Frequently asked questions

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You can request to add a family member to your policy through your Member Portal.

If you’re on a Health Plan originally issued under the Accuro brand, please contact us to add or remove family.

To remove someone from your policy, please contact us.

If you are reducing your cover (e.g. moving to a plan with lower benefit limits, removing a module or increasing your excess), then you do not need to complete a new application or health declaration.

If you are looking to increase your cover (e.g. move to a Health Plan with higher benefit limits, add a module that requires underwriting such as the Specialist module, or decreasing your excess), then you will need to complete an application including a health declaration.

To make a change, please contact us.

We recommend discussing with your financial adviser if you are considering changes to your plan.

When you increase your cover by upgrading your Health Plan, we will assess your application and health declaration and determine any personal exclusions that may apply to your new cover.

We recommend discussing with your financial adviser if you are considering changes to your plan.

Please contact us to cancel your policy – this request needs to be made by the Primary Member.

If you are experiencing financial hardship, we can support you with a suspension period of up to 12 months. See here for more information or contact us to discuss suspension options.

Please decide carefully if you wish to cancel. You will have 30 days from the cancellation date to reconsider and reinstate your policy. After that time, if you want to re-join this may require a new application and health declaration to be completed.

This means you will probably lose cover for any pre-existing conditions that were previously covered. New personal exclusions and no-claiming periods may apply and you will lose any loyalty benefits for which you were eligible.

We recommend discussing with your financial adviser if you are considering cancelling your policy.

Our Health Plans are not travel insurance plans and are not set up to cover treatment overseas.

Some of our Health Plans have a benefit for surgical treatment overseas. You must obtain prior approval first or there is no cover. Submit a prior approval request through your Member Portal, or contact us to discuss whether you have any cover for your proposed overseas treatment.

Please ensure you have travel insurance in place before leaving New Zealand. UniMed Members receive 15% off travel insurance through Allianz Partners. See here for more information.

Please contact us to update your name.

Other contact details (and your name if you’re on a policy originally issued under the Accuro brand) can be updated in your Member Portal.

We may require documentation to support your name change request.

Please do this through your Member Portal.

We always recommend using a personal email address (rather than your work email).

You can also complete this form.

Your Health Plan document sets out the services and benefits covered under the Health Plan.

Your Membership/ Policy Certificate contains the details that are specific to your own policy, including personal exclusions you or other people on your policy may have, any additional modules, as well as any excess.

There are a number of other documents that make up your policy. This depends on the brand the policy was originally issued under – UniMed or Accuro.

Some Health Plan documents contain all Terms and Conditions within them, and others refer to separate documents including Terms & Conditions. We will align these over time.

Please refer to your welcome pack, your Member Portal, the Important Documents page, or your group insurance scheme webpage (if applicable).

If you’re unsure or can’t locate a document, please contact us.

You can apply for prior approval to confirm your cover before a medical procedure or treatment. Please do this through your Member Portal or by contacting us.

Congratulations! Simply contact us with your baby’s full name and date of birth.

If you are adding your baby up to the age of 3 months, you do not need to complete a health declaration.

If you’re adding your baby after 3 months of age, a new application/health declaration will need to be completed for your baby.

Note, the timeframe for which you can add your baby without needing to complete a health declaration may differ according to your Health Plan. Please contact us as soon as possible after your baby is born.

Our preferred payment methods are direct debit or recurring credit card. We accept Visa and MasterCard.

You can also request to pay by invoice.

To change your details for making payments, please complete and return the Payment Authority /Payment Method Form.

You’ll find this on the Important Documents page and the form to use depends on whether your Health Plan was originally issued under UniMed or the Accuro brand.

For claim reimbursements, simply update your bank account details when you submit your claim in your Member Portal.

Yes, please contact us to do this.

If you have not paid your premium for 3 months (i.e. it is in arrears, or overdue) then your policy will be cancelled.

If you are in a group insurance scheme and paying some of the premium yourself and its 3 months in arrears, your policy will be downgraded to the level covered by your employer.

It is important to keep your payments up to date, as we may not pay claims or issue prior approvals if your premium is overdue/ you’re in arrears.

We do have options if you are in financial hardship, please see information about our financial hardship suspension, or contact us.

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

There are a range of options to help manage your premium, including changing to a different Health Plan, adding or increasing your excess, or removing optional modules.

Please contact us and we can work through the options with you and provide quotes.

If you are experiencing financial hardship, we encourage you to please get in touch.

An excess is the amount you must pay when you have a claim, before we pay the rest (up to the benefit limit).

For example, if the excess on your plan is $250 and we accept a claim for a CT scan costing $2,000, we’ll pay $1,750 and you would pay the excess balance of $250 to the clinic providing the CT Scan.

Increasing the excess on your health plan will reduce the overall premium that you need to pay. However, if you later want to decrease your excess, you may need to complete a health declaration and underwriting may apply. This may result in exclusions and/or stand down periods being applied to your policy.

Your excess, how it applies and on what benefits/modules, will be specified in your Health Plan document and in your current Membership/ Policy Certificate.

There are two types of exclusions:

• General exclusion means a condition, treatment, or situation that we do not cover for any Member. These are listed in our Terms & Conditions/ Conditions of Membership or in your Health Plan document (for policies issued under the Accuro brand).
• Personal exclusion (sometimes referred to as an endorsement) means signs, symptoms, medical conditions or body parts that we do not cover for a particular Member, as specified on your Membership/ Policy Certificate. Not all pre-existing conditions will require an exclusion, however our team do need to know about all previous and current signs, symptoms and conditions.

Personal exclusions are excluded for different lengths of time (from 1 year to life) or restricted in cover, and will be listed on your Membership/Policy Certificate against each Member.

Pre-existing condition means:

• any health or medical condition you are aware of, or any signs or symptoms that you are currently experiencing or have experienced in the past, that occurred before the start of your policy,

or

• a medical event that occurred before the start of your policy. 

Health insurance is set up to cover the unexpected, so we ask that you tell us about all your pre-existing conditions, current or previous.

Not all pre-existing conditions will be excluded from cover. However, to be able to tell you what isn't covered you will need to be honest about your medical history in your application. If a pre-existing condition isn’t declared when you apply for cover and you submit a claim for that condition, it could be declined so it is always best to declare everything as best you can.

Some Health Plans or additional modules have a no-claiming period. This means that we will not pay a claim for an event that occurred during that specified period.

If a no-claiming period applies, this will be stated in your Health Plan document.

If a Member is added to your policy later, then the no-claiming period for them will begin from their start date.

You may also see this referred to as waiting period, stand-down period or qualifying period.

Active Benefits are services included in your cover and are designed to help prevent illness, boost energy, and support lifelong wellbeing.

You can find out more here.

Some benefits are only available under specific Health Plans.

A loyalty benefit is a benefit you can only claim against or qualify for after a specific period of continual cover on your policy, such as 3 years.

To find out what loyalty benefits you may be entitled to, check your Health Plan document on your Member Portal.

If your Health Plan is not on our website, it’s likely that it’s one we no longer offer to new Members.

Please see your Member Portal for your Health Plan document or view Important Documents.

You can search for a registered specialist on the Medical Council of NZ website or we recommend speaking with your GP.

Some of our Health Plans offer lower premiums to non-smokers/vapers and people who have quit smoking or vaping for 12 months or more.

Each Health Plan has different benefits.

You can check your Health Plan document in your Member Portal to see if it includes cover for GP visits or contact us to discuss if this is something you can add to your Plan.

Each Health Plan has different benefits.

You can check your Health Plan document in your Member Portal to see if it includes cover for dental costs or contact us to discuss if this is something you can add to your Plan.

If your surgery is required due to the result of an accident or injury, then you need to apply for cover through ACC first.

If ACC decline your treatment, you can then apply for prior approval or contact us to clarify if your Health Plan provides cover for the surgery.

We may require some extra information from you which allows us to work on your behalf to seek a review through ACC.

Only some of our Health Plans and modules provide reimbursement of medical costs incurred for non-acute (non-urgent) medical conditions that are treated in Australia.

Please note that this benefit is only available on the Hospital and Surgical module and not additional modules (e.g. Surgical, Dental and Optical, GP, Natural Health).

Always refer to your Health Plan document for full benefit terms and conditions and ensure to apply for prior approval prior to undertaking any treatment. If you require further clarification, please contact us.

Everyone’s situation is different.

Depending on your circumstances, examples of how we can provide extra care and support include:

• Adjusting how we communicate with you (e.g. simplifying language, written follow-up) or allowing extra time for decisions or discussions
• Engaging with an authorised trusted support person or representative about your policy
• Providing flexible payment options or policy suspension support 
• Encouraging independent advice.

To discuss how we can support you, or to appoint an authorised person who can act on your behalf regarding your health insurance, please contact us.

We offer two types of group insurance schemes:

• A subsidised group – where the premium for the employees is paid in full or partially by the employer. When an employer fully subsidises health insurance for all employees, or all employees plus their family members, we can offer attractive terms (which may include cover for pre-existing conditions).
• A voluntary group – where the employer allows UniMed to promote health insurance to its employees at a reduced premium, but the employer does not pay any of the premiums. These schemes usually have lower employee participation than subsidised schemes which means that the benefits for employers are less (lower impact on reducing absenteeism and improving productivity).

We provide a range of comprehensive health and wellness plans, tailored to suit the unique needs of your organisation, and most importantly, your people.

Our flexible Health Plan options can cover standard hospital and surgical costs, as well as additional treatment such as specialists, diagnostic tests, GP visits, prescriptions, dental and vision care. Plan options can also include things like cover for physio and dietitian appointments as well as acupuncture, homeopathy and naturopathy treatments.

Not all options are available on all Health Plans so get in touch with our team for all the details.

Find out more here about workplace health insurance with UniMed.

Depending on the number of employees (and family members) you subsidise, pre-existing condition coverage is available.

Depending on the pre-existing condition coverage, cover for conditions may start immediately or after a stand-down period.

Some pre-existing conditions are never covered for any Member as they are general exclusions under our Terms and Conditions.

Please get in touch with our team to discuss the options, and you can find out more here about workplace health insurance with UniMed.

It depends on the number of employees and family members eligible for your group insurance scheme and the level of premium subsidy that you choose to contribute.

Please get in touch with our team to discuss the options.

You can select the Health Plan(s) and modules that you’ll make available to employees through your group insurance scheme, and the level of subsidy.

It is possible to subsidise different Health Plans and modules for different categories of employees.

Please get in touch with our team to discuss the options.

An ‘eligible employee’ is entitled to join your group insurance scheme and receive a subsidy.

When establishing your group insurance scheme, we will work with you to define who an eligible employee is.

Examples of eligibility may include a requirement that the employee:

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

If family members are not subsidised under your group insurance scheme, employees can add family to their policy and pay the premium for them directly to us.

Depending on the size of your scheme, family members may qualify for reduced premiums or cover for pre-existing conditions.

Please get in touch with our team to discuss the options.

We will work with you to determine the best method and frequency for paying premiums. Subsidised premiums are usually invoiced monthly in advance.

Our preferred payment method for employee-paid premiums is direct debit. We also offer recurring credit card and invoice.

Please contact our team and we’ll work with you to create value for money, tailored health insurance with a wellbeing difference for your people.

Please contact our team.

We’ll work with you to make it a smooth transition for your team.

Please contact your UniMed Account Manager as soon as your employee joins or becomes eligible for your scheme.

We’ll ensure they are set up on your scheme, and we’ll advise of any change to your payments.

Please notify us as soon as possible of the date we should remove the employee from your scheme and let us know their new contact details.

We will then contact the employee with options for how they can continue their health insurance with us.

If your employer offers a group insurance scheme, you may be paying a lower premium compared to being on an individual policy. This is because the costs and risks are spread across the group.

Several factors are considered in deciding the premium for a group insurance scheme. Some of these are:

• the number of Members in the group scheme
• the total claims for your group scheme
• the subsidy (premium contribution) that is paid by your employer.

To see if UniMed health insurance is available through your workplace, check with your employer.