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Health Cover Explained

 

Understanding Health Insurance Show content

Private Health insurance helps reduce or eliminate your out of pocket expenses for medical treatment in or outside of hospital, while giving you wider access to health care professionals.

While Medicare covers you for treatment in a public hospital, private hospital cover lets you choose when and where you are treated and the doctor you see. Extras cover also helps reduce the cost for many services not covered by Medicare like dental, optical and physio.

If you don’t have Hospital cover, you can still be treated by the public health care system in the event you need to go to hospital. If you require surgery, you will be placed on a waiting list.

It’s important to note, if you’re over 31 years old or earn more than $90,000 p.a. as a single or $180,000 as a couple, you may have to pay the Medicare Levy Surcharge or Lifetime Health Cover loading if you don’t have Private Hospital Cover and decide to take it later in life. Find out more on saving tax.

Australian Government Rebate Show content

The Australian Government offers a rebate to help cover the cost of your private health insurance premium and can be claimed on both Extras and Hospital cover. The amount of rebate you might receive is calculated based on your income. CUA Health can apply your rebate directly to your health cover policy to reduce the amount of your premium or you can claim your rebate at tax time.

If you’re eligible to Medicare benefits then you qualify to receive the rebate, it varies depending on your income.

Here you can find the rebate levels applicable.

Medicare Levy Surcharge Show content

The Medicare Levy Surcharge is an additional tax charged to people who earn more than the specified threshold and don’t have Private Hospital cover. All CUA Health Hospital Cover policies satisfy the Government criteria to avoid the surcharge (to avoid the tax, you only need Hospital cover, not Extras cover).

The Medicare Levy Surcharge will apply to you if you earn over $90,000 a year as a single, or $180,000 as a couple or family and don’t have Private Hospital Cover. The surcharge varies from 1% to 1.5% depending on your income.

Lifetime Health Cover Loading Show content

‘Lifetime Health Cover’ is a Government initiative designed to encourage people to take out private hospital insurance earlier in life and maintain their cover.

People who delay taking out cover will pay a 2% loading on top of their premium for every year they’re aged over 30 when they first take out private hospital cover and the loading applies for 10 years. For example, if you took out private hospital cover for the first time at the age of 40, you would have an additional 20% on your premium every year for 10 years.

‘Lifetime Health Cover’ is a Government initiative designed to encourage people to take out private hospital insurance earlier in life and maintain their cover.

People who delay taking out cover will pay a 2% loading on top of their premium for every year they’re aged over 30 when they first take out private hospital cover and the loading applies for 10 years. For example, if you took out private hospital cover for the first time at the age of 40, you would have an additional 20% on your premium every year for 10 years.

Hospital and Doctor’s gap Show content

A gap is the amount of the medical bill that remains to be paid by the patient after Medicare and/or private health funds have paid their share.

All of CUA Health Hospital Cover options include ‘gap cover’, which means that if your doctor and hospital agree to treat you on the ‘Access Gap Cover Scheme’ you will have little to no gap to pay.

It’s always a good idea to ask your doctor or medical provider for an estimate of any out of pocket expenses you may incur, particularly if you’re having surgery.

General Questions Show content

Switching to CUA Health is very easy. After you’ve chosen your cover options, you’ll be asked to provide your current health insurance policy details in the joining form. We’ll then contact them directly to cancel your policy and to transfer over any waiting periods you’ve served. Simple!

I have a pre-existing medical condition – can I get health cover? Show content

If you’re aware of a medical condition you already have, you can still take out health cover with CUA Health. You will have to wait 12 months before you will be covered for treatment relating to your pre-existing medical condition unless this waiting period was served with another provider.

A waiting period is the amount of time you must wait between taking out a policy and being able to claim. If you’re transferring from another provider to an equivalent level of cover with CUA Health and you served the waiting period with your previous provider, you will not have to reserve your waiting period.

If you’re upgrading your level of cover from either another provider or from a lower CUA Health policy, you’ll be covered at the previous level until your waiting period has been served.

We also take into account and apply any partial waiting periods served with other providers.

Health Insurance

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