(before any rebate, loading or discount)
Covers two adults & dependants, including non-student dependants (3 or more people, only 2 of whom are adults)
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).
| Back, neck and spine | Eye (not cataracts) | Miscarriage and termination of pregnancy |
| Blood | Gastrointestinal endoscopy | Pain management |
| Bone, joint and muscle | Gynaecology | Palliative care |
| Brain and nervous system | Heart and vascular system | Plastic and reconstructive surgery (medically necessary) |
| Breast surgery (medically necessary) | Hernia and appendix | Podiatric surgery (provided by a registered podiatric surgeon – limited benefits) |
| Chemotherapy, radiotherapy and immunotherapy for cancer | Implantation of hearing devices | Rehabilitation |
| Dental surgery | Joint reconstructions | Skin |
| Diabetes management (excluding insulin pumps) | Kidney and bladder | Sleep studies |
| Digestive system | Lung and chest | Tonsils, adenoids and grommets |
| Ear, nose and throat | Male reproductive system | Hospital psychiatric services |
| Assisted reproductive services | Insulin pumps | Pregnancy and birth |
| Cataracts | Joint replacements | Weight loss surgery |
| Dialysis for chronic kidney failure | Pain management with device |
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, 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. Treatments claimed as No Gap Dental benefits (where available) do not count to yearly limit 2) Full denture replacement limited to once every-three-years. 3) Surgical teeth extractions and gum-disease treatment included under Endodontics (12 month waiting period). 4) $40 per chiropractic x-ray fee, limit one per-person per-calendar-year. 5) Orthotic benefits are for supply only. 6) Travel vaccinations only | |||
|---|---|---|---|
| Treatment | Waiting period (months) | Benefit limits (per 12 months unless otherwise stated) | Examples of maximum benefits |
| General dental* | 2 | $800 per person up to $1,600 per policy (combined limit for general dental, major dental & endodontic) | Periodic oral examination - 50% of charge Scale & clean - 50% of charge Fluoride treatment - 50% of charge Surgical tooth extraction - 50% of charge |
| Major dental* | 12 | Full crown veneered - 50% of charge | |
| Endodontic* | 12 | Filling of one root canal - 50% of charge | |
| Orthodontic | 12 | $600 per person up to $1,200 per policy $1,800 lifetime limit | Braces for upper & lower teeth, including removal plus fitting of retainer - 100% of charge |
| Optical | 6 | $200 per person up to $400 per policy | Single vision lenses & frames - 100% of charge Multi-focal lenses & frames - 100% of charge |
| Non PBS pharmaceuticals | 2 | $300 per person up to $600 per policy (combined limit for non pbs pharmaceuticals & vaccinations) | Per eligible prescription - $40.00 |
| Physiotherapy | 2 | $400 per person up to $800 per policy (combined limit for physiotherapy & exercise physiology) | Initial visit - $50.00 Subsequent visit - $50.00 |
| Chiropractic* | 2 | $200 per person up to $400 per policy (combined limit for chiropractic & osteopathy) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Podiatry | 2 | $300 per person up to $600 per policy (combined limit for podiatry & orthotics (podiatric orthoses)) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Psychology | 2 | $200 per person up to $400 per policy | Initial visit - $80.00 Subsequent visit - $80.00 |
| Acupuncture | 2 | $300 per person up to $600 per policy (combined limit for acupuncture, remedial massage & dietetics/dietary advice) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Remedial massage | 2 | Initial visit - $40.00 Subsequent visit - $40.00 | |
| Audiology | 2 | $200 per person up to $400 per policy (combined limit for audiology, eye therapy (orthoptics), occupational therapy & speech therapy) | Initial visit - $40.00 Subsequent visit - $40.00 |
| Dietetics/dietary advice | 2 | Combined limit - see Acupuncture | Initial visit - $40.00 Subsequent visit - $40.00 |
| Exercise physiology | 2 | Combined limit - see Physiotherapy | Initial visit - $50.00 Subsequent visit - $50.00 |
| Eye therapy (orthoptics) | 2 | Combined limit - see Audiology | Initial visit - $40.00 Subsequent visit - $40.00 |
| Health management / Healthy lifestyle | 6 | $150 per person | Health management - 50% of charge |
| Occupational therapy | 2 | Combined limit - see Audiology | Initial visit - $40.00 Subsequent visit - $40.00 |
| Orthotics (podiatric orthoses)* | 12 | Combined limit - see Podiatry | Orthotics supply & fit - 50% of charge |
| Osteopathy | 2 | Combined limit - see Chiropractic | Initial visit - $40.00 Subsequent visit - $40.00 |
| Speech therapy | 2 | Combined limit - see Audiology | Initial visit - $40.00 Subsequent visit - $40.00 |
| Vaccinations* | 0 | Combined limit - see Non PBS pharmaceuticals | Per service - 100% of charge |
| Annual benefit limits apply per calendar year. Myotherapy - $40 per consultation, maximum $300 per person, $600 per family (combined limit - see Acupuncture), 2 month waiting period. Braces, Splints and Garments - up to 50% of the cost, maximum $300 per person, $600 per family (combined limit - see Podiatry), 12 month waiting period. Aids: Wheelchairs and crutches - up to 50% of cost, maximum $100 per person, $200 per family, 2 months 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 | Hearing aids | Other treatments - check with your insurer |
Please refer to the product Fact Sheet or contact Australian Unity for further details.
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 unlimited for 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.