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How to Claim

Home » Claims » How to Claim

Eligibility for Claiming
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How to Claim

Use our interactive claims guide to show you the process in making a claim.

Click on the situation statements that apply to you to follow the process and requirements for making a claim for your medical treatment. Get in touch with our Claims team at any time with any queries.

I am feeling unwell

I go to the GP

- The GP diagnoses my illness, and I get prescribed medication or treatment
- I am referred for a diagnostic test and/or to a specialist and the estimated cost is over $500
- I am referred for surgery
- I have GP and prescription cover
- I do not have GP and prescription cover
UniMed is unable to process a claim of this nature.
- I pay for my appointment and prescriptions, and keep the invoices
- I find a UniMed Claim for Medical Expenses form online
Claim for Medical Expenses form
- I fill out the claim form and submit with the receipts
- This claim is processed by UniMed
Payment is made to my bank account for eligible items and a remittance advice is sent to me
- I have cover for specialists and tests
- I only have cover for specialists and tests when directly related to surgery and within a timeframe of the surgery
I hold onto the invoice(s) for the consultations and tests and can claim them if related surgery occurs

Make a claim
- I request prior approval from UniMed by supplying a specialist report/referral letter and estimates
- UniMed advises my level of cover
- I have the test and send the invoice(s) to UniMed for payment together with the Confirmation of Surgery form
Confirmation of surgery form
UniMed pays the provider directly
- I have surgical cover
- I have no surgical cover
UniMed is unable to grant prior approval
- The specialist diagnoses my condition and determines the course of treatment
- If surgery is needed due to an injury I need to get an ACC decline letter first
ACC claims information
- I obtain the medical report, cost estimates and intended dates of treatment from the specialists
- I provide this documentation to UniMed and complete the Prior Approval form for prior approval
Prior approval form
- UniMed notifies me of my level of cover and any excess and estimated shortfall that I must pay
- I have the procedure
- I send UniMed the hospital and surgeon invoices with a completed Confirmation of Surgery form
Confirmation of surgery form
UniMed pays the invoices directly to providers and advises me of payment and any shortfall or excess which I pay to the provider
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Make a claim

Have a look at our claims checklist, and get your claim underway.

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