Frequently asked questions

Please go to the registration page and fill out the form. Please remember to include first name, last name, primary contact email, and date of birth in the request. For more information visit our smart claim member portal.

Once you submit all the details required to register for the UniMed Member Portal / Smart Claim, you will receive another email asking you to reset your password. Please copy and paste your temporary password in the password field on the form to ensure all characters are accurate. You only need to reset your password once.

The registration process may take up to 24 hours or longer depending on volumes of registration requests being received. Apologies if your registration is taking longer than expected. If you prefer, you can always download our claim form from our website and send to claims@unimed.co.nz

Please download and complete the form you need and send to claims@unimed.co.nz. Alternatively, you can call us on 0800 600 666.

If you attempt but fail to sign in correctly five times, your account will be temporarily locked out. Please wait up to approximately 15 minutes before trying to log in again. Apologies for any inconvenience this may cause. 

To make a Smart Claim, you’ll need to upload digital photos or scanned copies of your invoice or receipts. 

Please make sure all details are clear and visible on the photo or scan before you upload, and note:

• Accepted file types: jpg, pdf, png, gif, tiff, xlsx or docx files.
  We strongly recommend that you convert your documents to PDF files before uploading.
• Maximum upload limit is 15mb. 

Please make sure all your files loaded don't exceed the 15mb limit.

Accepted file types include jpg, pdf, png, gif, tiff, xlsx or docx files.
We strongly recommend that you convert your documents to PDF files before uploading.

If you are not already registered for the UniMed Member Portal/Smart Claim (our online claims service) please complete a Claims form (the form can be found under Claims>other ways to claim on our website) and send this, together with the paid invoices to claims@unimed.co.nz

Yes. Please refer to this page which has an instructional video. You can also refer to our helpful user guide. 

You can now do this in the UniMed Member Portal/Smart claim. You can register for the Member Portal here. If you have not registered, then you can contact us directly via email members@unimed.co.nz or call us on 0800 600 666 and our team can help with your request.

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.

UniMed's health plans are not travel insurance plans and as such we don't 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 now do this in the UniMed Member Portal/Smart claim. You can register for the Member Portal here. If you have not registered, you can complete the form or send us an email at members@unimed.co.nz. 

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.

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. Don't 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 10 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 10 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 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

We offer two types of employer groups:

A Subsidised group – where the premiums for the employees (and sometimes their families) is paid in full or partially by the employer. When an employer fully subsidises a health insurance plan for all employees or all employees and family members, we are able to offer attractive terms (which may include discounts and cover for pre-existing conditions).

A Voluntary group – where the employer allows UniMed to promote health insurance plans to its employees at a discounted rate, but does not pay any of the premiums. These schemes have lower employee participation than subsidised schemes which means that the benefits for employers are less (lower impact on reducing absenteeism and improving productivity).

A Voluntary group gives the employer access to a discounted premium. Premiums can be paid by direct debit from the employee to UniMed or through payroll deduction with the employer remitting the money collected to UniMed.

A Subsidised group enables UniMed to offer more competitive premiums than a voluntary scheme, due to higher levels of employee participation. A subsidy may also enable UniMed to offer coverage for pre-existing medical conditions (which are excluded in voluntary schemes).

Employers can choose to offer any of our standard plans to their employees. For employers who fully subsidise their employees premiums, we have developed some exclusive health insurance plans. Our employer group plans tend to offer more generous limits than those available to private individuals.

Standard group plans available are:

• Hospital Select(a surgery plan covering the reasonable costs of surgery and related specialist and diagnostic costs, with additional optional modules to extend cover).
• UniCare Advantage(a comprehensive plan providing cover for 80% of reasonable surgical costs, and a high contribution towards the cost of consultations, diagnostics, and some everyday healthcare services such as GP fees).
• MedicalCare(a surgery and specialist consultations and diagnostics plan covering reasonable costs, with additional optional modules to extend cover).
• Health Positive(a plan covering 50% or 80% of everyday healthcare costs, consultations and diagnostics but no cover for surgery).

We will work closely with you to determine the right plan to meet your needs and objectives.

Our range of standard and group health insurance plans have been designed to meet a variety of health care needs and budgets. This includes options to cater for employers who want to limit their employee subsidy to a defined budget.

However, depending on the number of subsidised employees (and family members) you expect to include in your group scheme, we may be able to tailor a plan to suit your needs.

Depending on the number of employees (and family members) you subsidise, we can cover most pre-existing conditions.

Cover can start immediately or after a stand down period, and can be limited to a dollar value or covered to the full extent of the subsidised plan.

The range of pre-existing conditions which can be covered can be varied to include high-cost conditions such as cancer, cardiovascular or musculoskeletal conditions. Some pre-existing conditions are never covered for any member and these are listed in the exclusions sections of our Conditions of Membership.

Adding cover for pre-existing conditions is a benefit that is only available to employer group schemes, and so provides a real benefit to your employees that they would not be able to access as a private member.

If you subsidise the premiums for family members, they too can access cover for pre-existing conditions.

It depends on the number of employees and family members eligible for your group scheme and the level of subsidy that applies. Please discuss this with your Account Manager.

Employers select the plan (or plans) they will subsidise for employees, and it is possible to subsidise different plans for different categories of employees.

We do require that the same plan is offered to eligible employees in the same category. For example, you might decide that eligible employees must be permanent employees with more than 6 months’ service, but that waged employees will get Plan A and salaried employees will get Plan B. In this situation, waged employees cannot get Plan B unless there is an upgrade option available to them.

Employers select the plan (or plans) they will subsidise for employees, and it is possible to subsidise different plans for different categories of employees.

We do require that the same plan is offered to eligible employees in the same category. For example, you might decide that eligible employees must be permanent employees with more than 6 months’ service, but that waged employees will get Plan A and salaried employees will get Plan B. In this situation, waged employees cannot get Plan B unless there is an upgrade option available to them.

An eligible employee is someone who is entitled to join your health insurance scheme and receive a subsidy. You can define eligibility according to your HR strategy and goals. As long as the eligibility criteria is applied consistently, your scheme will qualify as a subsidised scheme.

Examples of eligibility include a requirement that the employee –

• has a permanent contract with their employer,
• has completed a defined period of service,
• works in a specific role or geographical location,
• has achieved a specific level of seniority,
• has a particular type of employment contract.

We understand that some employers do not consider it their role to subsidise family members or may wish to subsidise them but do not have the budget available. In these circumstances we suggest that employees add their family members onto their policy at their own expense.

We collect the premiums from employees directly by Direct Debit, or we can work with employers to set up a payroll deduction process.

Family members will be able to access discounted premiums, and in some situations they may be able to access cover for some pre-existing conditions.

If your employees have adult dependants, they are able to set up a separate policy for that child at discounted premiums. Premiums will be collected by Direct Debit.

We will work with you to determine the best method and frequency for paying premiums. Subsidised premiums are usually billed monthly, although we are able to offer quarterly, six monthly and annual in advance payment options. We invoice you in advance for the subsidised premiums and you can pay by bank transfer.

Employee-paid premiums can be paid by Direct Debit or payroll deduction. If you choose payroll deduction we will provide regular schedules of required deductions which you collect from your employees and then pass on to us. We will provide weekly or fortnightly schedules, depending on the frequency of your payroll. More and more companies prefer the easy administration of Direct Debit which does not require any involvement for your payroll team. Our network of regional Relationship Managers will ensure that Direct Debit forms are completed at the time the employee signs up.

When you are happy with the details of your group scheme (including plans, premiums and terms) your UniMed Account Manager will arrange a time to meet. At the meeting we will agree the process and timeframe for setting up your group scheme. We will do all the legwork and minimise administration effort required by your payroll team. We will agree on an employee communications plan and our regional Relationship Managers will be available to ensure that your employees understand the scheme and complete any necessary paperwork. In many situations we can add subsidised employees into your scheme without the usual requirement to fill-in a membership application form for each employee.

Your Account Manager and Relationship Managers will be available on an ongoing basis to continue employee education and sign up, or to assist with all administration requirements.

As a specialist in employer group schemes we can provide an alternative option to your current insurer. You may wish to maintain the type of cover that you have (with an alternative insurer) or make more significant changes. Our Account Manager can make suggestions to meet your current business needs and budget constraints.

To make the transition easy, we can offer “no worse underwriting terms” so that your employees do not lose cover for medical conditions they are already aware of or have experienced.

Your UniMed Account Manager will agree a transfer process and timing with you to ensure minimal disruption to your employees, and minimal administration for your payroll team. We will agree a communications process and our regional Relationship Managers will be available to inform your employees and assist them with the transfer and set up of any additional cover (e.g. upgrades or addition of family members). In many cases, we can transfer currently insured, subsidised employees without the need for each of them to complete paperwork.

You should notify the UniMed Sales team or your Account Manager as soon as the person starts work or becomes eligible for your scheme. We will then discuss the cover with your employee and ensure that they complete the correct documentation. We will notify you of the subsidy premiums, and, if applicable, the amount and frequency of any voluntary payments to be deducted from payroll.

You should notify us as soon as you can to let us know when we should remove the employee from your scheme. We will then contact the employee and discuss options for how they can continue their cover with us.

You can do this in the UniMed Member Portal/Smart claim. You can register for the Member Portal here. If you have not registered, then please complete a Claims form and send this, together with the paid invoices to claims@unimed.co.nz

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 10 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.

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.