice | 2 | $200 per person | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - 60% of charge Subsequent visit - 60% of charge |
| Vaccinations* | 0 | $100 per person | Per service - 60% of charge |
| Annual benefit limits apply per calendar year. Myotherapy also included - 60% of the consultation fee, maximum of $200 per person (Combined limit with Acupuncture and Remedial Massage), 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. | |||
| Blood glucose monitors | Non PBS pharmaceuticals | Other treatments - check with your insurer |
| Hearing aids | Orthodontic |
In South Australia 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.
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.
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.
For information on what is covered under each category, see https://www.privatehealth.gov.au/categories
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.
These categories are not covered by this policy.