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Simple Insurance

A life that is healthy is a life that is rich

CUA Health has been helping Australians care for their family since 1976. We’ve put 40 years of experience into creating health insurance that offers more to help you care for the ones you love - with budget-friendly Hospital and Extras cover, more benefits for families, and the freedom to choose your healthcare provider.


CUA Health was recently awarded CANSTAR's Outstanding Value award for our Hospital Cover in Queensland for 2015. Speak to us today to learn more about our award winning health insurance.

Hospital Cover

Choose your amount of cover

Reminder

Dont forget to update Start your Quote on the right to get a quote!

Public Hospital Cover

Covers private treatment in a public hospital only. No excess or co-payment is payable by you.

100% Public Hospital Cover includes:

  • Default benefits for day surgery accommodation and standard single or shared hospital accommodation in a private hospital
  • Choice of your own doctor and/or specialist. However, public hospital waiting lists still apply.
  • Approved prostheses benefits such as artificial hips and knees
  • Cover for the difference between the Medicare benefit and Medicare schedule fee or Access Gap Cover agreed fee for doctor/specialist services whilst in hospital.

This product is not designed for use in a private hospital, as large out-of-pocket expenses may apply.

100% Private Hospital Cover

You’ll pay no excess or co-payment - apart from $250 if you choose the excess option.

100% Private Hospital Cover includes:

  • Same day surgery
  • Standard single or shared hospital overnight accommodation
  • Operating theatre fees
  • Labour ward
  • Intensive care charges

As well as:

  • Choice of your own doctor and/or specialist
  • Approved prostheses benefits such as artificial hips and knees
Did you know...

By choosing 100% Private Hospital Cover with $250 excess, you have the same comprehensive cover with a lower regular payment and a maximum excess of $250 per person per calendar year for hospital visits.

100% Private Hospital Cover with $250 excess also includes

  • $250 excess payable upon admission to hospital
  • Excess does not apply to day surgery or dependants and the excess is only payable once per person per calendar year
  • Choice of your own doctor and/or specialist
  • Approved prostheses benefits such as artificial hips and knees

90% Private Hospital Cover

You only pay 10% of a hospital admission capped at $500 per person per calendar year. Not payable by dependant children.

90% Private Hospital Cover includes:

  • Same day surgery
  • Standard single or shared hospital overnight accommodation
  • Operating theatre fees
  • Labour ward
  • Intensive care charges

As well as:

  • Choice of your own doctor and/or specialist
  • Approved prostheses benefits such as artificial hips and knees

75% Private Hospital Cover

You only pay 25% of a hospital admission capped at $1,000 per person per calendar year. Not payable by dependant children.

75% Private Hospital Cover includes:

  • Same day surgery
  • Standard single or shared hospital overnight accommodation
  • Operating theatre fees
  • Labour ward
  • Intensive care charges

As well as:

  • Choice of your own doctor and/or specialist
  • Approved prostheses benefits such as artificial hips and knees

65% Private Hospital Cover

You only pay 35% of a hospital admission capped at $1,000 per person per admission. Not payable by dependant children.

65% Private Hospital Cover includes:

  • Same day surgery
  • Standard single or shared hospital overnight accommodation
  • Operating theatre and ward fees
  • Intensive care charges

As well as:

  • Choice of your own doctor and/or specialist
  • Approved prostheses benefits such as artificial hips and knees
  • Provides 65% cover for hospital treatment as a private patient in a Private or Public hospital
  • Restricted cover for psychiatric and cardiac services
  • Excluded services: joint replacements (other than accident), obesity related treatments, pregnancy and birth related services, dialysis for chronic renal failure and cataract and eye lens related procedures.
  • 65% cover for all other clinically relevant treatments such as accidents, removal of appendix, tonsils and adenoids, cancer treatment, sterilisation, rehabilitation and palliative care
  • Remain fully eligible for Medicare Levy Surcharge exemption, Australian Government Private Health Insurance Rebate and Lifetime Health Cover loading requirements
Please contact us prior to any treatment so you fully understand what you are covered for.
Waiting periods

When you take out health insurance for the first time, switch insurers or increase your cover, CUA Health ask that you wait a period of time before you can claim for new or higher benefits. Take a look at the table below to find out what waiting periods apply. If you are switching from another insurer please read Switching is Simple.

Accident cover no waiting
Obstetrics-related condition 12 months
Pre-existing condition 12 months
Psychiatric care, rehabilitation or palliative care (even if the condition is pre-existing) 2 months
All other hospital benefits 2 months
We will waive waiting periods for newborns providing they are added to a single Parent or Family policy from date of birth.

Change your mind?

If you change your mind and want to cancel within 30 days, CUA Health will cancel your policy and refund any payments you’ve already made provided you haven’t made a claim.

What’s not covered

  • Hospital treatment for which Medicare pays no benefit, like cosmetic surgery.
  • In some cases your doctor’s and\or specialists’ (radiology, anaesthetist, etc) fees may still be more than the Medicare benefit plus the CUA Health gap scheme so you may be required to make an additional payment. Please check this with your doctor before consultation or treatment.
  • Gap payments may apply to certain prostheses (i.e. hip and knee joint replacements, artificial heart valves, pacemaker devices and intra-ocular lenses for cataract surgery).
  • Any items of a personal nature, including TV rental or phone calls while in hospital where not part of the agreed medical costs.
  • You’ll need to pay any additional costs that are applied to any 'nursing home-type' patient admission into a public or private hospital. This amount is determined by the Federal Government.
  • Experimental and some high cost or exceptional drugs.
  • Services not invoiced by the hospital.
  • If you go to an emergency room and are not admitted but the hospital still charges you for your visit, this charge is not covered by your health insurance and you’ll need to pay this yourself.
  • Services able to be claimed by way of compensation or damages. CUA reserves the right to a full and immediate reimbursement of any claims covered by way of compensation or damages from another party.
  • Services provided by a family member.
  • Any treatment considered an outpatient service. E.g. Radium
  • Benefits in relation to sport, recreation or entertainment unless they are part of an approved chronic disease management or a health management program
  • Benefits for treatment, goods or services if false or misleading information is provided
  • Extras cover services for which a Medicare benefits is payable, except as allowable as hospital substitute treatment
  • Treatment, goods or services provided during a waiting period

More on your hospital benefits

Obstetrics - related conditions

For CUA Health this specifically includes hospital admissions for the birth of a child. Any non-admitted check-ups and treatment are not covered.

IVF and other assisted reproductive services have several steps and only the component which involves an admission to hospital can be cover under private health insurance. Please contact us before undergoing any treatment to understand what you will be covered for.

Obesity-related treatments

A 12-month waiting period will apply to all obesity-related treatments if your condition is considered pre-existing in the opinion of a medical practitioner appointed by CUA Health (having regard for the information provided by your treating medical practitioner).

Benefit Limitation Periods

CUA Health has a 24 month benefit limitation period for the following hospital treatments:

  • Psychiatric treatment
  • Obesity related treatments
  • Hip and knee joint replacements and revisions (excluding accident)

During the first 24 months from joining, and after hospital waiting periods have been served, benefits paid for these treatments will be limited to the same amount you would receive in a public hospital for the same treatment. After 24 months from joining you will be eligible for the full benefits under the policy.

Pre-existing conditions

A pre-existing condition is one where signs or symptoms of your ailment, illness or condition existed anytime during the six months before the day you purchased your hospital insurance or upgraded to a higher level of Hospital Cover.

In a case where we need to look into a pre-existing condition, we’ll have your information reviewed by a doctor appointed by us to determine if your ailment, illness or condition is pre-existing. The doctor we appoint will consider any information regarding signs and symptoms provided by your previous doctor(s).

We may apply a special waiting period to new customers of private hospital insurance who have pre-existing conditions. This waiting period also applies to existing policy holders who have recently upgraded their level of hospital cover.

If your ailment, illness or condition is considered pre-existing:

  • We’ll ask new policy holders to wait 12 months for any hospital claims. However for psychiatric care, rehabilitation or palliative care, you will only need to wait a maximum period of 2 months (even if the condition is pre-existing).
  • Policy holders transferring or upgrading to a higher hospital level will be asked to wait 12 months before making a claim at the higher hospital level.

If you have upgraded your cover, you'll be covered under your previous level of cover until you have served waiting periods for the new level.

General conditions
  • Your regular health insurance premiums can be paid up to 12 months in advance if you wish.
  • Our family policies provide cover for the policy holder, their partner and any dependant children/young adults until their 23rd birthday. Full-time student dependants are covered up until they turn 25.
  • Claims are paid in line with CUA Health fund rules and they cannot exceed the cost of any service. However we will not make any payments for claims if your policy is in arrears.
  • All your claims will be paid within 2 years from the date the service was provided.
  • You may not contribute to similar products with more than one private health insurer.
  • Your health cover does not pay benefits for products, services or treatments purchased from or provided by practitioners overseas, whether you buy them in person, by mail or ordered online.
  • Benefits are not paid for services provided by a family member.
  • Benefits are not payable if you’re entitled to make a claim by way of compensation or damages.

Upgrading your cover

If you have upgraded your cover with us or transferred to a higher level of cover from another private health insurer, benefits will be paid under your previous cover until the waiting periods for your higher level of cover is served.

Suspension of your cover

While we wish you a safe trip we’re unable to pay for any services received while overseas. Policy holders may apply to put their policy on hold for periods of 2 months to 36 months while overseas. We may ask you to provide travel documents to confirm your dates of travel to ensure your policy starts again once you set foot back in the country.

Suspending your cover while overseas you might be liable for the Medicare Levy Surcharge if you income exceeds the relevant threshold.

Payments in arrears

If you get too far behind in your payments (two months or more) your policy will automatically be cancelled. If this happens full waiting periods will apply if you decide to re-join. Benefits won’t be paid while premiums are in arrears.

Extras Cover

Extras cover

CUA Health's Extras Cover is comprehensive and easy to understand.

There are two options you can choose from - Gold and Silver Extras. Both cover the full range of treatments such as optical, dental, physio and remedial therapy. The only difference is the amount you pay in your premium and the amount you can claim when you use these services. Simple!

Our Gold and Silver Extras Cover can only be purchased in conjunction with one of our Hospital Cover.

Silver extras Gold extras
Maximum Annual LimitsMaximum Annual Limits
Dental Expand formore info
General Dental Combined $1,0002 No annual limit
Endontic (e.g root canal services) $500
Major dental (e.g. crowns, bridges, dentures) & orthodontics^ Combined $2,000
Orthodontics $520 Sub-Limit
$1,250
The Orthodontic limit is a lifetime limit per person and forms part of the overall annual limit. An Orthodontic Treatment Plan is required and benefits are not payable in excess of the annual limit and accumulates to the lifetime limit.
Lifetime limit per person for orthodontics $1,500 $2,500
Kids receive additional general dental benefits to help reduce or eliminate the cost of dental care. For routine dental services (periodic oral examination – 012, scaling/cleaning – item 114 and fluoride – item 121) there will be no gap payable up to a total value of $250 per visit, for two visits per year.
The benefit is within the general dental annual limits and available to dependant children up to age 23.
2This limit is a combined limit.
^Sub-limit for orthodontics applies.
Show dental benefit examples
Comprehensive oral examination - item 011 $29 $38
X-rays - item 022 to 037 $21 - $72 $25 - $84
Scaling/cleaning - item 114 $52 $70
Fluoride application - item 121 $18 $22
Simple estraction - item 311 $83 $100
Filling/s (1-5 surfaces) - items 511 to 535 $59-$131 $84 - $177
Root canal (one canal) - items 415 & 417 $139-$140 $184-$187
Approved, fitted mouth guard - item 151 $78 $94
Crown - item 615 $760 $974
Bridge work (pre unit) - item 643 $593 $755
Single denture - item 711 $571 $667
Full dentures - item 719 $999 $1,166
Optical $230 $300
Calendar year limit per person $230 $300
Frames, lenses, tinting, repairs, contact lenses - items available by prescription only 100% up to limit 100% up to limit
Show optical benefit examples
Luxottica (OPSM, Laubman & Pank)
Lenses and Lens add-ons
Off the normal retail price for all lenses purchased at retail stores.
20% Discount
Non-prescription sunglasses
Off the normal retail price for all non-prescription sunglasses purchased at retail stores
15% Discount
Contact lenses
Off the normal retail price for all contact lenses purchased at retail stores.
10% Discount
OPSM Direct
Additional 5% off the on-line price, plus free delivery within Australia, for contact lenses purchased from OPSM On-Line (www.opsm.com.au)
Specsavers
Frames and lenses
Only available from the $149 and above range purchased at retail stores. No discount on two pair deals or complete glasses with less than $149 value.
25% Discount
Optical lens extra
Includes Suntint & UV filter, polaroid lenses, transition lenses, driving tints, Drivewear lenses, Thin & Light lenses.
20% Discount
Contact Lens assesment, fitting and trial Free
Eye test
Bulk billed to Medicare plus free Digital Retinal Photography
Free
Eyebenefit
Lenses
Spectacle lenses only
15% Discount
Frames and lenses
For one pair of complete spectacles
20% Discount
Contact lenses 10% Discount
VSP Global
Lenses and lens add-pns
all in store contact lenses15% discount
all lens add-ons20% discount
Choice of frames and lens packages available at discounted prices in store
Physiotherapy
First year $440 $600
Second year $490 $650
After second year $540 $700
Initial visits (Max. 3 per calendar year) $34 $50
Subsequent visits $29 $33
Extended home treatment $30 $41
Home & hospital visits $28 $32
Group therapy: Hydrotherapy or Pilates group sessions conducted by a physiotherapist $8 $9
Chiropractic & Osteopathic
First year $500 $800
Second year $550 $850
After second year $600 $900
Initial visits (max. 3 per calendar year) $33 $45
Subsequent visits $23 $27
Chiropractic X-ray $58 $70
Alternative therapies $500 $800
Calendar year limit per family/couple/single parent policies $500 $800
Calendar year limit per person $250 $400
Acupuncture, homeopathic & naturopathic services
Initial visits - Initial visits are limited to a maximum of 3 per calendar year combined for all Alternative therapies $33 $45
Subsequent visits $23 $27
Bowen therapy, remedial therapy, kinesiology, reflexology and aromatherapy per visit $23 $27
* Benefits for multiple consultations are payable only where services are provided with at least a two hour time differential between each consultation.
Occupational therapy, speech therapy, dietitian and nutritionist, clinical psychology, orthoptic (eye) therapy, Exercise physiology.$250$500
Orthoptic (eye) therapy Each visit $42 $86
Clinical psychology
Initial visits# $67 $85
Subsequent visits $53 $62
Group classes $30 $40
Occupational therapy
Initial visits# $50 $59
Subsequent visits $32 $38
Speech therapy
Initial visits# $68 $80
Subsequent visits $33 $38
Dietitian and Nutritionist
Nutritionists must be registered with the Nutritionist Society of Australia to be eligible to receive this benefit
Initial visits# $43 $51
Subsequent visits $25 $29
Exercise physiology $40 $45
Exercise physiology - Group Sessions $8 $9
# Initial visits are limited to a maximum of 3 per calendar year combined for all “other services” types.
Hearing aids $800 $1,600
Hearing aid repairs 60% 70%
Hearing aid benefit payable per person in a 5 year period
Pharmacy $300 $600
Cover for items prescribed or provided by a medical practitioner, excluding:
  • Pharmaceutical Benefit Scheme (PBS) scripts
  • items normally available without doctor's prescription
  • contraceptives unless prescribed specifically for the treatment of an illness (a letter of referral required annually)
  • An official pharmaceutical receipt is required
You pay an amount equivalent to the PBS contribution (eg. $37.70 as at 1 January 2015) and we pay up to $25 $50
Podiatry and orthotics $400 $600
Initial visits $31 $36
Subsequent visits $25 $29
Foot surgery performed by Australian Government accredited podiatrists 60% up to limit 80% up to limit
Podiatry related aids1 (including custom-made orthotics) 60% up to limit 80% up to limit
1No benefit is payable on pre-made and/or customised items
Health management aids and appliances $400 $600
Aids
Custom made braces
Non-surgically implanted prostheses
Compression stockings, mastectomy bras, wigs
Appliances
Nebuliser
Blood glucose monitor
CPAP pump, CPAP mask
TENS machine
Peak flow meter
Blood pressure monitors
Circulation booster
60% up to limit 80% up to limit
Benefits for replacements of approved appliances can only be paid 3 years from the date of previous supply.
Benefits are payable for custom made braces. No benefit is payable on pre-made and/or customised items
Benefits for compression stockings or circulation boosters are payable for chemotherapy or lymphedema, venous stasis or major surgery.
A letter from a medical provider may be required for payment of wigs, compression stockings or circulation boosters.
Benefits for wigs are payable from approved providers for chemotherapy or alopecia only.
A recognised ‘sleep studies’ programme must have been undertaken for a CPAP pump.
Replacements for full CPAP masks are payable every 12 months from the date of previous supply. Benefits are not payable towards any hire or CPAP mask and CPAP pump components.
Benefits are only paid on purchases from companies with registered Australian Business Numbers (ABNs).
Health management programs
You can claim for:
The following approved health management programs that are intended to prevent or improve a specific health condition:
- Stress management, quitting smoking, weight control
- Health screening services
First year $200 $200
Second year $250 $250
Third year $300 $300
You cannot claim for:
- Any sport club membership or sporting equipment, gym memberships, footwear and clothing
- Services where Medicare benefit is payable
- Medical examinations for, but not limited to employment and insurance purposes.
Claims for health management program benefits must include:
- a health management program benefit approval form
- a tax invoice from the program provider
Ambulance transport 100% 100%
For residents of all states, except Queensland and Tasmania, benefits are payable for emergency ambulance transport costs occurring anywhere within Australia (including aerial ambulance) or where the use of an ambulance is directed by a hospital or medical practitioner due to the seriousness of a policy holder's medical condition. State government ambulance transport schemes operate in Queensland and Tasmania. 100% 100%
Mammograms $65 $100
Benefits towards mammograms where not Medicare rebatable $65 $100
Travel expenses - $200
Family no benefit $200
Claimable when a hospital admission for a policy holder or dependant covered by the policy outside your usual place of residence is required and the return trip distance is greater than 400km. A tax invoice that includes the service provider's Australian Business Number must be submitted with any claim.
Waiting periods

When you take out health insurance for the first time, or increase your cover, CUA Health ask that you wait a period of time before you can claim for new or higher benefits. Take a look at the table below to find out what waiting periods apply. If you are switching from another insurer please read Switching is Simple.

Ambulance no waiting
General Dental
Physiotherapy
Chiropractic and Osteopathic
Alternative therapies
Pharmaceutical
Podiatry
Orthoptic (eye) therapy
Clinical Psychology
Occupational Therapy
Speech therapy
Dietitian and Nutritionist
Exercise physiology
Mammograms
Travel expenses
2 months
Optical
Health management programs
6 months
Major dental (eg. veneers, crowns and bridges, dentures, wisdom teeth, periodontics, orthodontics, endodontics)
Health management aids and appliances
Podiatry-related aids
Orthotics
12 months
Hearing aids 24 months

Change your mind?

If you change your mind and want to cancel within 30 days, CUA Health will cancel your policy and refund any payments you’ve already made provided you haven’t made a claim.

General conditions

General conditions

  • Your regular health insurance premiums can be paid up to 12 months in advance if you wish.
  • Our family policies provide cover for the policy holder, their partner and any dependant children/young adults until their 23rd birthday. Full-time student dependants are covered up until they turn 25.
  • Claims are paid in line with CUA Health fund rules and they cannot exceed the cost of any service. However we will not make any payments for claims if your policy is in arrears.
  • All your claims will be paid within 2 years from the date the service was provided.
  • You may not contribute to similar products with more than one private health insurer.
  • Your health cover does not pay benefits for products, services or treatments purchased from or provided by practitioners overseas, whether you buy them in person, by mail or ordered online.
  • Benefits are not paid for services provided by a family member.
  • Benefits are not payable if you’re entitled to make a claim by way of compensation or damages.

Upgrading your cover

If you have upgraded your cover with us or transferred to a higher level of cover from another private health insurer, benefits will be paid under your previous cover until the waiting periods for your higher level of cover is served.

Suspension of your cover

While we wish you a safe trip we’re unable to pay for any services received while overseas. Policy holders may apply to put their policy on hold for periods of 2 months to 36 months while overseas. We may ask you to provide travel documents to confirm your dates of travel to ensure your policy starts again once you set foot back in the country.

Suspending your cover while overseas you might be liable for the Medicare Levy Surcharge if you income exceeds the relevant threshold.

Payments in arrears

If you get too far behind in your payments (two months or more) your policy will automatically be cancelled. If this happens full waiting periods will apply if you decide to re-join. Benefits won’t be paid while premiums are in arrears.

Join today

Join CUA today

Why join us?
We think it’s important to have health insurance you know you can rely on when you need it. Don’t you? That’s why CUA Health's Cover is simple to understand, provides great value and gives you peace of mind should the unexpected happen. It’s even easy to join.

Isn’t it time you chose a better health cover for you and your family?

Follow these simple steps to join today.

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Get a quick quote

Before you join please read the information provided below, just so we’re upfront.

Benefits of health insurance

Benefits of health insurance

Don’t get caught out by the Medicare levy surcharge (MLS) at tax time. Not having health insurance when you’re in a higher income bracket could actually cost you more than you think when it comes to your tax return.

Not sure what the Medicare levy surcharge is?

The Medicare levy surcharge (MLS) is a surcharge on individuals and families on higher incomes who don’t have eligible Private Hospital Cover.

The surcharge is calculated at the rate of 1%-1.5% of your income and applies to singles earning over $90,000 or a combined family income over $180,000 as shown in the table below. If you’re a single person earning $100,000, paying an additional 1.25% would cost an extra $1,500 per year in tax.

This is based on an Australian resident with no spouse or dependents and incorporates the tax free threshold. Taxation information is indicative only. Contact the Australian Tax Office or your accountant for information regarding your personal circumstances.

Singles Families Medicare Levy Surcharge
Under $90,000 Under $180,000 0%
$90,001 - $105,000 $180,001 - $210,000 1%
$105,001 - $140,000 $210,001 - $280,000 1.25%
Over $140,001 Over $280,001 1.5%

Naturally, all the hospital policies offered by CUA protect you from the Medicare Levy Surcharge.

You can calculate your income for the Medicare levy surcharge and work out how much the surcharge will cost you using the Medicare Levy calculator.

Another way to avoid the Medicare surcharge without the cost of Private Hospital Cover is to choose the CUA Health Public Hospital 100% option. To find out more contact us on 1300 499 260.