Health Cover Claim Form - Australian Unity 2026

1. Click ‘Get Form’ to open the Health Cover Claim Form in the editor.
2. Begin by filling in your Membership Details. Enter your membership number, date of birth, and select the type of cover you have (Health Insurance or Overseas Visitors Cover). Provide your title, surname, first name, and update your contact details if necessary.
3. In the Claim Details section, input the patient's first name and date of birth. Specify the date of service and the name of the practitioner or type of service. Indicate whether the account has been paid by selecting 'YES' or 'NO'.
4. For Hospital Details, confirm if you are claiming medical gap claims for services received as a private inpatient. Fill in the hospital name and address along with the dates of service.
5. Complete the Accident Declaration section by answering whether your treatment is related to an accident. Describe the nature of your injury or ailment if applicable.
6. In Claim Payment, provide your financial institution's details including account holder name, BSB number, and account number. Ensure to sign where indicated.
7. Finally, review and sign the Declaration section confirming that all information provided is accurate before submitting your claim.

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