Health. Overseas Visitors Health Cover Guide. Stay well. Live longer.

Transcription

1 Health Overseas Visitors Health Cover Guide Stay well. Live longer. 1

2 Free interpreter service If you have difficulty reading or understanding this brochure and you wish to discuss matters relating to Australian Unity s Overseas Visitors Cover, then our free interpreter service is available to help. Calling from within Australia Calling from overseas healthcover@australianunity.com.au Contents What is Overseas Visitors Cover? p.5 Why do I need health cover when I visit Australia? p.5 Who is Overseas Visitors Cover recommended for? p.6 Benefits of Australian Unity Overseas Visitors Cover p.6 Choosing the cover that s right for you p.8 Overseas Visitors Cover Table of Benefits p.10 Exclusions, waiting periods and notes Premium Overseas Visitors Cover p.12 Standard Overseas Visitors Cover p.13 Budget Overseas Visitors Cover p Visitors Health Cover p.15 Overseas Visitors Cover Rates p.17 Additional Cover for general treatment services p.18 (Extras Cover) Our Extras covers options p.18 Extras Cover Rates p.21 How to purchase one of our Overseas Visitors Covers p.22 Frequently asked questions p.24 Information about Health Cover in Australia p.28 Definitions p.30 Application form p.32 Terms and Conditions p.34 This documentation should be read carefully and retained. Please refer to terms and conditions found in the back of this brochure. Information is current as at the effective date and is subject to change. 2 Stay well. Live longer. 3

3 What is Overseas Visitors Cover? Overseas Visitors Cover is health insurance for non Australian Residents, who are working in or visiting Australia for longer than three months. Should the unexpected happen and you find yourself in need of medical treatment while you are here, it will give you greater control over who treats you, where you are treated, and how soon. For visitors staying less than three months, we recommend that you contact us to discuss your health insurance options. Why do I need health cover when I visit Australia? Australia has world class medical services but they can be expensive if you need to use them. While Australian residents have access to no out-of-pocket or low-cost medical and hospital care through a public health care system called Medicare, most visitors who hold a temporary visa have no access to Medicare. This means that if you need medical attention while you are visiting Australia you could find yourself substantially out of pocket. Even in a public hospital you could be charged more than $1,000 a day in hospital fees alone. Without health cover you can find yourself responsible for the full cost of treatment. That s why, as a visitor to Australia, it is worth considering taking out Overseas Visitors Cover for the duration of your stay. With Overseas Visitors Cover you can obtain medical care or hospital treatment during your stay without having to worry about unexpected medical costs. In addition as part of your visa application process you may be required to take out a specific level of health cover that meets your visa subclass requirements. Some visitors to Australia have restricted access to Medicare for medically necessary treatment because their country has a Reciprocal Health Care Agreement with Australia. (Refer to the Information about health care in Australia section of this brochure for more information about Medicare and Reciprocal Health Care Agreements.) 4 Stay well. Live longer. 5

4 Who is Overseas Visitors Cover recommended for? Australian Unity s Overseas Visitors Cover options offer hospital and medical cover designed for people working in or visiting Australia. It is recommended if you: Are from another country (besides Australia) and are planning to visit Australia for a period of more than three months or if you are a resident of Norfolk Island. Do not have adequate travel insurance with a medical component Are from a country that has a Reciprocal Health Care Agreement with Australia (you may have restricted Medicare benefits), or for those visitors who are eligible for Reciprocal Health Care benefits but want the choice of being treated privately Benefits of Australian Unity Overseas Visitors Cover We make it easy for you to find a suitable cover for your needs with flexible payment options. Most of our covers also provide benefits towards repatriation back to your home country should you become ill and it becomes medically necessary for you to return home. Range of covers to choose from We offer a range of health covers designed to help you cover the cost of health care when you are in Australia. You can select from a budget cover right through to a premium health cover. Option to purchase general treatment services (Extras cover) If you also purchase our optional Extras cover you will get benefits on day-to-day health needs such as general dental, a new pair of prescription glasses, Chinese medicine or even a visit to an acupuncturist. Easy Claiming We have made the process of claiming your Hospital and Extras benefits as quick and easy as possible. We provide a number of different ways you can claim including by phone, , fax or completing a claim form and mailing it to Australian Unity. Manage your membership online As a health insurance member you can manage your membership quickly and easily online. Check your benefit limits, update your details and more, all with a few convenient clicks. Australian Unity Agreement Hospitals To help maximise the benefits you can receive, we have agreements with selected private and day hospitals. We recommend these hospitals to ensure you receive treatment at minimal or no additional costs. A list of these can be found by visiting australianunity.com.au/health- Insurance and then clicking on Health Service Providers. Interpreter Services If you have difficulty speaking or understanding English and you wish to discuss matters relating to Australian Unity health insurance, our free interpreter service is available to help. Calling from within Australia Calling from overseas Easy to join Joining Australian Unity is easy. We provide the option of online, over the phone or through an application form. The quickest and easiest way to join is through our website australianunity.com.au/overseas visitors. Health Cover Confirmation letter Australian Unity will automatically provide you with a Health Cover Confirmation letter shortly after purchase and if applying online you will receive this immediately. This letter can be forwarded to the Department of Immigration and Citizenship (DIAC) should you be required to provide evidence of your health cover arrangements in Australia, as part of your visa application process. 6 Stay well. Live longer. 7

5 Choosing the cover that s right for you Australian Unity offers a range of products - everything from a budget cover right through to a premium health cover. However, the cover you choose may depend on the reason for your visit, the length of your stay and whether or not you are eligible for Medicare. For example, some visa subclasses may be subject to condition 8501 whereby the holder (and any accompanying family members) must maintain adequate health insurance whilst in Australian (for example subclass 457 visa). If you are applying for a 457 long stay working visa, our 457 Visitors Health Cover meets the level of insurance required as set out by the Department of Immigration and Citizenship (DIAC). A letter to confirm that you have purchased a compliant level of cover will be issued to you following purchase. The information below is a guide to Australian Unity Overseas Visitors Covers and outlines who might be suitable for each cover. If you are coming to Australia on a visa subclass, we recommend that you contact the Australian Department of Immigration and Citizenship (DIAC) to confirm the health cover that meets the requirements of your visa subclass. Once you have worked out which cover suits your needs, please read through the relevant table of benefits on the following pages for further information. Premium Overseas Visitors Cover This cover is suitable for people (singles, couples or families with dependants) who plan on being in Australia for an extended period and who want extensive hospital and medical cover options. This cover also provides some additional benefits known as Extras cover which includes optical, pharmacy, general dental and general therapies such as physiotherapy, acupuncture and Chinese medicine. Premium Overseas Visitors Cover provides benefits towards treatment and medical costs in public hospitals and private hospitals that have an agreement with Australian Unity. It also includes doctors and specialist fees and diagnostic charges that are incurred in and out of hospital. Emergency ambulance services (when admitted or treated in hospital) are also included in this cover. Total benefits are capped at $120,000 per calendar year for a singles policy and $240,000 per calendar year for couples and families. Standard Overseas Visitors Cover This health cover is a good all-round hospital cover that is suitable for singles, couples or families with dependants visiting Australia. It provides cover for hospital treatment and medical costs in private hospitals that have an agreement with Australian Unity. It also covers doctors fees and any other specialists fees or diagnostic charges that are incurred in and out of hospital. In addition you ll get cover for emergency ambulance, when admitted or treated in hospital. The total benefits are capped at $50,000 per calendar year for a singles policy and $100,000 per calendar year for couples and families. Budget Overseas Visitors Cover This cover is a basic health cover for travellers who want to be covered for unexpected medical costs whilst in Australia and is suitable for singles, couples or families with dependants. It covers a range of hospital treatments incurred whilst in a private hospital that has an agreement with Australian Unity, as well as medical services including doctors and specialists fees or diagnostic charges incurred in and out of hospital. Total benefits payable by Australian Unity are capped at $30,000 per calendar year for a singles policy and $60,000 per calendar year for couples and families. 457 Visitors Health Cover This cover is designed for individuals or families that are coming to Australia on subclass business (long stay) visa. It meets the requirements of visa Condition 8501 under which holders of a subclass 457 visa are required to have adequate health insurance for the duration of their stay in Australia. We cover you for hospital treatment and medical costs in public hospitals and private hospitals that have an agreement with Australian Unity, as well as doctors and specialists fees up to the Medicare Benefit Schedule (MBS) where you are treated out of hospital. In addition, you ll get cover for medically necessary ambulance services or transport when admitted or treated in hospital. Total benefits payable by Australian Unity are capped at AUD$1 million per person per year. It is important that you confirm if your visa subclass has health insurance requirements before selecting the Overseas Visitors Cover that is right for you. For information about Australian visas, visit the Department of Immigration and Citizenship website at immi.gov.au/immigration.htm 8 Stay well. Live longer. 9

6 Overseas Visitors Covers - Table of Benefits The information in the table below is a summary of our different Overseas Visitors Covers and it lets you know what is covered, not covered and what is restricted. For full benefit details we recommend that you obtain the relevant Product Fact Sheet(s) which can be downloaded from our website or you can contact us to have the information sent out to you. 3 3 Covered Subject to benefits of individual products 3 Partially Covered Subject to benefits of individual products 8 Not Covered Benefits Premium Overseas Visitors Cover Standard Overseas Visitors Cover Budget Overseas Visitors Cover 457 Visitors Health Cover Agreement Private Hospital Accommodation 3 3 Public Hospital Accommodation* 3 3 Doctors and Specialists fees (MBS) 3 3 Theatre Fees 3 3 Intensive/Coronary Care 3 3 Pharmacy when admitted in hospital^ 3 3 Psychiatric/rehabilitation ~ 3 3 Emergency ambulance 3 3 Medically necessary ambulance 8 Emergency medical repatriation # 3 3 Pregnancy and birth-related services Additional benefits for general treatments such as optical, dental, Chinese medicine and acupuncture. Refer to fact sheet for annual limits For hospital accommodation benefits payable in non-agreement private hospitals, please contact Australian Unity. * No daily limit applies for Premium Cover and 457 Visitors Health Cover, however, a maximum of $600 per person per day for Standard Cover and $350 per person per day for Budget Cover will apply. ^ Limit of $5,000 applies excluding 457 Visitors Health Cover where no limit applies. 10 Stay well. Live longer. ~ Only available as a result of an accident after joining, except 457 Visitors Cover, where a minimum of a 2 month waiting period applies for full benefits to be payable. # At the discretion of Australian Unity. Refer to the Terms and Conditions at the back of this brochure. 11

7 Premium Overseas Visitors Cover Standard Overseas Visitors Cover Premium Overseas Visitors Cover has excellent hospital and medical benefits for visitors of all ages. Also included are some limited extra benefits such as optical, dental and Chinese medicine. Exclusions The following treatments will not be covered under this policy: Assisted reproductive services (IVF/GIFT) Sterilisations or reversals of sterilisations Elective cosmetic surgery unless as a result of an accident or surgical scaring occurring in Australia after becoming a member Services provided outside of Australia Hospital charges including accident and emergency facility fees when not admitted into hospital Surgery by a podiatrist Waiting Periods 12 month waiting period applies to pregnancy and birth related services, psychiatric, rehabilitation and treatment of pre-existing conditions* 2 months Hospital and medical treatment (unless you join prior to or within 2 weeks of arriving in Australia, in which case the 2 month waiting period is waived) 6 month waiting period applies to optical and eye exams Standard Overseas Visitors Cover offers substantial benefits including hospital and medical care to considerable limits, as well as emergency ambulance. It also provides good cover for a family. Exclusions The following treatments will not be covered under this policy: Treatment for pre-existing conditions* Psychiatric and rehabilitation programs unless as a result of an accident occurring in Australia after joining the membership Assisted reproductive services (IVF/GIFT) Sterilisations or reversals of sterilisations Pharmacy when not an admitted patient in hospital Elective cosmetic surgery unless as a result of an accident or surgical scaring occurring in Australia after becoming a member Services provided outside of Australia Hospital charges including accident and emergency facility fees when not admitted into hospital Surgery by a podiatrist Waiting Periods 12 month waiting period applies to pregnancy and birth relatedrelated services 2 months Hospital and medical treatment (unless you join prior to or within 2 weeks of arriving in Australia, in which case the 2 month waiting period is waived) * Refer to page 30 for definition. * Refer to page 30 for definition. 12 Stay well. Live longer. 13

8 Budget Overseas Visitors Cover 457 Visitors Health Cover Don t let an accident or unexpected illness stop you from enjoying your visit to Australia. If you re fit and healthy and visiting on a visa that does not have any specific health cover requirements, Budget Overseas Visitors Cover has you covered. Exclusions The following treatments will not be covered under this policy: Treatment for pre-existing conditions* Psychiatric and rehabilitation programs unless as a result of an accident occurring in Australia after joining the membership Pregnancy and birth related services Assisted reproductive services (IVF/GIFT) Sterilisations or reversals of sterilisations Cataract procedures including lens Pharmacy when not an admitted patient in hospital Elective cosmetic surgery unless as a result of an accident or surgical scaring occurring in Australia after becoming a member Services provided outside of Australia Emergency ambulance Hospital charges including accident and emergency facility fees when not admitted into hospital Surgery by a podiatrist Waiting Periods 24 month waiting period applies to cardiac conditions 2 months Hospital and medical treatment (unless you join prior to or within 2 weeks of arriving in Australia, in which case the 2 month waiting period is waived) Want a cover that meets the requirements of visa Condition 8501 plus cover for hospital treatment and medical costs in a private or public hospital, as well as doctors and specialists fees (up to the Medicare Benefit Schedule) for both in and out of hospital consultations, then 457 Visitors Health Cover is for you. Exclusions The following treatments will not be covered under this policy: Services provided outside of Australia Elective cosmetic surgery unless as a result of an accident or surgical scarring occurring in Australia after becoming a member Assisted reproductive services (IVF/GIFT) Bone marrow and organ transplants Private hospital accident and emergency facility fees Public hospital accident and emergency facility fees when not admitted into hospital Surgery by a podiatrist Waiting Periods 12 month waiting period applies to pregnancy and birth related services and treatment of pre-existing conditions* 2 month waiting period applies to psychiatry, rehabilitation and palliative care * Refer to page 30 for definition. * Refer to page 30 for definition. 14 Stay well. Live longer. 15

9 Overseas Visitors Cover Rates Effective 1 April 2012 Single Membership Payment Frequency 3 Months 6 Months 12 Months Premium cover (65 years of age or over) Premium cover (64 years of age or younger) $ $ $ $ $ $ Standard cover $ $ $ Budget cover $ $ $ Visa 457 cover $ $ $ Couple/Family Membership Payment Frequency 3 Months 6 Months 12 Months Premium cover (65 years of age or over) Premium cover (64 years of age or younger) $ $ $ $ $ $ Standard cover $ $ $ Budget cover $ $ $ Visa 457 cover $ $ $ All rates are Goods and Services Tax (GST) inclusive and in Australian dollars. Rates may be subject to change and may vary by a few cents due to rounding. You will be notified in writing should your rate change after you join however any change will not affect amounts paid in advance. 16 Stay well. Live longer. 17

10 Additional cover for general treatment services (Extras cover) If you are planning on staying in Australia for a while, you may want to use more health related general treatment services than those covered by your chosen Overseas Visitors Cover. Visiting a dentist because of a toothache or replacing lost glasses can be very expensive. With Extras cover, you can receive benefits towards expenses associated with health services and items other than those provided in hospital or by a doctor. Purchasing additional Extras with your Overseas Visitors Cover is a great way to help you look after the general health and wellbeing of you and your family. The types of services and treatments that you can get benefits for with the purchase of additional Extras cover include: Dental treatment (general and major treatment). Physiotherapy. Optical (prescription, spectacles and contacts). Alternative therapies like shiatsu, acupuncture, Chinese medicine, massage and aromatherapy. Premium Overseas Visitors Cover includes a range of extras, however you may wish to upgrade to one of our Extras cover options below. Our Extras cover options Super Extras Super Extras is Australian Unity s highest level of Extras cover. With generous benefits on a comprehensive range of health and support services such as general dental, major dental, orthodontics, alternative therapies and ante-natal classes, Super Extras, really does support you and your family s efforts to look, feel and be in the best of health. Extras includes major and general dental, optical, podiatry and a number of other health services. Through our member benefits, you ll also get great rewards for good health choices like quitting smoking. Basic Extras If you re in good health and on a budget, Basic Extras is a great value option that has you covered with benefits on all the important must have services such as general dental, optical, physiotherapy, naturopathy and more. With Basic Extras you ll also have access to our members Wellplan program that offers great advantages, incentives and rewards on a range of activities and services that are good for your health and your pocket. Recognised Providers Benefits are only payable for services provided by private practice health service practitioners recognised by Australian Unity. These can be found by visiting australianunity.com.au/health-insurance and then clicking on Health Service Providers or by calling us on It is recommended that you ensure your practitioner is recognised by Australian Unity prior to your first consultation. Harmony Natural Therapies Harmony Natural Therapies provides benefits on a wide range of natural and complementary treatments such as acupuncture, naturopathy and aromatherapy. Even hypnotherapy and Chinese medicine are available. In addition you can also take advantage of conventional services that include dental, optical, chiropractic and physiotherapy. Comprehensive Extras Comprehensive Extras offers an excellent choice of extras for anyone looking for a broader range of health options. With benefits on a wide range of preventative health and support programs, Comprehensive 18 Stay well. Live longer. 19

11 Extras Cover Rates Effective 1 April 2012 Single Membership Payment Frequency 3 Months 6 Months 12 Months Super Extras $ $ $ Harmony Extras $ $ $ Comprehensive Extras $ $ $ Basic Extras $ $ $ Couple/Family Membership Payment Frequency 3 Months 6 Months 12 Months Super Extras $ $ $ Harmony Extras $ $ $ Comprehensive Extras $ $ $ Basic Extras $ $ $ These prices are in Australian dollars and are indicative only as some prices vary by State. Rates may vary by a few cents due to rounding and are subject to change. You will be notified in writing should your premium change after you join however any change will not affect amounts paid in advance. 20 Stay well. Live longer. 21

12 How to purchase one of our Overseas Visitors Covers Once you have reviewed the types of cover available, read the product fact sheets enclosed and determined the cover most suitable for your needs, you can purchase Overseas Visitors Cover in one of the following ways: Call us on if in Australia or if calling from outside Australia, or Previous health insurer s details - if you have previously held private health insurance with another fund in Australia, you will be asked to provide the name of your previous insurer and your membership number. You can do this by requesting a transfer certificate from your previous health fund. Medicare details if you have a Reciprocal Medicare card* and wish to apply for the Federal Government Rebate* on Extras cover please have your card ready. * Refer to the Information about health care in Australia section in this brochure for further information. Visit our website at australianunity.com.au/healthinsurance/overseas-visitors, or Post a completed application form to Australian Unity 114 Albert Road South Melbourne VIC 3205 AUSTRALIA When you are ready to complete your application we recommend that you have the following information handy: List of all people to be covered details including full name, date of birth, place of education and study completion year for any dependents who are full time students. Credit card details only if you choose to pay by credit card. Australian postal address we will need an Australian mailing address so that we can send you your Welcome Pack which includes your membership card. (You will need your membership card when you visit a doctor or seek medical treatment in a hospital). If you are unable to provide an Australian postal address at the time of your purchase, you will need to contact us later to update your details and request your Welcome Pack as it will not be sent out until you have provided an Australian address. 22 Stay well. Live longer. 23

13 Frequently Asked Questions The following section contains the answers to the most frequently asked questions. Can I purchase before I arrive in Australia? You can purchase your cover up to before you arrive in Australia. The maximum period of cover you can purchase in advance is. Australian Unity requires a minimum purchase of 3 months membership. When will my cover start? If you join and pay your premium payment before you arrive in Australia, your membership starts on the day you told us you were arriving in Australia and will continue as long as all of your forms have been returned within 14 days of arrival. If you are already in Australia when you join, your membership starts on the day you first pay your premium, or on the date you have nominated to be your start date. If you are transferring from another Australian Health Fund, you will need to nominate your start date when your first payment will begin. What happens if I need to change my cover start date? If the date of your arrival in Australia is delayed, you can also delay the date your cover starts. To change the date your cover starts, you will need to contact Australian Unity, preferably prior to your arrival. You may be asked to supply a Statement of Movement form. What happens after I join Australian Unity? Following the purchase of an Australian Unity Overseas Visitors Cover, you will receive your membership details, information about the cover you have purchased and other important information. If you do not receive the following information from us then you should contact us immediately: Health Cover Confirmation letter one of the very first things you will receive is a letter that confirms your health cover with Australian Unity. You will need to forward this letter to the Department of Immigration and Citizenship (DIAC) if you are required to provide evidence of your health cover arrangements in Australia, as part of your visa application process. If you have provided us with your address we will it to you immediately. Welcome Pack if you have provided us with an Australian mailing address you will be issued with your Welcome Pack, within 7-10 business days, which includes your membership card and other important information. You will need your membership card when you visit a doctor or seek medical treatment in a hospital. Product Fact Sheet contains complete information about the product you have purchased including what is covered, any waiting periods, and what is excluded or restricted. Overseas Visitors Membership Guide outlines the Terms & Conditions and other information about your cover. What do I need to do when I first arrive in Australia? Within the first 14 days of arriving in Australia, we require a photocopy of the pages of your passport containing the following information: Full name and date of birth Date of arrival stamp (if the date or arrival stamp is not clear, please attach a copy of your airline ticket) Unfortunately if we do not receive these photocopies within the first 14 days, a two month waiting period will apply and Australian Unity will not be able to assess any claims from you until we receive this information. The photocopies can be sent to (no stamp required): Australian Unity Member Services Reply Paid Melbourne VIC 8060 Can I extend my Overseas Visitors Cover later? You can extend your cover at anytime. Simply call our Customer Service team on with your credit card details and make a credit card payment. We will automatically send you an Account Notice (like an invoice) to your Australian mailing address closer to your cover end date for you to renew your membership. Information on the different payment options will be outlined on the back of the Account Notice. Can I suspend my membership? If you have Premium Visitors Cover or 457 Visitors Health Cover and you need to undertake an extended overseas trip or return to your home country for a period of time, you can apply for (prior to departure) a suspension of membership. You must have had your cover for at least three months. The suspension time available is a minimum of one month and a maximum of. Payments must have been made for at least one month in advance of departure date. There is a maximum of one suspension per year. 24 Stay well. Live longer. 25

14 Benefits will not be payable for any treatment that occurs during the suspension period. Waiting periods cannot be served while a membership is suspended. Suspension is not available on our Standard Overseas Visitors Cover or Budget Overseas Visitors Cover. Cooling off period We will allow any Overseas Visitors Cover health member who has not yet made a claim to cancel their policy and receive a full refund of any premiums paid within a period of 30 days from the commencement of their policy. What happens if I need to cancel my membership? If your reason for cancellation after the cooling off period is due to a visa not being granted, we will refund your policy less an administration fee of no more than $50. A copy of the letter of visa denial must also be forwarded with the cancellation request. Can I get a refund of premiums paid? If you wish to claim a refund of contributions paid in advance after the cooling off period, you must apply to Australian Unity in writing. A refund will be calculated minus an administration fee of no more than $50. Can someone else act on my behalf? Yes but we need to protect your privacy and obtain your written consent first. You will need to complete a Delegated Authority form which allows you to nominate another person who will be able to act on your behalf. This is recommend for those who are having trouble understanding or speaking English or for Couple/Family memberships where they want their partner or spouse to access information about their health cover or membership. Can I change to Australian Unity if I already have cover with another health fund? You can join Australian Unity at anythime, however we recommend that you do it within 30 days of ceasing your previous cover otherwise you will be required to serve the intital waiting periods. What happens if I become a permanent Australian resident later? Once you become an Australian resident you will be able to select from one of our many other health insurance covers as our Overseas Visitors Cover will no longer be suitable cover for your needs. So make sure you contact us on to discuss your options as we can offer a range of other covers to suit your needs. How do I find hospitals that have an agreement with Australian Unity? Most private hospitals and day facilities have an agreement with Australian Unity which guarantees that you ll be covered for accommodation and most other services like theatre fees. To find out which hospitals these are visit our website at australianunity.com.au and select health service providers. How does Australian Unity protect my privacy? The personal information, including health information that Australian Unity obtains from you is collected for the purposes of processing your application and offering and administering your health insurance as well as assisting Australian Unity obligations in developing and informing you of new products, services and special discount offers. (This is subject to your right to opt out of receiving direct marketing material at any time, simply by calling us on or ing healthcover@ australianunity.com.au ). You can view the full details of Australian Unity s privacy policy at australianunity.com.au/privacy How do I provide feedback or make a complaint? If you have feedback with any aspect of our health cover services or products, or feel that our service has failed to meet your expectations, we would like to hear from you. We are committed to resolving complaints in a fair and efficient manner and view your feedback as a vital opportunity to improve our services, products and policies. Simply contact us with all relevant information and our Customer Service Team will assist you. We also have escalation procedures in place to address your complaint. Phone healthcover@australianunity.com.au Mail Australian Unity 114 Albert Road, South Melbourne VIC 3205 If you believe that Australian Unity has not made reasonable attempts to address your complaint or you are not satisfied with our resolution, you have the option of contacting the Private Health Insurance Ombudsman. This organisation is an independent office, appointed by the Australian Government, whose services are free to all health fund members. The Private Health Insurance Ombudsman handles enquiries, suggestions and complaints and will assist you in resolving a dispute. For more information on this service visit If you wish to contact this service you may do so via any of the following channels: Phone info@phio.org.au Mail Private Health Insurance Ombudsman Level 7, 362 Kent Street, Sydney NSW 2000 Fax Stay well. Live longer. 27

15 Information about Health Care in Australia Medicare Medicare is the name of Australia s publicly funded health care system that provides no out-of-pocket or low-cost health care to Australian residents. Visitors from countries that have Reciprocal Health Care Agreements with Australia also receive limited Medicare cover, but this does not include treatment as a private patient in a private or public hospital for medical and hospital treatment or elective surgery. For more information about Medicare please ring or visit medicareaustralia.gov.au Reciprocal Health Care Agreement Australia currently has Reciprocal Health Care Agreements with New Zealand, the United Kingdom, the Netherlands, Belgium, Norway, Sweden, Finland, Italy, Malta and Ireland. If you are a resident of a country which has a Reciprocal Health Care Agreement with Australia, you are entitled to apply for restricted access to Medicare, for medically necessary treatment, only once you have arrived in Australia. To find out whether you have access to Medicare and what medical benefits you are eligible for, you should call Medicare on or visit medicareaustralia.gov.au. Taxation and the Medicare Levy To help fund Medicare, Australian resident taxpayers and residents of a country with a Reciprocal Health Care Agreement are subject to a tax known as the Medicare Levy. In most cases, the Medicare Levy is calculated at 1.5% of your taxable income. If you are on a higher income you may be required to pay the additional Medicare Levy Surcharge (MLS) (1% of your income) as part of your annual tax bill. private health insurance product with a registered health fund is eligible for the Rebate. As an overseas visitor, if you choose an Extras cover, you may be eligible for the Government Rebate on your Extras premiums. This only applies if you are from a country that has a Reciprocal Health Care Agreement with Australia and you hold a reciprocal Medicare card. To apply for the Government Rebate upfront, eligible overseas visitors must be able to provide details of their reciprocal Medicare card upon joining. All the people listed on the policy must be eligible to claim Medicare for you to receive the Rebate as a reduced premium. For further information about the Government Rebate visit medicareaustralia.gov.au. The Medicare Benefit Schedule (MBS) The Medicare Benefits Schedule (MBS) is a list of all the medical services subsidised by the Australian Government. For more information about the MBS visit the Medicare website at medicareaustralia.gov.au The Pharmaceutical Benefits Scheme (PBS) The Pharmaceutical Benefits Scheme (PBS) is a Government run scheme which provides reliable, timely and affordable access to a wide range of medicine within Australia. Under the PBS, all Australian residents and overseas visitors with selected reciprocal benefits have access to prescription medicine at a more affordable cost. More information about the PBS can be found on the Medicare website at medicareaustralia.gov.au Please note that none of the Overseas Visitor Cover options will exempt you from the Medicare Levy Surcharge. Persons who are not entitled to Medicare can seek an exemption from the Medicare levy in their income tax return. If you are a high income earner please contact us on for other health cover options. For more information on the MLS contact the Australian Taxation Office on , or visit Federal Government Rebate The Federal Government 30% Rebate on private health insurance reduces your premium and makes health insurance more affordable. Anyone who is eligible for Medicare and who takes out an eligible 28 Stay well. Live longer. 29

16 Definitions Pre-existing Conditions A pre-existing condition is any illness, ailment or condition, the signs or symptoms of which were known, or which a medical or paramedical practitioner appointed by Australian Unity considers, after examining information furnished by the member s practitioner, and other material relevant to a claim for benefits, were in existence during the six months ending on the day on which you became insured. Only with the 457 Visitors Health Cover and Premium Overseas Visitors Cover can you claim on pre-existing conditions for services provided after a waiting period of. Waiting Periods A waiting period is a period of time a member must wait before benefits are payable (make a claim). Benefits are not payable for goods and services obtained while you are serving a waiting period. For more information about waiting periods please refer to the Terms and Conditions in the back of this brochure. Exclusions An exclusion means you will not be covered for certain specified conditions, and benefits will not be payable by Australian Unity towards any treatment or service fees, such as doctors or hospital bills. Contact Australian Unity on to check what exclusions apply to your selected level of cover. Restricted Benefits Restrictions apply to selected hospital treatments and services that will be covered at a reduced level of benefit. This benefit will be paid by Australian Unity at an amount equal to the cost of a shared room in a public hospital with no intensive or coronary care, labour ward or theatre fee benefits. If you are treated in a private hospital, you will be required to pay the difference, which may be a significant out-of-pocket cost. Contact Australian Unity on to check if benefit restrictions apply to your selected level of cover. 30 Stay well. Live longer. 31 Application Form for Overseas Visitors Cover Please use a black or blue ballpoint pen OFFICE USE ONLY Membership no. IMPORTANT: Please read the product fact sheet and Overseas Visitors Health Cover guide. Once you have completed your application you must sign the Declaration on the back of this form (section 9). 1. To apply for Australian Unity s Overseas Visitors Cover please provide the following details: Title Surname First name Date of Birth (dd/mm/yy) / / Address in Australia (if known) City/Town State Postcode Telephone (home) Telephone (work) Mobile Address in country of origin City/Town State Country Postcode Telephone (home) Telephone (work) Visa subclass Expiry date / Passport number Expiry date / 2. Which Overseas Visitors Cover do you wish to have? 3. Would you also like Extras cover? Yes No I wish to purchase: Standard cover Premium cover Budget cover 457 Visitors cover If yes, please select which Extras cover you would like to buy: I need cover for: Single Couple or Family Basic Extras Comprehensive Extras If you selected Couple or Family, please provide details of the other people to be included on this cover. Date Sex Full-time Relationship First name Surname of Birth M/F student to applicant dd/mm/yy Yes/No Son Robert Sample 21/2/90 M Yes e.g. Harmony Natural Therapies Cover Super Extras Are you an Australian Medicare card holder? If so, please insert number: 4. Do you, your spouse/defacto or dependants have any ailment, disability, illness or pre-existing condition? Yes No Should you, your partner or dependants have a pre-existing medical condition, please supply details of the condition below. Failure to advise us of these conditions may result in benefits not being paid where the condition or illness treated is found to be pre-existing. For further information see the enclosed Terms and Conditions. Surname First name Condition 5. When would you like to commence your Overseas Visitors Cover? I wish to commence my cover from the date my application is accepted OR I wish to commence my cover from / / (specify date dd/mm/yy: Cannot be backdated) Initial length of cover: 3 months 6 months Expected length of stay: months Reason for visit/stay in Australia: Work using 457 visa Work Tourism Retirement Study Other 6. Payment options Payment is for initial length of cover. Before your membership expires Australian Unity will send an account to your address so you may extend your Overseas Visitors Cover if you wish. I wish to pay by Cheque and I have attached payment of (AUD$) Credit Card Card Type Mastercard Visa Amex Amount Paid $ Card No. Expiry date / Name on credit card Cardholder s signature 7. GST information Is your employer paying for your health cover contributions? Yes No

17 OFFICE USE ONLY Agency code Arrival date H234 4/11 By Mail By Fax From within Australia (no stamp required) From Overseas From within Australia Australian Unity Health Membership Australian Unity Reply Paid Albert Road Melbourne VIC 8060 South Melbourne VIC 3205 AUSTRALIA Please return this completed application to: Where the date of entry to Australia is not visible on your passport or visa, also attach a copy of your airline ticket or boarding pass. Copy of date of arrival stamp. Your full name and date of birth as shown in the passport. * To confirm your eligibility for Overseas Visitors Cover, you will need to provide, within 14 days of the date of entry to Australia, a photocopy of the pages of your passport which contains the following information: Payment is attached OR credit card details completed. Both sides of this application form are completed. CHECKLIST Make sure you have done the following before sending this application to Australian Unity. Signature of applicant Date / / I have read understood my duty of disclosure and confirm that the answers and statements in this application are correct and that no information has been withheld which may affect the decision to accept this application or the terms and conditions. I declare the information on this application to be true and correct and that I accept and agree to abide by the health benefit fund rules of Australian Unity Health Limited (ABN ), a summary of which is set out in the Terms and Conditions of the Overseas Visitors Health Cover guide. I have read and understand the information contained in the product fact sheet and the Overseas Visitors Health Cover guide, including that regarding pre-existing conditions, waiting periods and benefit exclusions. I also confirm that where this form contains personal information about other persons, I have obtained all necessary consents to disclose that information to Australian Unity, and have the authority to act on those persons behalf. I authorise all such persons to make claims on this policy. I acknowledge that the personal information Australian Unity collects from me is collected for the purpose of processing this application, fulfilling Australian Unity s obligations in providing services to me, for the development of products and services, and to allow the Australian Unity Group to market products and services. A current sample of those products and services appears on the back of the Overseas Visitors Health Cover guide. By submitting this application form, I consent to the Australian Unity Group collecting and using this information for these purposes. I authorise Australian Unity to obtain from any previous fund, personal information about me or any others covered under this policy, for the purpose of continuity of health cover. 9. Declaration Signature Date / / as of / / and obtain details about my membership. I further request you to forward a Transfer Certificate directly to Australian Unity Health Membership, 114 Albert Road, South Melbourne VIC 3205 I hereby authorise Australian Unity to terminate my membership with your organisation as a (please tick one) single person couple family / / Date paid to Cover name / Code Name of existing health fund Membership Number Residential Address Suburb State Postcode / / Transfer Certificate Request Form (please print) Title Surname First Name Sex M/F Date of Birth Stay well. Live longer. If you require another Transfer Form, photocopy this section, or call Your previous fund will subsequently forward a Transfer Certificate to us that will confirm your previous cover details so we are able to apply all appropriate waiting period waivers on your new membership. If your previous fund sends you the Transfer Certificate directly, you must forward it to Australian Unity within 7 days for processing. The Transfer Certificate will determine your Federal Government 30% Rebate on Private Health Insurance and it will also identify you and your partner s Lifetime Health Cover status including your certified ages at entry, any applicable loadings and accumulated days without hospital cover. Please note: You must personally advise your bank to cancel your deduction if you have a direct debit arrangement with your existing health fund. 8.Transfer Certificate Request Complete this form only if you are transferring from another fund and Australian Unity will cancel your existing health fund I understand that I may terminate this authority at any time in writing to Australian Unity. I have read and understood Australian Unity s Privacy Policy and will communicate information contained in the Policy to the Authorised Person nominated on this form. I declare that the information I have provided is correct. I understand that there are penalties for giving false or misleading information. Enduring (for the lifetime of my membership or when terminated upon written request from me) Fixed by the periods: Start date / / End date / / The duration of the granting of these rights is: I nominate this person to conduct all business with Australian Unity on my behalf. Telephone Date of Birth / / Address Authorised Person Do you want another person to deal with Australian Unity on your behalf? Australian Unity cannot discuss your Overseas Visitors Cover with anyone else without your permission. If you fill in this section, you will provide another person ( Authorised Person ) with the authority to deal with Australian Unity on your behalf. 8. Delegated Authority Terms & Conditions 1. Eligibility A person may purchase Overseas Visitors Cover if the person is a resident of an overseas country and visiting Australia on a temporary basis, a citizen of an overseas country intending to reside permanently in Australia or a citizen of Australia who is residing overseas PROVIDED THAT in all cases the member is ineligible for full Medicare benefits under the Health Insurance Act Any member that becomes eligible for full Medicare benefits should contact us immediately to arrange alternative cover as they will no longer be entitled to coverage under their Overseas Visitors Cover. 2. Single/Couple/Family membership Single membership covers the member only. A couple/family membership covers the member, spouse/defacto (if any) and their dependant children up to the age of 23 years. Children can also be included under a couple/ family membership while they remain unmarried and continue to attend an Australian Unity approved full-time course of study at a school, college or university in Australia up until the age of 25 years. 3. Accident Accident means any injury inflicted as a result of unintentional and unexpected actions or events which requires treatment by a registered medical practitioner, but excluding accidental illness, surgical procedures, pregnancy, injuries or illnesses induced by alcohol, drug dependence or aggravation of a pre-existing condition. 4. Members transferring from other funds 4.1) Overseas Visitors Cover (Premium, Standard, Budget) If a member joins Australian Unity within 30 days of ceasing their previous overseas visitors cover from another Australian registered private health fund, the initial two-month waiting period will be waived. A Transfer Certificate from the previous private health fund must be supplied. All other applicable waiting periods such as for pre-existing conditions and obstetrics will apply. 4.2) 457 Visitors Health Cover If a member takes out Australian Unity s 457 Visitors Health Cover within 30 days of ceasing coverage under a health insurance policy that meets the health insurance requirements for a 457 visa with another Australian registered private health fund, the years of membership and benefits paid with the previous health fund will be taken into account when calculating Australian Unity waiting periods and benefits payable. 4.3) Extras cover Years of membership and extras benefits paid with another Australian registered private health fund will be taken into account when calculating Australian Unity waiting periods and extras benefits payable if the member takes out an Australian Unity Extras product within 30 days of ceasing extras membership with their previous private health fund. Note: Members should request a Transfer Certificate from their previous private health fund after joining Australian Unity, or tick the Request for Transfer Certificate, in the My Health Fund Details section of the application form Waiting periods Hospital and Medical Cover The tables below contain details of hospital benefits and waiting periods for the various Overseas Visitors Covers. Premium, Standard, Budget Hospital benefits and waiting periods All hospital/medical treatment (unless the member joins prior to or within two weeks of arriving in Australia, in which case the two month waiting period is waived) All childbirth, pregnancy and related obstetric services; only applicable to Standard and Premium covers All Psychiatric and Rehabilitation in a Private hospital; only applicable to Premium cover All pre-existing conditions*; only applicable to Premium cover All Cardiac conditions; only applicable to Budget cover 2 months 24 months 457 Visitors Health Cover Hospital benefits and waiting periods All psychiatric and rehabilitation All pre-existing conditions* All childbirth, pregnancy and related obstetric services 2 months * A pre-existing condition is any illness, ailment or condition, the signs or symptoms of which were known, or which a medical or paramedical practitioner appointed by us considers, after examining information furnished by your doctor, and any other relevant information, were in existence at any time during the six months ending on the day on which you became insured. This is irrespective of whether you were aware of the illness, ailment or condition. 35

18 6. Waiting Periods for Extras Cover Premium cover is the only Overseas Visitors Cover that includes benefits for general treatment like physiotherapy, dental and acupuncture. However, separate Extras cover which offers benefits towards these services, can be purchased at a minimal cost in addition to the other Overseas Visitors Covers (Standard, Budget and 457 Visitors Health Cover). The following tables set out the waiting periods for Extras benefits. No benefits are payable during the waiting periods. Extras benefits Premium cover only Optical benefits and eye examinations All pre-existing conditions* Extras benefits All other Extras cover options Extraction of wisdom teeth Optical St John Ambulance First Aid Course Pre-existing conditions Major dental (including dentures, crowns, bridgework, implants) Orthodontics e.g. braces Orthotics e.g. shoe inserts Hearing aids Blood glucose monitors/blood pressure monitors Asthma pumps/peak flow meters TENS pain control machine C-PAP airways pressure machine Non-surgical prostheses Waiting Period 6 months Waiting Period 6 months 6 months 6 months * A pre-existing condition is any illness, ailment or condition, the signs or symptoms of which were known, or which a medical or paramedical practitioner appointed by us considers, after examining information furnished by your doctor, and any other relevant information, were in existence at any time during the six months ending on the day on which you became insured. This is irrespective of whether you were aware of the illness, ailment or condition. When upgrading your cover you may claim benefits at the higher rate for services provided on and from the date of the upgrade. However, where a waiting period applies to a service the benefit paid is equivalent to what would have been paid under your previous cover for that service (provided you have served applicable waiting periods under the previous cover) until the waiting period on the higher cover has been served. Dental maximums - Extras cover. Dental benefit maximums under Extras cover are different and can affect a member s dental entitlement when transferring from one Extras product to another. Additional qualifying periods apply when transferring to Comprehensive Extras or Super Extras from Basic Extras for major dental treatment such as crowns or bridges and for overall dental maximums. 7. Medical benefits Medical benefits will be paid to the levels detailed in the Australian Unity Overseas Visitors Health Cover Product Rules. The reference document for the payment of medical benefits will be the Medicare Benefits Schedule of Fees and Services. The method and guidelines to determine the amount of an eligible claim for medical benefits will be as detailed in the Medicare Benefits Schedule, as at the date a professional service was rendered. Benefits under Australian Unity s Medical Gap Cover Scheme are not available under these covers. Members will have an out-of-pocket cost if the medical practitioner charges more than the benefits paid by Australian Unity. 8. Exclusions from benefits The following are excluded services: 8.1) Overseas Visitors Cover (Premium Standard Budget) Pre-existing conditions on Standard and Budget cover IVF, GIFT and all infertility/sterility treatment programs Psychiatric and rehabilitation programs/services unless as a result of an accident occurring in Australia after the member was accepted for membership. Premium cover offers benefits on psychiatric and rehabilitations services after continuous membership Elective cosmetic surgery unless as a result of an accident or surgical scarring occurring in Australia after the member was accepted for membership Fees charged by hospitals where the member has not been admitted to hospital (e.g. hospital fee for treatment in Emergency Department) Non-hospital pharmacy (Premium cover offers benefits under Extras cover) Emergency ambulance is excluded on Budget cover Obstetrics, child birth and pregnancy services are excluded on Budget cover Benefits for cataract conditions are excluded on Budget cover Services provided outside of Australia 8.2) 457 Visitors Health Cover IVF, GIFT and all infertility/sterility treatment programs Elective cosmetic surgery unless as a result of an accident or surgical scarring occurring in Australia after the member was accepted for membership 36 Stay well. Live longer. 37

19 Emergency department fees charged by a public hospital where the member has not been admitted to hospital Emergency department fees charged by a private hospital Non-hospital pharmacy Bone marrow and organ transplants Surgery by a podiatrist Services provided outside of Australia 9. Compensation from other sources Benefits are not payable where a member has a right to claim damages, compensation or benefits from any other source or where such a right to claim later arises. The member is required to reimburse Australian Unity for any benefits paid where damages, compensation or benefits are later received from another source. Please contact our claims policy department for information concerning compensation claims. 10. Extent of benefits 10.1) Benefits on Hospital cover All covers Benefits are limited to the insured rate or actual amount charged, whichever is the lesser. Conditions and benefits apply as at the date of service. Payment of benefits on Hospital cover for hospitalisation in excess of 35 days will require medical evidence to be provided to Australian Unity, certifying the need for on-going acute care in hospital. Surgical procedures listed on the Government Exclusion List may require medical certification before benefits are payable. Hospitalisation benefits are available at the insured rate for 365 days per year subject to medical certification as to the need for on-going acute care or until the yearly maximum benefit entitlement has been paid. 10.2) Public hospitals or non-agreement private hospitals - Budget and Standard Overseas Visitors Cover Subject to total benefits set out in Condition 12, benefits for accommodation in public hospitals or non-agreement private hospitals are limited to a maximum of $350 per person, per day on Budget cover and $600 per person, per day on Standard cover. Premium cover has no daily limits. 10.3) Non-agreement private hospitals Premium cover and 457 Visitors Health Cover Benefits for accommodation in non-agreement private hospitals are limited. Please contact Australian Unity for benefits entitlements. 10.4) Benefit Restrictions 457 Visitors Health Cover Limited benefits apply to hospitalisations for obstetrics, rehabilitation, psychiatric or palliative care. Benefits paid will be limited to the rate of a shared room in a public hospital. 10.5) Dental benefits - Premium Overseas Visitors Cover Please contact Australian Unity to confirm the benefits applicable before proceeding with any treatment. 10.6) Ambulance transportation benefits Under Standard and Premium cover, benefits are payable for emergency ambulance transportation for treatment at a hospital. The account must be coded as an emergency by the Ambulance Service to qualify for benefits. Benefits under 457 Visitors Health Cover are payable for medically necessary ambulance transportation where there is a clinical need for para-medical supervision during transportation to a hospital or other approved medical facility due to the patient s medical condition. Benefits will not be payable on ambulance transportation where the member is covered under an ambulance subscription scheme or the transportation is claimable from another source. 11. Pharmacy benefits when admitted to hospital 11.1) Overseas Visitors Cover (Premium Standard Budget) Benefits payable toward the cost of in-hospital pharmaceuticals will be limited to a maximum of $5,000 per person per calendar year. Benefits are payable for drugs prescribed on discharge from hospital or for any pharmaceutical prescriptions outside of hospital for members on Premium Cover (please refer to your Extras benefit entitlements for limits) however these are not available for members on Standard or Budget cover. 11.2) 457 Visitors Health Cover Benefits payable are limited towards the cost of in-hospital pharmaceuticals only. There are no benefits payable for drugs prescribed on discharge from hospital or for any pharmaceutical prescriptions outside of hospital. Note: Members with 457 Visitors Health Cover, Budget or Standard cover requiring insurance for pharmacy scripts outside of hospital should consider taking out Australian Unity Extras cover. 12. Total benefits All yearly maximums and benefit limits are calculated from 1 January through to 31 December each year. The total overall benefits payable by Australian Unity in a calendar year for each level of Overseas Visitors Cover are: Budget Overseas Visitors Cover: AUD$30,000 per person up to a maximum per family of $60,000. Standard Overseas Visitors Cover: AUD $50,000 per person up to a maximum per family of $100,000. Premium Overseas Visitors Cover: AUD $120,000 per person up to a maximum per family of $240, Visitors Health Cover: AUD $1 million maximum per person. 13. Claims Benefits are not payable for periods during which a membership is in arrears nor are they payable on claims submitted more than two (2) years after the date of service. 14. Liability Australian Unity may refuse to pay a claim should an application or claim form contain false or inaccurate information or where membership payments are in arrears. 15. Membership application/renewal The company reserves the right to decline an application for membership or to decline to renew the membership of a member. 38 Stay well. Live longer. 39

20 16. Membership arrears All contributions should be paid in advance. Failure to pay a contribution within 60 days of the expiration of the last contribution period will result in cessation of the membership and benefit entitlements. 17. Membership suspension Members covered under Premium and 457 Visitors Health Cover who need to undertake an extended overseas trip or return to their home country for a period of time may apply for (prior to departure) a suspension of their membership. Eligibility criteria for temporary suspension: Minimum period of membership 3 months Minimum suspension time 1 month Maximum suspension time There is a maximum of one suspension per year Benefits will not be payable for any Hospital or Extras services that occur during the suspension period. Waiting periods cannot be served while a membership is suspended. Policy payments must be at least one month in advance prior to any suspension. 18. Cooling Off Period We will allow any Overseas Visitors Cover health member who has not yet made a claim to cancel their policy and receive a full refund of any premiums paid within a period of 30 days from the commencement of their policy. 19. Refund Policy General refund request - After the cooling off period a member wishing to claim a refund of contributions paid in advance must apply to Australian Unity in writing. A refund will be calculated minus an administration fee of no more than $50. Refunds due to unsuccessful visa applications - Where the applicant was unsuccessful in obtaining an entry visa to Australia and a policy cancellation request is received after the cooling off period, a refund of premiums paid will be calculated minus an administration fee of no more than $50. In this case, a copy of the letter of visa denial must also be forwarded with the cancellation request. 20. Visa Requirements 20.1) Overseas Visitors Cover (Premium, Standard, Budget) It is the responsibility of the member to understand their visa requirements as set out by the Department of Immigration and Citizenship and to ensure that the health insurance purchased meets these requirements. 20.2) 457 Visitors Health Cover While Australian Unity has endeavoured to provide a compliant cover, which meets the requirements of visa Condition 8501 for holders of subclass 457 Visa, it is the responsibility of the member to understand their visa requirements as set out by the Department of Immigration and Citizenship and to ensure that the health insurance purchased meets these requirements. 21. GST A Goods and Services Tax (GST) applies (currently 10%) to Overseas Visitors Cover in accordance with A New Tax System (Goods and Services Tax) Act GST does not apply to Extras cover. 22. Medical repatriation The provision of this benefit is at the discretion of Australian Unity. Up to $20,000 in benefits (included within the overall yearly limit set out in Condition 12) will be payable for medically necessary services and transportation and where a medical or paramedical practitioner appointed by Australian Unity considers, after examining information furnished by the member s practitioner (and other material relevant to a claim), that it is medically necessary to repatriate the member to their country of origin. Benefits will not be payable for medical repatriation in respect of: any pre-existing conditions for Standard and Budget members; any pre-existing conditions known to a Premium or 457 Visitors Health Cover member or their medical practitioner at the time of joining Overseas Visitors Cover but not declared on the application; or treatment which in the opinion of our practitioner could be delayed until the member s scheduled original date of return to their country of origin. 23. Recognised providers Benefits are only payable for services provided by private practice health service practitioners which are recognised by Australian Unity. Recognition of health service practitioners is subject to change without notice. Recognition by Australian Unity is for benefit payment purposes only and should not be taken or construed in any way as sponsorship, approval of, or any recommendation as to the qualifications and skills of, or services provided by, a practitioner or therapist. Members should check that their practitioner is recognised by Australian Unity before commencing treatment. 24. Agreement hospitals Agreement hospital means a private hospital or day hospital facility that has entered into a hospital purchaser-provider agreement with Australian Unity. Please contact Australian Unity for a list of agreement hospitals. 25. Age upon application The age of a member at the time of joining is a determinant of the premium of Premium Overseas Visitors Cover. The premium is classified into two price tiers: under 65 years and 65 and older. If the membership is a couple or family, the age of the oldest member will be used to determine the premium tier of the membership. 26. Notice for benefit/ rate change Australian Unity has the right to change the premium of Overseas Visitors Cover and add or remove benefits with 30 days notice. Notice will be provided in writing to the address notified to Australian Unity. Please ensure your address details are kept up to date. 27. Disclosure In order for your application for Overseas Visitors Cover to be valid, you must sign the declaration on the application form and provide details of any preexisting conditions where asked. 28. Summary of Terms & Conditions These Terms & Conditions should be used as a guide only. The complete Australian Unity Overseas Visitors Health Cover Product Rules set out in full the terms and conditions of membership under the Fund. These rules are available for inspection at Australian Unity s registered office, 114 Albert Road, South Melbourne VIC Stay well. Live longer. 41