CUA Health Insurance Review
Overview
CUA Health Insurance (Credit Union Australia) Health is a subsidiary of one of the largest member-owned financial organizations in Australia, the CUA Company. Established 73 years ago and founded on a few small credit unions, the company rapidly grew and expanded into CUA Health Insurance, which was formed in 1977 to deliver full health cover to its members. CUA Â has been providing affordable private health insurance since.
Health Fund Key Facts
Founded:Â 1976
For-Profit or Not-For-Profit?: Mutual OrganisationÂ
Private Hospital Agreements Nationwide: 286
Day Hospital Agreements Nationwide: 268
Head Office: Brisbane, QLD
Health Deal Represented?: No
CUA Health Hospital Cover
CUA currently has five hospital covers to choose from. Starting with Accident Only Hospital (Basic), which covers just accidents and ambulance, going all the way up to Premium Hospital Gold.
The level of cover you take out determines the degree of medical services available to you. So where most entry-level covers like Accident Only provide restrictive services on rehabilitation, psychiatric and palliative care, CUA’s Premium Hospital Gold covers all procedures with a Medicare Item Number.
CUA Health has 5 hospital covers:
- Premium Hospital Gold
- Premium Non-Obstetrics (Silver Plus)
- Standard Hospital (Silver Plus)
- Basic Plus Hospital
- Accident Only Hospital (Basic)
CUA Health Extras Cover
Extras help take care of the everyday healthcare service expenses you may incur outside of a hospital such as dental visits, glasses, chiro and physio.
Members of CUA Health can choose between 6 different levels of Extras Cover. Beginning with 50% and ranging all the way up to 75% extras. Each extras policy covers a variety of common extras. Listed below is a current list of available extras plans with CUA, ranging from most to least expensive:
- 75% Extras
- Total Extras
- Classic Extras
- 60% Extras
- Essential Extras
- 50% Extras
CUA Health Combined Cover
Hospital and Extras Covers can be bought individually or combined to provide members with a more comprehensive health care package. CUA Health’s Combined Cover is called:
- Healthy Start Package (Basic Plus)
CUA Health Insurance Wait Periods
When you take out your first health insurance policy, a waiting period must be served before you can claim your benefits. If you opt to switch health funds within or after this time, you will not have to re-serve your wait period, and it will simply cross over into your new health fund policy, allowing you to claim immediately or when your original waiting period is up.
CUA Health Insurance recognises the waiting periods you have already served with a previous health fund when switching funds and taking out a similar level of cover. For first-timers taking out a health fund plan, the waiting periods below will have to be served before members can benefit from their health scheme.
CUA Hospital Wait Periods
- Ambulance services: 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
Selected CUA Extras Wait Periods
- Dental (General): 2 months
- Dental (Major): 12 months
- Orthodontics: 12 months
- Hearing aids: 12 months
- Optical: 2 months
- Physiotherapy: 2 months
- Remedial Massage: 2 months
How Do You Claim With CUA Health?
On the spot: Swipe your membership card at a health provider that uses the HICAPS system to have your claim processed immediately.
Via a mobile app:Â Submit a claim by uploading a photo of your receipt.
Online: You can log into your online account through their website and lodge your claim by providing the details on your receipt.
What Is CUA Health Gap Cover Like?
CUA’s medical gap cover is called the Access Gap Cover.
When you have a surgery, your health fund will always pay 25% of the MBS fee and Medicare will pay the other 75% of the set fee.
Your doctor can, however, charge you more than the standard Medicare Benefits Schedule Fee (MBS) and the difference will have to come out of your pocket. That difference is called ‘the gap’.
Some doctors and hospitals have agreements with health funds to cover the complete gap. This is called a ‘no gap agreement’. An agreement to cover a partial gap is known as a ‘known gap agreement’ and Bupa members pay no more than $500 out-of-pocket.
All of CUA Health’s Hospital Covers include the Access Gap Scheme, so as long as your doctor agrees to treat you under the scheme, you will have a small amount or no gap to pay.
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.Â
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.Â
The information below outlines the percentages of services covered under no-gap and known-gap.
CUA Health Insurance Medical Services with No Gap: 82.3%
Industry Average 79.1%
CUA Health Insurance Medical Services with No or Known Gap: 96.6%
Industry Average: 90.5%
CUA Health Insurance Medical Services with No Gap: 91.0%
Industry Average: 89.5%
CUA Health Insurance Medical Services with No or Known Gaps: 97.2%
Industry Average: 95.7%Â
CUA Health Insurance medical services with No Gap: 90.9%
Industry Average: 86.7%
CUA Health Insurance medical services with No or Known Gap: 98.2%
Industry Average: 95.1%
CUA Health Insurance medical services with No Gap: 94.2%
Industry Average: 89.2%
CUA Health Insurance medical services with No or No or Known Gap: 98.1%
Industry Average: 94.5%
CUA Health Insurance medical services with No Gap: 86.9%
Industry Average: 89.5%
CUA Health Insurance medical services with No or Known Gap: 98.9%
Industry Average: 96.6%
CUA Health Insurance medical services with No Gap: 88.7%
Industry Average: 84.4%
CUA Health Insurance medical services with No or Known Gap: 96.1%
Industry Average: 96.2%
CUA Health Insurance Medical Services with No Gap: 90.5%
Industry Average: 90.2%
CUA Health Insurance Medical services with No or Known Gap: 99.5%
Industry Average: 96.7%
CUA Health Insurance Medical Services with No Gap: 86.7%
Industry Average: 84.2%
CUA Health Insurance Medical Services with No or Known gap: 93.9%
Industry Average: 93.8%
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