What is Health Insurance?
Private health insurance lets you have more control over your treatment if you need to go to hospital or use other medical services. While Medicare covers you for treatment in a public hospital, private health insurance lets you choose to be treated in a private hospital, what doctor you see and when you are treated. It also helps reduce the cost for many of those services not fully covered by Medicare like dental, optical and physio.
There are two parts to health insurance: Hospital cover and Extras cover. At CUA Health you can choose Hospital cover, Extras cover, or a combination of both.
The benefits of having private health insurance include:
- Shorter wait times for surgeries
- Your choice of doctor and hospital
- Financial peace of mind
- Tax benefits
Our private hospital options let you choose the level of cover that best suits your needs and your budget.
Basic 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 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.
With all our Extras covers, you're not restricted to a network of preferred providers - so you can choose when and where you're treated.
Total Extras and Classic Extras offer the same full range of services, including preventative Wellness Benefits to help you stay healthy. What sets them apart is how much you can claim each year. Basic Extras is a great entry-level cover with affordable dental, physio and optical benefits.
Aren't I covered by Medicare? Show content
Public vs private hospitals - what's the difference? Show content
Are there tax benefits with private health? Show content
How does it work?
When you take out health insurance for the first time, you’ll choose whether you want Hospital cover, Extras cover or a combination of both. You’ll select how much of an excess you’re willing to pay for Hospital cover and what level of Extras cover you’d like. Some waiting periods will then apply before you can make a claim.
When it comes to receiving medical treatment, it’s always a good idea to ask exactly what fees you may have to pay for yourself up front.
Joining and membership
Once you’ve taken out a CUA Health policy, we’ll send out your CUA Health card. While you’re waiting for your card, register for Online Services and download the CUA Health Mobile Claiming app for fast claiming.
Going to hospital
If you ever need to have surgery or are admitted to hospital, provide them with your CUA Health policy details and we take care of everything directly with the hospital – so you just need to focus on getting better.
All you’ll need to do is sign your claim form and pay your excess payment to the hospital.
Claiming on Extras
When it comes to payment, if they use HICAPS you can claim on the spot by swiping your CUA Health card. All you’ll have to do is pay the difference.
Otherwise, pay your bill then make a claim online, on your mobile, in a branch or by mail. Online and mobile claims under $300 are assessed immediately and the funds transferred to your bank account.
What is HICAPS? Show content
What happens if I’m in an accident? Show content
Waiting periods explained Show content
What cover is right for me?
It really comes down to how healthy you are, what you’ll use and what’s important to you. If you are over 31 or earn more than $90,000 a year as a single or $180,00 as a couple or family, you should consider Hospital cover to avoid paying the Medicare Levy Surcharge and the Lifetime Health Cover Loading.
If you use health services like optical, dental or physio, have a look at the full list of services covered by Extras and consider if it’s right for you.
What is an excess? Show content
Choose your Hospital & Extras cover
Find the policy that's right for you - you can choose Hospital cover, Extras cover or a combination of both.
# The quoted price assumes you live in Queensland and you’ll receive 26.791% Australian Government Rebate for Private Health Insurance. Hospital cover prices are based on no Lifetime Health Cover Loading and an excess of $500 per person per calendar year (excluding dependants).
Important information Show content
*First month free is available only to new policy holders who join via Credit Union Australia Limited. ABN: 44 087 650 959 (CUA) directly.
^New policy holders who purchase a CUA Health combined hospital and extras policy between 20 March 2017 and 30 June 2017 will receive a $100 EFTPOS Gift Card. Click here for offer terms and conditions.
Please read the information carefully and retain for your future reference. If you join CUA Health, confirmation of your cover and policy information will be sent to you. If you change your mind CUA Health provides a cooling off period of 30 days from the start date of your policy. For more information including Code of Conduct and Complaints resolution refer to information for policy holders.
CUA Health insurance is provided by CUA Health Ltd 98 098 685 459 (CHL) which is not an authorised deposit-taking institution. While CUA Health Insurance may be distributed by Credit Union Australia Ltd ABN 44 087 650 959 (CUA), CUA is not liable for this product and does not stand behind CHL.
It’s important to know that we only pay a benefit for services performed by private practitioners in a private practice, provided their associations and services are recognised by us. If you’re unsure if the provider you have selected, or service you require is covered under your policy, please contact CUA Health for confirmation. The items, limits and benefits are provided as a general guide only. Please call us if any further information is required. Calendar year limits cover the period 1 January to 31 December each year.
When changing health insurers, Extras benefits paid by your old health fund will be counted towards your annual limits in your first year of membership with us.
Benefit limitation periods
During the first 24 months from joining and after waiting periods have been served, benefits paid for these treatments will be limited to the same amount you would receive in a public hospital for the same treatment. After 24 months from joining you will be eligible for the full benefits under the policy.
The medical charge is the cost for any services performed by doctors or specialists. This includes, but is not limited to – surgeons, anaesthetists, pathologists and assistant surgeons. Medicare sets an amount payable toward the medical costs, called the Medicare schedule fee. Medicare pays 75% of the schedule fee and CUA Health pays the remaining 25%. If the doctor or specialist chooses to charge above the schedule fee, then the difference is paid by you, unless your doctor or specialist chooses to participate in CUA Health’s Access gap cover scheme – see below for more info.
Access gap cover scheme
The Access Gap Cover Scheme will reduce or in some instances eliminate your out-of-pocket expenses for specialist care you receive while in hospital.
Doctors and specialists electing to participate in the Access Gap Cover Scheme can bill CUA Health directly. So, not only does your hospital treatment cost you less, but the billing system is made easier for you too.
Access to a complete list of doctors and specialists participating in the Access Gap Cover Scheme is available here. If your doctor or specialist chooses to use the Scheme, you will either:
- have no out-of-pocket expenses, or
- be provided with an estimate of out-of-pocket expenses before your treatment
Your doctor or specialist may choose to use the Scheme on a patient-by-patient basis. Of course, whether or not your doctor or specialist participates in the Access Gap Cover Scheme will not change the relationship you have with him or her, or affect the treatment you receive.
Excess: An upfront amount that you agree to pay towards the cost of hospital treatment, in exchange for lower premiums. For example, if you have Premium Hospital cover with $250 excess, and require hospital treatment you’ll pay $250 per person, per calendar year. This does not apply to dependants listed on the policy.
CUA Health has agreements with the majority of private hospitals and day surgeries. If your hospital or day surgery doesn’t have an agreement with CUA Health, you may be subject to large out-of-pocket expenses, in addition to any excess or co-payment. Please check with your hospital prior to admission. Access to a complete list of agreement hospitals is available here.