Brochures & forms

CUA Health brochures and application forms are provided in PDF format. You can download Acrobat Reader for free.

Health insurance brochure and application form

Before you fill in the application form, we recommend that you specifically read the following sections of the CUA Health insurance brochure outlining your entitlements:

• Waiting periods (pages 12-13)
• Conditions (pages 15)
• Hospital Exclusions / Benefits / Benefit limitation periods (pages 16-20)
• Extras Exclusions / Benefits / Benefit limitation periods (pages 21-27). 

If you are not yet already a CUA customer, please fill in the direct debit request form. 

Premiums

• Health insurance premiums for Queensland, South Australia, Tasmania and Northern Territory  
• Health insurance premiums for New South Wales, Australia Capital Territory and Western Australia 
• Health insurance premiums for Victoria

Forms

• Application Form (PDF File, 187.7 KB)
  
• Direct Debit Form (PDF File, 147.3 KB)
• Claim Form (PDF File, 111.2 KB)