A waiting period is the amount of time you have to wait after joining or upgrading until you can make a claim for a service or treatment.

Excess is the additional amount you agree to pay towards accommodation costs if you need hospital treatment. Please refer to your product Fact Sheet for details about the maximum excess payable in a calendar year and any excess waivers that may apply.

A pre-existing condition is an ailment, illness or condition that in the opinion of a medical practitioner appointed by Australian Unity (not your own doctor), the signs or symptoms of that ailment, illness or condition existed at any time in the period of six months ending on the day on which you joined Australian Unity or upgraded your cover, irrespective of whether you were aware of it. If you make a hospital claim in the first 12 months of your joining or upgrading your cover, we will ask you to get your consulting doctors or other practitioner (e.g. your dentist, GP or specialist) to complete a medical report. You should ask us to carry out this assessment before going into hospital.

Accident means an unplanned and unforeseen event, occurring by chance, and leading to bodily injuries caused solely and directly by an external force or object requiring treatment from a Medical Practitioner (defined here as a medical doctor who is not the member or a relative of the Member) within 7 days of the event, but excludes injuries arising out of: surgical procedures; unforeseen illness; pregnancy; drug use; and aggravation of an underlying condition or injury.

Restricted services are hospital claims which are limited to a minimum (default) benefit. This is the minimum dollar amount set by the Australian Government for accommodation as a private patient in a shared room of a public hospital. A Restricted service does not pay any money towards the cost of intensive or coronary care, labour ward or theatre fees in a private hospital or private day centre. Therefore you may incur a large out-of-pocket expense. Contact us for more information.

If you select a hospital cover that has treatments listed as ‘Excluded’ or 'Not Covered', this means that we will not pay any benefits for the treatment you have received and this can result in you incurring large out-of-pocket costs. Always refer to your product Fact Sheet for more details about your hospital cover entitlements.

If you are admitted to hospital (including for Covered treatments) you may have out-of-pocket costs, e.g. an excess,  a ‘gap’ in your doctors’ medical bills, emergency department fees, or the additional cost of a private room in a public or non-agreement hospital. If you want more specific information about what you can expect these costs to be, we recommend you obtain a quote from your doctors/hospital before undergoing treatment. Then contact us for details of benefits before proceeding with your treatment. Additionally, benefits are not payable for claims where you have the right to claim compensation, damages or benefits from another source (e.g. TAC or WorkCover), now or at a later date.

A waiting period is the amount of time you have to wait after joining or upgrading until you can make a claim for a service or treatment.

Depending on your level of cover, you may be eligible for the following Healthy Lifestyle benefits:

• gym membership
• nicotine replacement therapy
• skin checks

Preventative Health Services can offer practical support to help bring about positive change in members’ lives to help you get and stay healthy. They include things like losing weight, getting fit, quitting smoking, and working with a health coach to improve your general health and wellbeing. You’ll receive personalised and practical support plus information designed to bring about positive change giving you the tools needed to enjoy a longer, healthier and happier life.

To check your eligibility, which providers and programs you are able to use and any waiting periods that may apply, please contact us on 13 29 39. More information can be found here.

Where an Extras cover is taken with Hospital cover, benefits are payable under the Hospital cover only.

Extras cover can help you get money back on common health treatments that aren’t generally covered by Medicare. You’ll get either a percentage of the cost back, or a set dollar amount, on included Extras every time you claim, until you reach your yearly limit. Therefore, you only pay the difference between what you get back from Australian Unity and the cost set by your provider.

Please call us or refer to your Member Guide and Terms & Conditions for further information on how this cover works. If you want more specific information about what you can expect your out-of-pocket costs to be, we recommend you obtain a quote from your provider before undergoing treatment, along with a list of item numbers. You can then contact us or log in to Online Member Services for details of benefits before proceeding with your treatment.

We only pay benefits when you see a recognised provider in a private practice. Please contact us to check if your provider is recognised by us. Providers recognition conditions apply.