Australian Unity Health Insurance Review 2024

Founded over 180 years ago, Australian Unity is Australia’s first member-owned wellbeing company. It provides health, wealth and aged care services to over 1 million customers, including 175,000 health insurance policy holders across the country. While Australian Unity isn’t not-for-profit, as part of the Members Health Fund Alliance, it diverts profits back into the business to benefit members rather than shareholders.

It has six hospital health insurance policies for customers, including Gold, with no restrictions. That includes three Silver Plus plans designed for different life stages, from young couples, to single parents, to growing families. There is also a range of extras plans. Members also have access to Wellplan Rewards®, a loyalty program with a range of discounts on everyday shopping. Compare Australian Unity and other insurers on our panel.

Hospital cover

It’s always a good idea to be prepared for any medical mishaps - hospital cover is a great way to ensure you’re protected. It can also help you save on long-term costs for hospital room fees and inpatient medical services.

Consider carefully what services you’re likely to need, and whether they work with your budget. If you are earning over $90,000 individually, you may be able to avoid paying the Medicare Levy Surcharge.

Australian Unity offers a choice of hospital plans, from no-frills basic cover through to a Gold plan that covers almost everything. There’s also three mid-level Silver Plus plans, based on the needs of your family unit. 

All Australian Unity hospital plans come with:

• Excess waived for accidents.

• Hospital care and rehabilitation at home.

• Increased cover if injury or illness is caused by an accident for members on basic, bronze and silver hospital covers (but some conditions will apply).

• Access to the Wellplan Rewards® loyalty program.

Simple Hospital (Basic Plus)

Australian Unity’s budget cover for accidents and simple hospital procedures. A lot of services will be excluded or restricted with this level of cover. It’s typically taken out by healthy young singles and couples without children.

Key inclusions:

• Dental surgery.

• Joint reconstructions.

• Tonsils, adenoids and grommets.

Standard Hospital (Bronze Plus) 

A hospital plan that’s a step above the Basic Plus package. It covers accidents and common hospital services. It’s typically taken out by singles, couples and families. 

Key inclusions:

• Breast surgery (medically necessary).

• Chemo, radiotherapy and immunotherapy.

• Gynaecology.

Intermediate Hospital (Silver Plus)

A medium level of cover with a wider range of common procedures than the Bronze and Basic packages.

Key inclusions:

• Chemotherapy, radiotherapy and immunotherapy for cancer.

• Ear, nose and throat.

• Heart and vascular system.

Value Hospital (Silver Plus) with $100 daily co-payment

Mid-lever cover with a broad range of procedures including cataracts and joint replacements that aren’t covered in the Intermediate Hospital package. 

Key inclusions:

• Joint replacements.

• Tonsils, adenoids and grommets.

• Chemotherapy, radiotherapy and immunotherapy for cancer.

Classic Hospital (Silver Plus)

One of the highest levels of cover for most hospital services, but doesn’t include pregnancy or birth.

Key inclusions:

• Excess waived for dependants.

• Joint reconstruction, heart and vascular system.

• Cataracts.

Prime Hospital (Gold) with $100 daily co-payment

Australian Unity’s most expensive plan. Comprehensive cover for all Medicare recognised hospital services, including pregnancy, the BumptoBaby program for mums-to-be, psychiatric services in a private hospital and more. 

Key inclusions:

• BumptoBaby program, pregnancy and birth.

• Cataracts, dental surgery and palliative care.

• Joint replacement.

Ambulance Cover 

All hospital plans include emergency ambulance trips to hospital (some conditions apply, so check if you’re considering this policy). You’re also covered for two ambulance attendant visits per person, per year, where you’re not taken to hospital.

Extras cover

Australian Unity's extras reset on January 1 every year.

Extras cover means you’re covered for routine treatments such as chiro, dental and optical care. 

Take some time to consider exactly what you need and whether you have the budget for these services. Our experts at Compare Club can help you determine what is and isn’t included in an Australian Unity extras policy.

Australian Unity has four extras plans to choose from, ranging from Basic to Top.

A quick note: the limits below are the cumulative total of what you could claim back if you claimed back the full amount on every extra. It’s not the limit per extra.

Base Extras

Covers the basics, including general dental, physio, optical and remedial massage, with an overall benefit limit of $1,150 per person, per year.

Key inclusions:

• Preventative Dental, General Dental, root canal, gum disease treatments and surgical extractions.

• Optical 

• Physiotherapy, chiropractic and osteopathy, remedial massage, myotherapy and acupuncture.

Mid Extras

Mid-level cover that lets you claim 100% back up to yearly limits on optical and 100% back on selected dental services through Australian Unity’s No Gap Dental Network, to an overall benefit limit of $2,400 per person, per year.

Key inclusions:

• Preventative Dental, General Dental, root canal, gum disease treatments and surgical extractions.

• Optical 

• Podiatry

Active Extras

Mid-level cover that lets you claim up to 100% back on optical and selected dental services through Australian Unity’s No Gap Dental Network, subject to annual limits. You can claim up to an overall limit of $5,750 in the first year.

Key inclusions:

• Acupuncture, remedial massage and more.

• Root canal, gum disease treatments and surgical extractions.

• Podiatry, psychology and hearing aids.

Prime Extras

The highest level of cover includes hearing aids, natural therapies and remedial massage. You can claim up to $8,750 in the first year.

Key inclusions:

• Preventative dental and No Gap Dental Network.

• Orthodontics

• Psychology

Waiting periods

Waiting periods are designed to stop people from signing up to health insurance, claiming what they need and then cancelling their cover. All health insurers implement waiting periods across hospital and extras cover.

Depending on the insurer, sometimes offers will be made to reduce waiting periods, but these are usually only around extras waiting periods.

Simple Hospital (Basic Plus), Standard Hospital (Bronze Plus), Intermediate Hospital (Silver Plus) and Classic Hospital (Silver Plus)

• 12 months for pre-existing conditions, excluding psychiatric, rehabilitation and palliative care.

• 2 months for psychiatric, rehabilitation and palliative care as well as all other treatments included in your cover.

• No waiting period for emergency ambulance or hospital treatment for accidents.

Advanced Hospital (Silver Plus)

• 12 months for pregnancy and birth in an Australian Unity agreement private hospital,  midwife in private practice services as well as pre-existing conditions, excluding psychiatric, rehabilitation and palliative care.

• 9 months for default (shared room/public hospital) for pregnancy and birth.

• 2 months for psychiatric, rehabilitation and palliative care as well as all other treatments included in your cover.

• No waiting period for emergency ambulance or hospital treatment for accidents.

Prime Hospital (Gold)

• 12 months for pregnancy and birth in an Australian Unity agreement private hospital as well as pre-existing conditions, excluding psychiatric, rehabilitation and palliative care.

• 2 months for psychiatric, rehabilitation and palliative care as well as all other treatments included in your cover.

• No waiting period for emergency ambulance or hospital treatment for accidents.

Extras waiting periods

• 12 months for  Root canals, gum disease treatments, surgical extractions, major dental, which includes crowns, bridges and dentures, orthodontics, which includes procedures to correct the positioning of your teeth and jaw, hearing aids, health aids, health devices and orthotics.

• 6 months for prescription glasses and contact lenses.

• 2 months for general dental and all other services, including wheelchairs and crutches, hearing aid repair and psychology.

• No waiting period for preventative dental, selected diagnostic services from general dental, emergency ambulance and ambulance attendance.

Member benefits

Along with a broad range of hospital and extras covers, Australian Unity offers members a range of health programs. Depending on your level and length of cover, you can get free support for mental health, living with chronic conditions, preparing for parenthood, dental health and more.

Members also have access to Australian Unity’s Wellplan Rewards®, a loyalty program that comes with a range of discounts at popular retailers. You’ll be able to save on everyday shopping like groceries, petrol, meals and alcohol.

How to claim

Australian Unity offers a range of ways to claim. You can claim on the spot through the HICAPS payment system at your provider. You can also claim online, through the mobile app, or by phone, email, mail or fax.

Hospital agreements

Australian Unity works with most private hospitals and clinics across Australia under formal agreements.

Before committing to an Australian Unity policy, make sure that they have an agreement with your local hospital or clinic.

Our specialists at Compare Club can assist you with this.

Customer service

Australian Unity received 4.8% of complaints vs 2.5%^ market share in 2022.

FAQS

1. Is ACA Health a not-for-profit fund?

No, but profits go back into the business to benefit members.

2. Who can apply? Are there restrictions? 

There’s no restrictions to joining Australian Unity. Anyone can apply.

3. Is it easy to switch to Australian Unity?

Yes, you can sign up right here, right now. We’ll take care of the paperwork.

4. Do I need to re-serve waiting periods?

No. Providing you transfer to an equivalent or lower cover with Australian Unity within 30 days of leaving your old fund.

5. Can I change my level of cover?

Yes, you can choose to change to a cover of a higher or lower level. If you change to a policy with a higher level of colour (e.g. from basic to gold), you may need to serve waiting periods for the higher benefits.

6. Do I get the government rebate?

Most Australians are eligible to receive a rebate of up to 32.812% from the government. This will depend on your age and income.

7. Do I have to pay the Lifetime Health Cover loading?

If you’re joining for the first time and you’re 31 or over, you usually need to pay 2% loading for each year you’ve gone without hospital cover (yearly limit). You can learn more here.

8. What age are children covered up to?

Generally, most health funds cover children up to 23. If they’re studying full time, dependents may be able to be covered as a student under a family policy up to the age of 31. Children must not be married or living in a de facto relationship. 

At the time of writing, Australian Unity is not implementing the changes introduced by the Federal Government to allow dependants to be covered up until the age of 31. 

This guide is opinion only and should not be taken as medical or financial advice. Check with a financial professional before making any decisions. ^Private Health Ombudsman, Australian Unity, accessed 22 June 2022. #Compare Club compares selected products from a panel of trusted insurers. We do not compare all products in the market.