Simply complete and sign the General Medical Expenses form, available on the Important Documents page. Include information about the purpose for the treatment and send this, together with the paid invoices to our postal address. Don’t forget to include your bank account details so we can pay your reimbursement directly to your account.
It’s not mandatory, but we encourage you to seek prior approval for all treatments or procedures over $500. If you don’t seek prior approval you risk finding out that your claim was not eligible or that the extent of cover is less than you thought.
We issue prior approvals for a period of 3 months. If your treatment falls outside this period you should contact us to ask for it to be reissued.
In all cases, for a prior approval to be valid your policy must be current on the date of treatment.
Your prior approval is issued on the basis of the plan we expect you to be holding on the date of the treatment. If you change your plan in the meantime you should request a new prior approval as your benefit limits and entitlements might have changed.
If there are any changes to your healthcare providers or the facility you will go to, you can request a new prior approval be issued. This is especially important if there are changes to any costs or the type of procedure or duration of stay.
We usually reimburse claims you have paid within 3 business days and if you gave us a bank account number we can direct credit the reimbursement to you on the same day we process the claim. Most prior approvals can be processed within 3 business days but more complex surgeries or situations can take longer.
This information is needed to allow us to understand the reason for your claim and to check eligibility.
Usually the specialist and hospital will send their invoices directly to UniMed, but sometimes they send them to you. As soon as you receive an invoice, send it to us, by post or by email, together with your full name, DOB and (if you know it) membership number. We can then pay the invoice directly. Don’t hold on to invoices for too long as the healthcare provider might start to chase you for payment!
There are a few reasons that you might have to pay some of the costs. If you have an excess on your policy or if benefit limits have been reached are the main reasons. There might also be amounts relating to things we don’t pay for, such as crutches or appliances. In very rare cases the shortfall could relate to the cost of the procedure being more than the cost which we consider to be “usual and customary”. In this case you can choose to see a different healthcare provider or you can pay the difference yourself.
Your excess or shortfall is payable directly to the healthcare provider(s) and/or hospital. You will receive an invoice from them after we have made our payment to them.
The information on this website is intended as a general guide. Please read your Benefit Schedule, Membership Certificate and Conditions of Membership for the full terms and conditions of your policy.