What you can get with our Hospital Cover
Our private hospital options let you choose the level of cover that best suits your needs and your budget.
Essential Hospital is ideal if you’re healthy and don’t want to pay for what you don’t need. For greater cover, Standard Hospital is a good option, while our top Premium Hospital covers can give you the peace of mind that you and your family are well protected. There’s a choice of excess levels, plus a Premium Hospital – Non-obstetrics cover if pregnancy isn’t on your roadmap.
|Premium Hospital||Premium Hospital - Non-obstetrics||Standard Hospital||Essential Hospital||Accident Only Hospital||Healthy Start Package|
|Pregnancy (including childbirth)||✔||x||x||x||x||x|
|IVF & assisted reproduction||✔||x||x||x||x||x|
|Gastric banding & obesity-related services||✔
24 month BLP
|Joint replacements (incl. Revisions)||✔||✔||x||x||x||x|
|Cataract & eye lens procedures||✔||✔||x||x||x||x|
|Cardiac & related services||✔||✔||✔||x||x||x|
|Non Cosmetic Plastic and Reconstructive Surgery||✔||✔||✔||x||x||x|
|Sterilisation (incl. Reversal)||✔||✔||✔||x||x||x|
|Nerve treatment (for Movement Disorders or Chronic pain)||✔||✔||✔||x||x||x|
|Grommets in Ears||✔||✔||✔||✔||x||✔|
|Accidents after joining||✔||✔||✔||✔||✔||✔|
24 month BLP
|Minor gynaecological procedures||✔||✔||✔||✔||x||✔|
|Major gynaecological procedures||✔||✔||✔||✔||x||x|
|Removal of appendix or Appendicitis treatment||✔||✔||✔||✔||x||✔|
|Surgical removal of tonsils||✔||✔||✔||✔||x||✔|
|Surgical removal of adenoids||✔||✔||✔||✔||x||✔|
|Surgical removal of wisdom teeth||✔||✔||✔||✔||x||✔|
|Joint reconstructions and investigations (incl. Arthroscopy and Minisectemy)||✔||✔||✔||✔||x||✔|
|All other in-patient treatments receiving medicare benefits||✔||✔||✔||✔||x||x|
|$0, $250 and $500 excess options||Nil||500||500||500||500||500|
|Available without extras cover||✔||x||✔||✔||✔||x|
Benefit Limitation Period (BLP) - Benefits are limited to public hospital rates if treated in a private hospital. If deemed a pre-existing condition, no benefits are payable for the first 12 months, then public hospital rates only for the next 12 months.
Restricted Benefits - Covered in a public hospital with choice of doctor only. If treated in a private hospital, benefits limited to public hospital rates as set by the federal government.
Why choose CUA Hospital Cover?
No excess for kid’s hospital admissions
If you hold a Family or Single Parent policy, your kids are covered up until they turn 23 (or 25 if studying fulltime). If they’re admitted to hospital, the excess will be waived.
Avoid paying extra tax
All CUA Health Hospital Cover options meet the government criteria to avoid paying the Medicare Levy Surcharge or Lifetime Health Cover loading.
Talk to us in person
Have a question about your CUA Health insurance and want to speak to us in person? Easy! We’re part of CUA, so just drop into your local branch for a chat.
Access Gap Cover Scheme
The CUA Health Access Gap Cover Scheme helps to reduce or eliminate your out-of-pocket expenses for hospital treatment and takes the paperwork off your hands.
Waiting periods and pre-existing conditions Show content
When you take out health insurance for the first time, switch insurers or increase your level of cover, CUA Health asks that you wait a period of time before you can claim for new or higher benefits. Take a look at the table below to find out what waiting periods apply.
What is covered? Show content
With our private hospital cover you can be treated as a private patient in a private or public hospital. CUA Health has agreements with the majority of private hospitals and day surgeries where you will receive benefits for your hospital accommodation, including:
- accommodation for overnight or same-day stays
- standard single or share hospital accommodation
- operating theatre, intensive care and ward fees
- surgically implanted prostheses up to the approved benefits in the Government’s Prostheses List
- your choice of doctor or specialist
Please contact us prior to any hospital admission to make sure your hospital is in agreement with CUA Health.
What is not covered? Show content
- Hospital treatment for which Medicare pays no benefit, like cosmetic surgery.
- In some cases your doctor’s and/or specialists’ (radiologist, anaesthetist etc) fees may still be more than the Medicare benefit plus the CUA Health gap scheme so you may be required to make an additional payment. Please check this with your doctor before consultation or treatment.
- Gap payments may apply to certain prostheses (e.g. hip and knee joint replacements, artificial heart valves, pacemaker devices and intra-ocular lenses for cataract surgery).
- Any items of a personal nature, including TV rental or phone calls while in hospital that are not part of the agreed medical costs.
- You’ll need to pay any additional costs that are applied to any 'nursing home-type' patient admission into a public or private hospital. This amount is determined by the Federal Government.
- Experimental and some high cost or exceptional drugs.
- Services not invoiced by the hospital.
- If you go to an emergency room and are not admitted but the hospital still charges you for your visit, this charge is not covered and you’ll need to pay this yourself.
- Services able to be claimed by way of compensation or damages. CUA Health reserves the right to a full and immediate reimbursement of any claims covered by way of compensation or damages from another party.
- Services provided by a family member.
- Any treatment considered an outpatient service, e.g. Radium.
- Benefits for products, services or treatments purchased from or provided by practitioners overseas, whether you buy them in person, by mail order or online.
- Benefits in relation to sport, recreation or entertainment unless they are part of an approved chronic disease management or a health management program.
- Benefits for treatment, goods or services if false or misleading information is provided.
- Extras cover services for which a Medicare benefits is payable, except as allowable as hospital substitute treatment.
- Treatment, goods or services provided during a waiting period.
Ready to join?
Simply choose the cover that’s right for you. If you’re transferring from another provider, be sure to have your policy details handy and we’ll look after all the paperwork for you.Join now
Have a few questions?
If you have any questions about your health cover, you can take a look at our Health Insurance Frequently Asked Questions. Alternatively you can call us on 1300 499 260 or drop into your local CUA branch.