What if?

We've listed some if the most common questions from members regarding their health cover. If you can't find what you're looking for here or under 'About Private Health Insurance', please contact us.

My circumstances change
I'm expecting a baby (or my partner is)
I have a pre‑existing condition
My benefit limits have been reached
My child is a student dependant
I'm seeking third party compensation
My treatment is related to my employment or insurance
Health legislation changes

My circumstances change

It's your responsibility to notify GU Health of changes to your circumstances that may affect your membership, like adding or deleting a spouse or a dependant. You must also notify GU Health if you change your address or contact details, to make sure that you continue to receive important notices or communications.

It's possible to remain on the same membership following separation or divorce ‑ if this is what you and your partner decide to do.

If any disputes arise from separation or divorce, GU Health is obliged to keep the agreement first made with the policyholder upon joining. This may mean that claims payments will be made to the policyholder, regardless of who paid for the treatment.

I'm expecting a baby (or my partner is)

You can only claim for obstetrics and newborn infants if you have Hospital cover that doesn't exclude pregnancy, pregnancy‑related and birth‑related services. Waiting periods may apply.

a mother on a Single Membership with appropriate Hospital cover is covered for the costs of the birth ‑ but not for any costs incurred for the baby. You must upgrade your Single Membership to a Family Membership at least two months prior to the expected due date so the baby is also covered from birth.
for a mother on a Family Membership with appropriate Hospital cover, the baby is automatically covered from birth. However, you must notify GU Health of the newborn within two months of birth so no waiting periods will apply to the baby.

Remember to let us know your newborn baby's details so we can update your membership details.

I have a pre‑existing condition

A pre‑existing condition is a condition where your signs or symptoms were evident up to six months prior to joining your cover or increasing your level of Hospital cover, irrespective of the date of your actual diagnosis. There is a standard waiting period of 12 months for benefits on pre‑existing conditions, from the time you join or increase your level of cover. Any claims you make relating to pre‑existing conditions may be referred to GU Health's consulting doctor before being approved for payment. However, pre‑existing condition restrictions do not apply to Extras cover.

My benefit limits have been reached

All GU Health Extras covers have set annual limits on the amount of benefits that can be claimed for treatments and services. These may be limits that apply per person or per membership. If the annual limit on benefits in a particular area is reached, no further benefits are payable for the remainder of the year. Limits will reset at the start of your membership year.

You can request an Annual Statement of Claims for information about how much has been claimed under your membership. Call your GU Health Member Relations Team.

My child is a student dependant

Student dependants may be covered under a Family membership. Once they turn 21, you may re‑register your child as a student dependant under your cover each year until they turn 25 ‑ as long as they remain unmarried and a full time student of an approved school, college or university.

I'm seeking third party compensation

If you're injured as the result of an accident for which you may be eligible for compensation or damages from a third party (including a workers' compensation claim), you're not eligible to claim benefits from GU Health ‑ including future costs of treatment ‑ whether or not you pursue the claim.

My treatment is related to my employment or insurance

Treatments or healthcare services (e.g. health checks) that you're required to undergo because of your employment, as part of an application for employment, industrial undertaking or application for life insurance are not covered by GU Health.

Health legislation changes

Changes to the legislation governing private health funds may happen from time to time, and changes affecting your membership may be effective immediately. Where appropriate GU Health will notify you of these as quickly as possible.

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