Australian Unity Health Insurance Review


With a 175-year history, Australian Unity is Australia’s oldest health fund.

Australian Unity has more than 340,000 members, AU is the 6th largest private health insurer in the country. 10,000 of those members have been with Australian Unity for over 50 years.

As a mutual company, it is entirely owned by its policyholders and profits are retained within the company or rebated to members in dividend distributions.

Australian Unity has been playing a major role in promoting community wellbeing and constructing aged care and veteran homes since their inception in 1840 as the Manchester Unity Independent Order of Oddfellows, part of an international fraternity. 

AU is a member of AHSA (Australian Health Service Alliance) and has agreements with over 90% of hospitals across Australia.

AU’s Extended Family policies cover dependents up to the age of 23, have competitive yearly limits and offer no gap preventative dental treatments at any of their 13 No Gap Dental Network locations.

Australian Unity Health Insurance Key Facts

Founded: 1840

For-Profit or Not-For-Profit?: Mutual Organisation

Private Hospital Agreements Nationwide: 280

Day Hospital Agreements Nationwide: 262

Head Office: Melbourne, VIC

Health Deal Represented?: Yes

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Australian Unity Health Insurance Hospital Cover

Australian Unity’s hospital policies cover a range of needs to suit people of all ages. These extend from Simple Hospital, which provides cover for accident only, all the way up to Ultimate Gold. Here is a list of some of the current hospital covers available:

  • Simple Hospital (Basic Plus)
  • Standard Hospital (Bronze Plus)
  • Intermediate Hospital (Silver Plus)
  • Advanced Hospital (Silver Plus)
  • Ultimate Gold (Gold)

Australian Unity Health Insurance Extras Cover

Extras cover takes care of the everyday healthcare service expenses that are not covered under Medicare such as dental visits, prescription glasses, and chiropractor and physiotherapy requirements. Here is a list of some of the current extras covers available:

  • Basic Extras
  • Standard Extras
  • Classic Extras
  • Intermediate Extras
  • Advanced 80% Extras

Australian Unity Health Insurance Combined Cover

Hospital and extras covers can be bought individually or combined to provide members with a more comprehensive health care package. Here is a list of some of the current combined covers available:

  • Simple Saver (Basic Plus)
  • Care’n Repair (Basic Plus)
  • Smart Start (Basic Plus)
  • Top Choice (Silver Plus)

Australian Unity Health Insurance Waiting Periods

Australian Unity recognises the waiting periods you have already served with a previous health fund if you switch, this is called “portability”. For first-timers taking out a hospital cover, members who may have lapsed in-hospital coverage and those upgrading their level of cover, the waiting periods below will have to be served before members can claim on services:

Australian Unity Health Insurance Hospital Wait Periods

Ambulance services: 1 Day

Accidental Injury: 1 Day

New Conditions: 2 Months

Pregnancy and birth-related services: 12 months

Pre-existing conditions: 12 months

Rehabilitation & Palliative care: 2 months

Weight Loss Surgery: 12 months

How Do You Claim Extras with Australian Unity Health Insurance?

Claim extras with Australian Unity is super easy! Here are some of the most common ways:

On the spot: You can swipe your membership card at almost 20,000 health care providers that support the HICAPS electronic claims to have your claim processed immediately.

App: Upload a photo of your receipt to the app to lodge a claim.

Online: You can log into your online account through the website and make your claim by providing the details on your receipt.

Email or fax:  Claims can be made by scanning and faxing a completed Health Cover Claim form and attaching receipts to the form.

By post: Claims can be lodged by submitting a completed claim form along with your receipt from your health provider. Mailing details are included on the form.

Australian Unity Health Insurance Gap Cover

Australian Unity’s medical gap cover is called Gap Cover Scheme.

If your doctor charges you more than the standard Medicare Benefits Schedule (MBS), this is known as the ‘gap’ and can leave you with an out-of-pocket expense.

Gap Cover can help to minimise or eliminate personal expense but it is the choice of the physician to participate in any given gap scheme.

Australian Unity Health Insurance Review: Gap Cover Ratings By State

You can gauge how efficient a gap scheme is by comparing health funds in the same state or territory and determining which of the fund offers a greater proportion of medical services covered at no gap. While it is more likely that a medical service covered under your fund can be utilised at no personal cost to the customer, it is entirely the choice of the physician whether or not to participate in the gap scheme. 

Medical Services with No Gaps: The percentage of claims that were fully refunded.

Medical Services with No or Known Gaps: The percentage of claims that were fully refunded, or where the policy holder knew the cost before the surgery was performed. 

he information below outlines the percentages of services covered under no-gap and known-gap.

AU Medical Services with No Gap: 84.2%

Industry Average 79.1%

AU Medical Services with No or Known Gap: 93.3%

Industry Average: 90.5%

AU Medical Services with No Gap: 91.3%

Industry Average: 89.5%

AU Medical Services with No or Known Gaps: 96.6%

Industry Average: 95.7% 

AU medical services with No Gap: 92.0%

Industry Average: 86.7%

AU medical services with No or Known Gap: 97.7%

Industry Average: 95.1%

AU medical services with No Gap: 92.3%

Industry Average: 89.2%

AU medical services with No or No or Known Gap: 96.7%

Industry Average: 94.5%

AU medical services with No Gap: 92.6%

Industry Average: 89.5%

AU medical services with No or Known Gap: 98.5%

Industry Average: 96.6%

AAMI Health Insurance medical services with No Gap: 88.5%

Industry Average: 84.4%

AAMI Health Insurance medical services with No or Known Gap: 95.7%

Industry Average: 96.2%

AU Medical Services with No Gap: 90.7%

Industry Average: 90.2%

AU Medical services with No or Known Gap: 97.6%

Industry Average: 96.7%

AU Medical Services with No Gap: 82.1%

Industry Average: 84.2%

AU Medical Services with No or Known gap: 91.8%

Industry Average: 93.8%

What Is Australian Unity Health Insurance Ambulance Cover?

Ambulance Cover is included in all Australian Unity Hospital, Extras and Combined policies.

Do you need Ambulance Cover?

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