Overseas Visitors Health Cover
Overseas Visitors Cover
Frequently Asked Questions
Find out about how the Australian healthcare system works and how Overseas Visitors Cover fits in.
Understanding the Australian Healthcare system
What is Medicare?
Medicare is Australia's public healthcare system. It provides free or subsidised health care to Australian residents, and is funded by Australian tax payers.
Although Medicare covers many essential medical treatments, it doesn’t cover everything, which is why many Australians also have private health insurance. For example, there are no Medicare benefits for ambulance services, and extras treatments including things like glasses, physiotherapy and chiropractic services. Medicare may not fully cover treatments in a private hospital.
What does Medicare cover?
What does Medicare NOT cover?
What is a Reciprocal Health Care Agreement (RHCA)?
The Australian Government has signed Reciprocal Health Care Agreements (RHCA) with a number of countries:
- Visitors from countries that DO have an RHCA with Australia are eligible to receive some subsidised health services for essential medical treatment in Australia.
- Visitors from countries without an RHCA must pay for their treatment with their own money.
Note that even if you have a Reciprocal Medicare card, you may still need to maintain health insurance to satisfy your visa requirements.
Do I qualify for reciprocal Medicare benefits in Australia?
That depends on where you're from.
You can find out whether your country has an RHCA with Australia at the Reciprocal Health Care Agreements website.
Do I still need health insurance if I have access to reciprocal Medicare benefits?
Your visa type may still require that you have health insurance. Also, bear in mind that
- RHCA agreements vary from country to country, so it’s important to understand what you are and aren’t covered for before deciding on health insurance.
- Even if you are entitled to reciprocal benefits, Medicare does not cover you for everything (which is why many Australians also have private health insurance).
Will private hospital insurance cover 100% of medical expenses?
That depends on the fees charged by the health professional looking after you in hospital.
The Australian Government sets a schedule of benefits (called the Medicare Benefits Schedule or MBS) for treatments by doctors in a hospital or day surgery.
Private health insurers use this schedule to calculate benefits for hospital treatments (note that the same schedule applies to both Australian permanent residents and non-residents.)
So if your doctor’s fees are above the MBS, you may be required to pay a ‘gap’ fee. The gap fee is the difference between the doctor’s fee and the benefits provided by Medicare and your health insurance provider.
Talk to your doctor when planning any surgery to make sure you fully understand whether you will have any out-of-pocket expenses.
For more information about the MBS, visit the Medicare website.
Which medicines and pharmaceuticals are covered by health insurance?
The Australian Government provides subsidised prescription drugs to residents of Australia through the Pharmaceutical Benefits Scheme (PBS).
Under the PBS, all Australian residents, and non-residents from countries that have a Reciprocal Health Care Agreement (RHCA) with Australia, have access to a range of prescription medicines at a lower cost.
More information about the PBS can be found on the Medicare website.
What is the difference between an inpatient and outpatient?
Some hospital insurance products provide different levels of cover depending on whether you’re an inpatient or outpatient — so it’s important to understand the difference.
You are an inpatient if
- You are formally admitted to a hospital with a doctor’s order.
You are an outpatient if
- You have not yet been admitted as an inpatient. You are also an outpatient while you receive emergency department services (e.g. being under general observation, receiving outpatient surgery, X-rays, or any other hospital services) and the doctor hasn’t written an order to admit you to a hospital. In these cases, you’re an outpatient, even if you spend the night at the hospital.
Understanding Overseas Visitors Cover
Do I need health insurance if my visa has no specific requirements?
It's not a legal requirement, but it's still a smart idea.
Health services in Australia can be expensive. So if the unexpected happens, you could be paying large medical bills, with limited control over your treatment options.
With private health insurance, you'll have the peace of mind you need.
Find out how to purchase Overseas Visitors Cover from Australian Unity.
How do I receive my health insurance confirmation letter?
Once you select and purchase Australian Unity's Overseas Visitors Cover, you will automatically receive your health insurance confirmation letter by email.
Please provide a valid email address to ensure the letter reaches you without unnecessary delay
Does Australian Unity offer health insurance that satisfies the Australian Government's visa condition 8501 (to maintain adequate health insurance)?
Under some visas, you may be required to meet condition 8501. Condition 8501 means that you must have and maintain adequate health insurance for the whole of your stay in Australia.
All our Working Visa Covers meet condition 8501. None of our current Non-Working Visa Covers meet these requirements.
Am I covered for all ambulance services?
Most of our Worker Covers include emergency (or medically necessary) ambulance transportation.
Note that in order to be able to claim for this service, the account you receive for your transportation must be coded and billed as an emergency by the ambulance service.
You can find out more about emergency ambulance transportation in the Overseas Visitors Cover Terms and Conditions.
Can a relative or friend manage my membership for me?
Unless you have requested otherwise, a partner/spouse on your policy has automatic Delegated Authority. This means your partner or spouse will have authorisation to act on your behalf to access and discuss personal information (including claims information) about all members covered under the policy and can make changes to the policy e.g. change the level of the cover or contact details, add or remove a dependant, suspend the policy or cancel the membership.
If you wish to give this authority to other people not listed on your policy, like a relative or a friend, simply complete the Delegated Authority form and return it to Australian Unity or call us on 1300 720 695 (8.30am – 6.30pm AEDT weekdays)
You can learn more about Delegated Authority here.
How can I pay for my health insurance?
Your health insurance needs to be paid in advance at all times, and can be paid up to a maximum of 12 months in advance. There are two ways you can pay your premiums:
- Direct debit
A direct debit is an instruction from you to your bank or other financial institution. It authorises Australian Unity to collect your health insurance premiums from your account on a date that matches your selected payment frequency (e.g. monthly, quarterly, yearly). You can set up direct debits to be paid from your credit card or only from an Australian bank account.
- Account notice
When you pay by account notice, you'll receive a bill for your health insurance premiums on a date that matches your selected payment frequency. Instructions describing the different ways you can make payments are included on the account notice.
Can I cancel my health insurance?
Yes. But before you do, it’s a good idea to get advice on things like
- Is hospital insurance a requirement for your visa type?
If yes, cancelling your cover may put you in breach of your visa and negatively affect your chances of being granted a new visa in future.
- Are you intending to apply for permanent residency?
If yes, check whether cancelling hospital insurance for your visa type will have a negative impact on your application.
Do you need to change your level of health insurance if your visa status changes?
If you become a permanent resident or citizen of Australia, you should let Australian Unity know immediately.
That way we can transfer you across to a more suitable level of cover (if necessary).
How do I get my money back for medical expenses?
For out of hospital claims, such as visiting a doctor or specialist, you can send us a copy of your receipt by mail or even claim online.
If you have to go to hospital, they will usually contact us directly to process your claim, so you won't receive a bill for your treatment.
Find out more about lodging a claim.
Is there anything I need to know before I go to hospital?
Before you go to hospital, you should ask both your doctor and the hospital if there will be any additional costs that might be higher than those covered by your Overseas Visitors Cover.
It is also highly recommended that you contact Australian Unity before you go to hospital — that way we can let you know if there are any exclusions, restrictions or limits on the treatment you require under your selected level of cover.
What is a pre-existing condition?
A pre-existing condition is defined as any ailment, illness, or condition where, in the opinion of a medical practitioner appointment by Australian Unity (not your doctor), the signs or symptoms of that ailment, illness, or condition existed at any time within the six months before you became insured under the policy. Australian Unity may also ask you for more information to determine if you are eligible for benefits.
For more information about pre-existing conditions refer to the Overseas Visitors Cover Terms and Conditions.
What is a waiting period?
A waiting period is simply the time you must wait before you can claim a benefit. It begins on the day you join our fund, and ends the day you're able to start claiming on a service or treatment.
There are different waiting periods for levels of cover and different procedures and treatments.
What is the difference between public hospitals and agreement private hospitals?
These hospitals are controlled by the respective State Governments, and there are different charges in every state. For example, patient admission costs can range from around $650 to $2,000 per day.
Agreement Private hospitals
Agreement private hospital means a private hospital or day hospital facility that has a negotiated contract with Australian Unity. We have agreements with over 500 private hospitals and day surgeries across Australia.
Find out which private hospitals have an agreement with us.
Refer to your Overseas Visitors Cover Fact Sheet for details your level of cover in private agreement and public hospitals.
Why do I need a medical report when I make a claim?
When making a claim, you need to include a medical report completed by the first doctor you visited in relation to the condition.
Without a medical report, Australian Unity may be unable to assess whether the condition relates to a pre-existing condition, and therefore we may be unable to pay benefits for your claim.