General FAQs

Please send us an email or letter outlining your request. If you are adding a family member then you will need to complete an application form.

If the plan you are moving to is a reduction in cover, then you do not need to complete an application form, just  send us an email or letter outlining the plan you wish to move to and the date you would like this new plan to start. If the plan you are moving to is an increase in cover (i.e. upgrade), then you will need  to complete an application form including a health declaration. In all cases the request for a change of plan must be in writing, (by email or letter).

We will assess your application form and the medical declaration and determine any limitations that will apply to your new cover. In general, any exclusions on your previous policy will remain in place and you will retain cover for any pre-existing conditions to, at least, the same benefit limit as were on your previous plan. Note that the benefit itself must be present on your new plan. Medical conditions which are newly arising after the upgrade will be covered to the benefits and benefit limits of the new plan.

All requests to cancel policies must be made in writing (by letter or email). Please make this decision carefully as you will not be able to reinstate your policy and if you re-join you will probably lose cover for any pre-existing conditions that were previously covered.

UniMeds health plans are not travel insurance plans and as such we dont cover emergency treatment overseas. Some of our plans have a benefit for surgical  treatment overseas and if this is something you are considering  you should contact us to discuss whether you have any cover for your proposed treatment. (There is no cover if you did not obtain prior approval for treatment overseas).

If you have recently married and wish to take on your spouses name, please send us a copy of your marriage certificate (by email or letter) and we will update your membership.  If you changed your name by deed poll, please send us a copy of the deed poll certificate.

You can complete the form or send us an email at members@unimed.co.nz.  If you have set up an account on the Member Self Service portal, you can update contact details there (access via the link top right).

You can download a Benefit Schedule for our standard plans from the Important Documents section of the website. If you joined through an employer scheme or a UniMed partner programme, you will need to send us an email to request your Benefit Schedule. You should also read the Conditions of Membership, List of Approved Surgical Procedures and check your own Membership Certificate. Your Membership Certificate can be accessed in the Member Self Service area once you have set up an account, and the other documents are available on the Important Documents page.

There are a few reasons that you might have to pay some of the treatment costs. If you have selected a health insurance plan with an excess or if benefit limits have been reached. There may be other items that are not included in your cover 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 may be able to seek treatment from another healthcare provider whose fees are within our usual and customary” limits 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 outlining how much you are required to pay after we have made our claims payment to the healthcare provider or hospital.

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 receipts to our postal address. Dont forget to include your bank account details so we can pay your reimbursement directly to your account.

Its not mandatory, but we strongly encourage you to seek prior approval for all treatments or procedures over $500. You can find out how your UniMed health insurance cover can apply before you seek treatment. If you dont seek prior approval you risk finding out that your claim was not eligible or that the extent of cover is less than you might expect.

We issue prior approvals for a period of 3 months. If your treatment falls outside this period you should contact us to ask for the Prior Approval to be reissued.

For a prior approval to be valid your policy must be current on the date of treatment.

Your prior approval is issued for 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 provider or healthcare facility, you need to request a new or updated prior approval. This is particularly important if there are changes to your treatment plan that could affect any fees charged including changes in the type of procedure or duration of hospital admission.

We usually reimburse claims you have paid within 3 business days. If you provide us with your bank account details, we can direct credit your claims 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 required so we can understand the reason for your claim and to check eligibility for cover.

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, date of birth 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 may contact you requesting payment of their invoice.

If you are adding your newborn baby within 30 days of their birth all you need to do is email us advising the baby’s full name and DOB. If outside of the 30 days, a new application/health declaration will need to be completed for your baby.

You can pay your premiums by direct debit, cheque or credit card. We accept Visa and MasterCard.

To change your bank account, download the Direct Debit / Credit Card Authority Form and email the completed form to accounts@unimed.co.nz or click the link below to complete and submit the form online.

If we have a bank account on file for reimbursement of claims, you can change this by sending us an email to claims@unimed.co.nz

You can change the date of you direct debit. Call us on 0800 600 666 or email us at accounts@unimed.co.nz for assistance.

You will continue to receive invoices showing the outstanding premium. If your account goes into arrears for three months your policy will lapse.

When reviewing or premiums annually we consider the increasing costs of medical technology, the increasing number of claims and the cost of claims. Because there is generally a need to claim more as one gets older, premiums will increase with age.

You can review your level of cover or add an excess to your policy.

If you are part of a work scheme, it is possible that you receive a discounted premium rate. This may be different from individual members as administration and risk profile is different. You can check with your employer if they offer UniMed Health insurance.

It is possible that you receive a discounted premium rate if you are part of a group scheme. A number of factors are considered in deciding the premium rate. Some of these are:

  • The number of members in the group scheme
  • The total claims for your group scheme
  • The subsidy that is paid by your employer
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Further information

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.