Our Terms and Conditions are changing
We’re updating some of the key documents that make up a UniMed Member's policy from 1 April 2026
- Terms and Conditions will replace Conditions of Membership
- List of Approved Healthcare Services will replace Approved and Unapproved Surgical Procedures
- List of Unapproved Healthcare Services will replace Unapproved Medical Services and Approved and Unapproved Surgical Procedures
These changes do not apply to all UniMed Health Plans. Please see details and key updates summary below.
Which clients do these changes apply to?
Why are these changes being made?
What are the key updates?
The below changes take effect from 1 April 2026.
1. Conditions of Membership
Terms and Conditions will replace Conditions of Membership.
Key changes include:
- Babies (up to 3 months of age) can be added to policies with no underwriting (previously 30 days).
- Suspension rules have been clarified (minimum membership requirements, timeframes between suspensions) and new suspension options have been introduced.
- Modules can now only be removed at the start of the policy year.
- General exclusions have been consolidated and simplified, with clearer explanations of what is not covered.
- The Member conduct and misrepresentation framework has been updated, including:
- A new Vulnerable Member section
- A new Unacceptable Member Behaviour section
- Strengthened disclosure requirements.
- Additional detail has been added relating to ACC, drug cover, reasonable charges, eligibility, and membership rules.
- Terminology has been updated to plain English for improved readability.
2. Approved and Unapproved Surgical Procedures
List of Approved Healthcare Services will replace Approved and Unapproved Surgical Procedures.
List of Unapproved Healthcare Services will replace Unapproved Medical Services and Approved and Unapproved Surgical Procedures.
Key changes include:
- The lists have been modernised to remove duplication and adopt current clinical terminology.
- Changes have focused on clarifying coverage, not reducing cover or assessing or introducing new healthcare services.
