All about private health insurance

We've listed some commonly requested information on Private Health Insurance. If you can't find what you're looking for here please contact us.

Your rebate on private health insurance
Your Annual Statement of Claims
Partner Private Hospitals
Lifetime Health Cover
Medicare Levy Surcharge
Pharmaceutical Benefits Scheme (PBS)
Private Health Insurance Ombudsman
Privacy and access to membership details
Suspension of membership
Transferring between funds

Your rebate on private health insurance

If you're eligible for full Australian Medicare, and hold a current Medicare card, you're entitled to the Federal Government 30% Rebate on private health insurance.

Regardless of your income or level of cover, you're entitled to a 30% rebate on your membership contributions. If you're aged between 65 and 69, the rebate increases to 35%, and if you're 70 or older the rebate rises to 40%. Best of all, you can choose to receive your rebate as a reduction in your contributions, as a rebate on your annual income tax, or as a reimbursement from Medicare.

Your Annual Statement of Claims

When requested by the policyholder, a private health fund must provide an Annual Statement of Claims. This statement gives you general information about your membership, the people covered under your membership, and a breakdown of how much each person has claimed under the categories of medical, hospital, extras and dental treatment. The exact details of the treatments aren't specified on this annual statement of claims.

Partner Private Hospitals

Partner Private Hospitals are facilities that have entered into an agreement with Grand United Corporate Health. This agreement guarantees that if you have Hospital cover, you'll be covered for 100% of accommodation and other services such as theatre fees, less any excess (if applicable).

At facilities where no agreement exists (Non Partner Private Hospitals), your benefits will be paid at the lowest contracted amount for that specified treatment in any agreement hospital in that state, subject to the benefit not being lower than the Default Benefit set by the Minister for Health and Ageing.

We recommend you contact your GU Health Member Relations Team to check that the hospital where you'll be treated is a Partner Private Hospital.

Your benefit limit for pharmaceutical drugs is $300 per person per membership year in hospitals with which no agreement exists.

Search for a GU Health Partner Hospital

Lifetime Health Cover

Lifetime Health Cover is a Government initiative introduced on 1 July 2000 to encourage people to take out private hospital cover at a younger age, to lock in lower hospital contribution rates throughout their lifetime.

On 1 July 2004, the Government introduced a standard birthday for everyone turning 31 in a given financial year. Before that, people had only until their 31st birthday to take out private hospital cover without incurring a Lifetime Health Cover loading.

Now, if you take out private hospital cover before the Standard 31st Birthday (that is, before the end of the financial year in which you turn 31) you'll pay the lowest available contribution rate (the base rate) for that cover, and continue to be eligible to pay the base rate for as long as you maintain hospital cover.

People who take out hospital cover after the 30 June following their 31st birthday pay a 2% loading for every year they're over 30 when they join, on top of the base rate contribution. The maximum loading a person can be required to pay is 70% and loadings are only calculated on the hospital component of your health cover.

In April 2007, the Government also announced that any loading will be removed for members who have held continuous hospital cover for 10 years

There are also certain circumstances where people are exempt from Lifetime Health Cover, or are allowed a period of grace beyond their 31st birthday before Lifetime Health Cover applies. To find out more, call your GU Health Member Relations Team or visit the Department of Health and Ageing website at www.health.gov.au.

Medicare Levy Surcharge

The Medicare Levy Surcharge is a Government scheme that imposes an additional 1% tax (on top of the 1.5% Medicare Levy) on people who haven't taken out private Hospital cover, whose incomes as singles exceed $50,000, or who have a combined income as a couple or family of $100,000 or more (this income threshold increases by $1,500 for each child after the first).

Pharmaceutical Benefits Scheme (PBS)

The PBS is the national pharmaceutical scheme funded by the Commonwealth Government that subsidises the cost of pharmaceuticals.

Private Health Insurance Ombudsman

The Private Health Insurance Ombudsman deals with enquiries and complaints about any aspect of private health insurance. You can get free advice from the Ombudsman if you have a complaint about your private health fund.

Complaints Hotline: 1800 640 695 (free from anywhere in Australia except from a mobile phone)

Or write to:
Private Health Insurance Ombudsman
Level 7, 362 Kent Street
SYDNEY NSW 2000

Privacy and access to membership details

Grand United Corporate Health Limited (ABN 99 002 985 033) ("GU Health") respects the privacy rights of its members and is committed to complying with all applicable privacy laws.

These laws include the Privacy Act 1988, which incorporates the National Privacy Principles for the fair handling of personal information, as administered by the Office of the Federal Privacy Commissioner.

What this means for you:

We will be fair in the way we collect personal information: we will only collect personal information necessary for what we do.
We will be open with what we do with your personal information: it will only be used or disclosed in ways that accord with applicable privacy laws and this policy.
We will be open with you about the personal information we hold about you: we will let you correct it should it be wrong.

Personal Information Handling Practices
Who has access to membership details?
Third Party Policy Access Authority
What are the individual member's rights to privacy on a Family Membership?
What is GU Health able to do?
What are GU Health's other legislative requirements?
More information

Personal Information Handling Practices
We will be fair in the way we collect personal information: we will only collect personal information necessary for what we do. Wherever possible, personal information is collected directly from our members and applicants.

Personal information is collected for the following purposes:

To initiate or extend a relationship with a member or customer.

To administer products and services and manage our relationship with you.

To process transactions, to answer queries and for security purposes.

So that GU Health can continually develop and offer products and services.

Examples of the types of personal information GU Health collects are:

Name, address, phone number and other contact details ‑ collected for product administration and so we can contact you.

Date of birth ‑ sometimes required for product administration and development, or for security reasons.

Product specific information ‑ collected as required for the administration of each product.

If some or all of that information is not provided, it may not be possible to provide (or administer) the product or service.

Please note that different companies within the Australian Unity Group may use the personal information collected about you, but only if this is necessary in order for us to provide you with our products or services.

Sometimes we may need to collect personal information about individuals who are not customers of GU Health (for example, business contact details of a company representative with whom we deal).

Who has access to membership details?
The policyholder and the policyholder's spouse/partner (if named on the membership) may:

access the membership information of all people named on the membership

make changes to the membership, including correcting information, adding and deleting the rebate, updating cover choices, and adding and deleting dependants.

The policyholder is the only person on the membership who may:

cancel a membership

nominate a third party to share equivalent levels of access and authority as the policyholder and the policyholder's spouse/partner.

Third Party Policy Access Authority
A spouse/partner on a Family Membership has access to membership information, and may make changes to the policy, but cannot cancel the policy. If your spouse/ partner is not named on the membership and you want to give them access to the membership, you must complete a Third Party Policy Access Authority form.

What are the individual member's rights to privacy on a Family Membership?
Members aged 16 and over who are named on a Family Membership, but who are not the policyholder, may request that access to details about their claims against the membership be limited. While this is possible to an extent, health funds are bound to comply with laws which may reduce GU Health's ability to ensure complete privacy from others named on the Family Membership.

If any disputes arise from separation or divorce, GU Health is obliged to keep the agreement first made with the policyholder upon joining.

What is GU Health able to do?
GU Health is able to separate an individual's claims information from that of others named on the Family Membership on the Claims Benefit Statement.

On request, we can generate individual statements for each person, and these can be sent to different addresses if required.

What are GU Health's other legislative requirements?
GU Health is committed to your privacy by acting in accordance with the requirements of the Privacy Act 1988 (Cth) and the Privacy Amendment (Private Sector) Act 2000 (Cth) including the National Privacy Principles as regulated by the Office of the Federal Privacy Commissioner. The National Privacy Principles represent a legal obligation which sets out the way in which GU Health collects, stores, uses and discloses your personal information. A copy of the National Privacy Principles may be obtained from the Office of the Federal Privacy Commissioner or the Commissioner's website, www.privacy.gov.au. This policy will apply equally to any future legislative amendments to, or additions to, State and Commonwealth law.

More information
If you'd like to know more, you can get a copy of GU Health's Privacy Policy or discuss your privacy concerns by calling your GU Health Member Relations Team.

Suspension of membership

Suspension is permitted for a period from one month to two years in the event of overseas travel or employment. You'll retain full membership entitlements when you resume your membership. However, benefits are not payable for claims incurred while your membership is suspended.

To suspend or reinstate your cover after a period of suspension, you'll need to provide supporting documentation to GU Health.
Termination of membership GU Health has the right to terminate a person's membership at any time if, in the opinion of GU Health, the person has provided false information or falsely claimed benefits. In such cases, GU Health reserves the right to seek compensation from any involved parties. GU Health reserves the right to terminate the membership if contribution payments are more than two months in arrears.

Subject to legislation, GU Health has the right to terminate a person's membership without cause by giving two months' notice in writing and refunding any contribution payments already made for any period after the date of termination.

Transferring between funds

If you transfer to GU Health within two months of leaving another registered Australian health fund, you're entitled to continuity of membership from the previous fund under the National Health Act. You don't have to serve waiting periods for equivalent cover with GU Health if you've already done so with your current fund. If your GU Health benefit is greater than that payable by your previous fund you may have to serve waiting periods for the additional benefit.

If you're transferring from a recognised international fund you may apply for GU Health to recognise waiting periods already served with your previous fund. Please note that GU Health reserves the right to assess transfers from international funds on a case‑by‑case basis.

Accrued entitlements are not transferable between funds.

Your claims history is made known to GU Health through your Transfer Certificate when you transfer from another fund. The proportion of annual limits claimed with your previous fund may be taken into consideration when calculating your benefits for equivalent services under GU Health cover.

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