Claim on hospital procedures
The hospital procedures (including day surgeries) that you can claim on will vary depending on your level of cover:
If possible, contact Australian Unity before you go to hospital to get pre-approval for your procedure. This is important for two reasons:
- You’ll receive confirmation of whether (or not) you’re covered for the condition you’re being admitted for.
- Pre-approval can significantly help to speed up the claiming process.
If you’d like to get someone else to contact us on your behalf, make sure you’ve given us permission to speak to that person on your behalf by completing a Delegated Authority Form.
Accommodation and theatre fees
Most private hospitals and day facilities have an agreement with Australian Unity, which guarantees that you’ll be covered for some (or all) of the accommodation costs and most other services like theatre fees (up to your yearly limit).
Search the list of agreement hospitals
If you’ve got pre-approval, the hospital will bill Australian Unity directly, and all you’ll need to pay is any excess that applies to your cover.
If you weren’t able to arrange pre-approval, the hospital may ask you to pay a deposit before they admit you:
The hospital will contact us directly to find out about your level of cover.
If your claim is approved, the hospital will bill Australian Unity directly. (They bill us at a special agreed rate, which is usually much lower than their standard rates.
The hospital will then issue you with a refund of any amount owing.
The way you claim the bills from your surgeons and other doctors will vary depending on the arrangements you make with them.
Pay the doctors up front, and then claim money back from us, OR
Submit any unpaid accounts to Australian Unity, and we’ll issue you with cheques that you can forward to your doctors.
For both types of payments, follow the same claiming process as described above for doctor visits.
You may also need to include a Medical Authority Form with your claim (if you haven’t already provided one to Australian Unity). This form needs to be completed by the first doctor you consulted about your condition.
Note that there may be some out-of-pocket expenses for medical costs, depending on your level of cover and whether any restrictions or exclusions apply. If you have any out-of-pocket expenses, your doctor should have informed you of these costs before your admission.