AHM
Australian Unity Health
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NIBWhether you’re purchasing health insurance for the first time or want to switch to a different health fund, it’s a good idea to compare similar policies from a variety of health insurance brands in Australia.
Australian Unity Health Insurance has been providing Hospital and Extras cover to Australian citizens for over 179 years. You have the option to choose any one of their 5 Hospital or 5 Extras policies. Mix and match Hospitals and Extras to create a plan suited your specific requirements and budget, or choose one of their 3 pre-packaged options.
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Who is Australian Unity?
Australian Unity Health is a for-profit health fund with headquarters situated in Melbourne, Victoria. The health fund has agreements with over 500 hospitals across Australia with more than one million Australians benefiting from their services. Australian Unity is not only restricted to private health insurance, but they also offer banking services, home loans, financial advice and travel insurance.
Australian Unity health insurance plans
The health fund offers 5 Hospital only policies and 5 Extra cover options. Although you can combine your Hospital and Extras cover into a single package option, 3 pre-packaged options are available; however, these policies can’t be sold separately.
Hospital insurance
Australian Unity Hospital cover pays a benefit for services and treatments received inside the hospital. When admitted, you will be required to pay an excess amount of either $250, $500 or $750. Generally, a higher excess amount will result in lower premiums.
However, If you are injured, in an accident, you will generally not have to pay an excess and specific Hospital policies will waive the excess fee for children admitted to the hospital.
Basic Plus – Simple Hospital
The Basic Plus option provides you with low-level hospital coverage. The Simple Hospital plan is the cheapest option that will exempt you from paying the Medicare Levy Surcharge (MLS).
- Receive cover for 4 clinical categories, including dental surgery, joint reconstruction, hernia, appendix and tonsils, adenoids and grommets.
- There are restrictions on hospital psychiatric care, palliative care and rehabilitation.
- Cover is excluded on 31 clinical categories, for example, joint replacement, back, neck and spine and heart and vascular system.
Bronze Plus – Standard Hospital
The Standard Hospital option covers a broader range of procedures, compared to the Basic Plus policy.
- Covers 22 clinical categories, including, gastrointestinal endoscopy, joint reconstruction and medically necessary plastic and reconstructive surgery.
- Rehabilitation, palliative care and hospital psychiatric care are restricted.
- There are exclusions on 13 clinical categories, such as assisted reproduction services, implantation of hearing devices and pregnancy and birth-related services.
Silver Plus – Intermediate Hospital
The Silver Plus options provide mid-level hospital cover that excludes pregnancy and birth-related services but offers full coverage for rehabilitation. You are also entitled to emergency ambulance services.
- Full coverage for 30 clinical categories like chemotherapy, radiotherapy and immunotherapy for cancer, insulin pumps, and lung and chest services.
- Hospital psychiatric care is restricted.
- Cover is excluded on 7 clinical categories including dialysis for chronic kidney failure, joint replacement and cataract surgery.
Silver Plus – Advanced Hospital
The Silver Plus, Advanced Hospital option, is a mid to high-level hospital care plan that provides coverage for pregnancy, birth and fertility treatments.
- Covers 38 clinical categories, including joint replacements, cataract surgery and dialysis for chronic kidney failure.
- Restricted cover for hospital psychiatric services.
- No exclusions.
Gold – Ultimate Hospital
This plan is Australian Unity’s premium Hospital policy, providing the most comprehensive coverage.
- Receive full coverage for all 33 clinical categories without any restrictions or exclusions. For example, weight loss surgery, birth and pregnancy-related services, hospital psychiatric care and medically necessary plastic and reconstructive surgery.
Australian Unity Extras cover
Extras cover pays a benefit for general treatments and services received outside of the hospital. With Australian Unity, you have the choice of 5 Extras options each with a different benefit limit and monthly premium.
Compare low-level Extras
| Extras | Basic Extras Set benefit limits | Standard Extras Claim 60% back |
| General dental | Combined limit | Combined limit and sub-limits apply |
| Endodontic | Combined limit | Combined limit and sub-limits apply |
| Major dental | Combined limit and sub-limits apply | |
| Orthodontic | ||
| Optical | ||
| Non-PBS pharmaceuticals | ||
| Physiotherapy | Combined limit and sub-limits apply | Combined limit and sub-limits apply |
| Chiropractic | Combined limit and sub-limits apply | Combined limit and sub-limits apply |
| Acupuncture | Combined limit and sub-limits apply | Combined limit and sub-limits apply |
| Remedial massage | Combined limit and sub-limits apply | Combined limit and sub-limits apply |
| Osteopathy | Combined limit and sub-limits apply | |
| Podiatry | ||
| Orthotics (podiatric orthoses) | ||
| Psychology | ||
| Hearing aids | ||
| Blood glucose monitors | ||
| Audiology | ||
| Chinese medicine | ||
| Dietetics/dietary advice | ||
| Eye therapy (orthoptics) | ||
| Occupational therapy | ||
| Speech therapy | ||
| Vaccinations |
Source: privatehealth.gov.au (31 October 2010)
Compare mid to high-level Extras
| Extras | Intermediate Extras Claim 60% of your cost back | Classic Extras Set benefit limits | Top Extras Claim 80% back |
| General Dental | |||
| Major Dental | |||
| Endodontic | Combined with other services | ||
| Orthodontic | |||
| Optical | |||
| Non-PBS pharmaceuticals | Combined limit | ||
| Vaccinations | Combined limit | ||
| Physiotherapy | Combined limit | Combined limit | |
| Chiropractic | Combined limit | Combined limit | Combined limit |
| Osteopathy | Combined limit | Combined limit | Combined limit |
| Podiatry | Combined limit | Combined limit | |
| Orthotics (podiatric orthoses) | Combined limit | Combined limit | |
| Psychology | |||
| Acupuncture | Combined limit and sub-limits apply | Combined limit and sub-limits apply | Combined limit and sub-limits apply |
| Remedial massage | Combined limit and sub-limits apply | Combined limit and sub-limits apply | Combined limit and sub-limits apply |
| Chinese medicine | Combined limit and sub-limits apply | ||
| Dietetics/dietary advice | |||
| Hearing aids | Combined limit | ||
| Blood glucose monitors | Combined limit | ||
| Audiology | Combined limit | ||
| Eye therapy (orthoptics) | Combined limit | Combined limit | |
| Occupational therapy | Combined limit | Combined limit | |
| Speech therapy | Combined limit | Combined limit |
Source: privatehealth.gov.au (31 October 2010)
Australian Unity no gap dental and eye care advantage
To avoid out of pocket costs for preventative or general dental care as well as optical services, it may be a good idea to apply for Extras cover from Australian Unity.
Australian Unity, No Gap Dental services, offer members discounted treatments on an initial consultation, custom mouth guards, scale and clean, preventative check-ups, x-rays and topical fluoride treatments when visiting a No Gap Dental practice.
With Eyecare Advantage you can get up to 25% discount on your spectacles as well as a free pair of prescription sunglasses. Other services include retinal photography, eye tests, and comprehensive eye examinations bulk billed to Medicare.
Australian Unity pre-packaged options
You can create your own package by combining any of the above Hospital and Extras policies. However, the insurer offers 3 pre-packaged options, including:
Simple Saver – Basic Plus
This package is generally more suited to people on a tight budget as it combines low-level Hospital and Extras cover. You’ll receive a few essential in-hospital services and up to $1,100 back on certain Extras like physio, chiro and general dental, although sub-limits will apply.
You will be entitled to hospital and rehabilitation care at home as well as the ability to choose your Extras provider. However, you are entitled to only one emergency ambulance transportation per year.
Smart Start – Basic Plus
The Smart Start Basic Plus option combines Basic Hospital with Basic Extras. Claim up to $1,400 back on Extras with a $1,000 cap on emergency ambulance transportation. On this plan, you will not be required to pay any excess for hospital admissions due to accidents as well as day surgeries. You will also be entitled to 100% back on dental procedures through the No-Gap Dental Network.
Top Choice – Silver Plus
This high-level Hospital and Extras package provides you with a wide range of procedures including cataract surgery, joint replacement and heart and vascular system services. You’ll have access to a wide variety of general treatments, such as natural therapies, endodontic and remedial massage. Get up to $3,450 back on Extras per calendar year.
Waiting periods
- Pre-existing conditions: 12 months.
- Pregnancy and birth-related services: 12 months.
- Chronic Disease Management and Hospital Substitution programs: 12 months.
- Hearing aids, blood glucose monitors and orthotics: 12 months.
- Major dental: 12 months.
- Endodontic: 6 Months
- Optical: 6 months.
- General dental: 2 months.
- Psychiatric, rehabilitation and palliative care: 2 months.
- All other services: 2 months.
- Accidents and ambulance services: No waiting period.
- Vaccinations: No waiting period.
Pros and Cons of Australian Unity health insurance
| Advantages | Disadvantages |
| The No-Gap Dental Program will allow you to receive up to 100% back for preventative dental care. | You will generally not have access to the No-Gap Dental Program when you are on the Basic Plus Extras option. |
| Generally, no excess payment is required if you are hospitalised due to an accident. | Ambulance only cover is not available. |
| Generally, no excess payable for kids and they can usually stay on your policy up until they’re 23 years old. | Pre-packaged options like Smart Start, cannot be purchased as separate policies. |
| Access a wide range of programs and services aimed at helping you maintain a healthy lifestyle. | Pre-existing condition will mean that you are required to wait 12 months before you can claim a benefit. |
| Health insurance members get free access to Wellplan rewards that help you save up to 9% on groceries, petrol and movie tickets. | |
| Depending on your level of cover, you can get up to 100% back on prescription glasses and contact lenses. | |
| Receive a $100 gift card if a friend you’ve referred joins Australian Unity and takes out eligible coverage. |
Frequently asked questions
Who owns Australian Unity?
Australian Unity is a publically owned company with closely held subsidiaries that control the operations of the company. The insurer thus works on a for-profit basis.How do you join Australian Unity Health Insurance?
To sign up for a health insurance policy, you can visit the Australian Unity website, then download and submit an application form. Alternatively, you can call them directly on 1300 060 625 to speak to an agent who will guide you through the application process.
You can also request a quote when completing the quote form at the top of this page. Before you join a health fund you might want to compare their offering against other major health insurance brands in Australia.How do I lodge a claim with Australian Unity?
To claim Extras, you can swipe your Australian Unity card at your providers’ HICAPS or CSC machine. You can claim online through their website, send your claim via email or phone the helpline. When being admitted to hospital, you generally only need to pay your excess amount, and the bill will be sent directly to Australian Unity.
However, it’s best to contact your health fund before going to the hospital so you can get pre-approval to ensure that your procedure will be covered.How do you cancel your health insurance?
You can cancel your health insurance by submitting the cancellation form that can be found on the Australian Unity website. You will then receive a letter of confirmation stating that your account has been suspended. If you cancel during the cooling-off period, your premiums paid thus far will be refunded, if you have not submitted any claims.Is Australian Unity not for profit?
No, this company is publically owned and operates on a for-profit basis. However, a certain percentage of the profits are returned to members in the form of benefits.Does Australian Unity offer any discounts?
Yes, if you apply for health cover from Australian Unity, you might gain access to several discounts, for example, save 9% on every-day items with Wellplan Rewards, and reduced prices on select optical and dental offers. You might also get a $100 a gift card when a friend or family member you referred, takes out an eligible policy.Does Australian Unity offer ambulance cover?
Yes, you’ll generally receive emergency ambulance transportation when purchasing a Hospital policy from Australian Unity. However, stand-alone ambulance coverage is not available.Will you be covered when travelling overseas?
No, your health insurance only covers you while in Australia and generally will not extend to international locations.
I am an AHM customer and I am wondering if AHM has any incentive type programs that cover mental health, health coaching or hospital in the home? I am assisting a friend to find a suitable health fund with the best things she may need. These are things she would like to know more about.
Hi Fiona. Thanks for reaching out and having your friend’s back.
Because the type and level of coverage for health insurance are so diverse, your friend might want to start her search for the right policy by requesting quotes from various health funds and comparing their premiums, services and benefits against one another. That way, she can choose a policy best suited to her unique requirements.
AHM does provide some health improvement benefits to eligible customers, for example, stress management courses. However, it’s best to read the policy’s Standard Information Statement (which you can find on privatehealth.gov.au) before making a decision.
Please answer. Why, when I agreed to transfer my health insurance from Australian Unity to HCF ins. on the 23rd Feb, I was informed that HCF would do all the necessary changes necessary. It is now the 29th or April, ( 10 weeks later) and having paid two months payments to both Australian Unity and two months to HCF ( plus twelve months in advance ) I am still waiting for my refund amounting to $315.13 from Australian Unity.
I might well add that my daughter followed my instructions on the same day ( with the same company and is still waiting for her refund WHAT A SCAM.
Hi Jean. I’m sorry to hear about your frustrations. When switching health funds it’s always a good idea to check with your new insurer whether they’ve completed all the relevant changes after you’ve provided them with your Interfund Clearance Certificate. Please give HCF and/or Australian Unity a call so they may assist you and your daughter with your refunds.
I have a question regarding pain therapy with a device. There is a new government legislation that says private insurers are only obliged to cover pain therapy with a device under the gold hospital plans, starting April 2019. What will be the situation for the non-gold policyholders if they are trial patients proceeding to permanent implantation or if they already have their device implanted years ago but need a revision procedure? Will those patients not be covered unless they upgrade to a gold policy? Thanks.
Hello Sam. This is a great question!
The Australian Government is introducing the new gold, silver, bronze and basic classification system starting 1 April 2019, as you mentioned. As per this new system, chronic pain devices and treatment will:
– Not be a minimum requirement for Basic plans. Insurers can choose to offer this service on a restricted or unrestricted basis.
– Not be a minimum requirement for Bronze or Silver plans, but insurers can offer this as an additional service on an unrestricted basis.
– Be a minimum requirement on an unrestricted basis for Gold policies.
So, if you do not have a Gold plan, it very much depends on the health fund you choose and whether they decide to include chronic pain services and devices on their more basic type policies. Please contact your insurer and request that they provide you with a break-down of what their plans will and will not cover in 2019.
If you would like some support in comparing policies, please give the health consultants a call on 1300 786 328.
My mother, aged 80 years, is visiting Australia from September 16 to January 26, 2019. Can you tell me what insurance would be good for her?
I’m mainly looking to cover emergencies, hospital, and ICU services. Not interested in mental, podiatry etc. She is in good health except has type 2 diabetes that is well controlled
Thank you.
Hi Raj,
To ensure your mother gets suitable cover at an affordable price, please fill in the quote form above because there are a few things that the specialist will have to take into consideration, for example where in Australia she’ll be staying and if she needs any support regarding her diabetes.