How do I make a claim on my extras cover?
There are many ways to claim your extras benefit, including through the Union Health mobile app.
Electronic claiming services
On-the-spot claiming is available at a range of extras providers via electronic claiming terminals such as HICAPS or HealthPoint.
To claim your benefit, simply swipe your membership card and your claim is processed straight away. All you have to pay is the balance. Please note claiming via HICAPS is unavailable for some services.
Medical expenses while in hospital
If your doctor or specialists have agreed to charge you under the Access Gap Cover Scheme, they'll charge us directly for your hospital treatment. If your doctor doesn't use Access Gap Cover, they may send you an account. You can take this to Medicare and then to us for payment.
Just use our claim form and make sure you include the “Statement of Benefits” from Medicare with your claim. Medicare will pay 75% of the Medicare Benefits Schedule (MBS) Fee and we will pay the remaining 25% of the MBS Fee. You will need to pay any amount the doctor charges above the MBS Fee.
What is not covered?
We pay benefits in accordance with the law and TUH Fund Rules and policies. We do not pay hospital benefits for:
Admissions that occurred during your waiting period
Booking fees including cancellation fees
Treatment that is excluded from your policy
Treatment provided as part of an aged care service
Elective procedures that are not considered to be medically necessary e.g. cosmetic surgery
Treatment provided in an emergency department or associated short stay unit of a hospital
Treatment for which you have received compensation or damages
Restrictions may apply for multiple treatments on the same day.
