Notice to patients of AHSA member funds
Following six months of negotiations, UnitingCare Queensland (UnitingCare) has been unable to reach an agreement with Australian Health Service Alliance (AHSA). As a result, UnitingCare has given notice to terminate its existing agreement with AHSA.
UnitingCare’s contract with AHSA will terminate effective 21 November 2024. Patients of AHSA member funds who are currently being treated at UnitingCare hospitals will not immediately be affected.
Throughout negotiations, UnitingCare has had a clear objective – to reach a fair and sustainable agreement that provides adequate funding to allow the continued provision of quality healthcare for our patients and recognises the impact of rising costs on providing this care.
We are committed to continuing negotiations throughout the termination period in hope of reaching agreement. However, if we are unable to do so, following a transitional period, additional out-of-pocket costs will apply for patients of AHSA member funds when attending a UnitingCare Hospital – The Wesley Hospital, St Andrew’s War Memorial Hospital, Buderim Private Hospital and St Stephen’s Hospital, Hervey Bay.
The decision to terminate our contract has been a difficult one. As a hospital group, we are focused on driving efficiencies and reshaping models of care to meet the evolving needs of those we care for. But we require funding agreements which financially support innovative care in our hospitals and return patients to their homes as soon as clinically appropriate.
Below is a list of key FAQs to help answer any questions you may have relating to this matter. If you have any further questions, please contact our Call Centre on 1800 882 217 or email us at: understandyourcover@uchealth.com.au
You can read our full media release here.
The following funds form AHSA and are affected by this announcement
- ACA Health Benefits Fund
- AIA Health Insurance
- Australian Unity Health Limited
- CBHS Corporate Health Pty Ltd
- CBHS Health Fund Limited
- Defence Health
- Emergency Services Health Pty Ltd
- Frank Health Insurance
- GMHBA
- HBF Health Ltd (previously CUA)
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited (HIF)
- Health Partners
- Latrobe Health Services
- Navy Health
- Nurses & Midwives Health Pty Ltd
- Onemedifund
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Ltd
- RACQ Health Insurance
- Reserve Bank Health Society Ltd
- See-u
- Teachers Health Fund
- The Doctors’ Health Fund Pty Ltd
- Teachers Union Health (TUH)
- Territory Health Fund
- UniHealth Insurance
- Union Health
- Westfund
The following funds and their associated brands have agreements at UnitingCare Hospitals
- ahm health insurance
- Bupa
- CDH Benefits Fund
- GU Health
- HCF
- Medibank Private
- Mildura Health Fund
- Nib
- RT Health
- St Lukes Health
Transitional arrangements to support AHSA members
The following transitional arrangements for AHSA member funds take effect after midnight 20 November 2024:
| Treatment Type | Out-of-pockets for patients may apply from* |
| Emergency admission (in circumstances noted below^) | 21 February 2025 |
| Admission before 21 November 2024 | Covered until discharge |
Certain** courses of treatment commenced before 21 November 2024, including:
|
21 May 2025 or on completion of course, whichever occurs first |
| Maternity services booked before 21 November 2024 | 21 August 2025 |
| All other procedures/services booked online before 21 November 2024 | 21 May 2025 |
| To help minimise any concern, please book online via bookmyadmission.com.au as soon as possible prior to midnight 20 November 2024. | |
*Information is subject to change.
^What is an emergency admission?
An emergency admission is one where the patient is:
- at risk of serious illness or death and requires urgent assessment and resuscitation.
- experiencing suspected acute organ or system failure.
- experiencing illness or injury where the function of a body part or organ is critically threatened.
- experiencing a drug overdose, toxic substance or toxin effect.
- experiencing severe psychiatric disturbance where the patient's health or the health of others is at immediate risk.
- experiencing severe pain where the viability or function of a body part or organ is suspected to be acutely threatened.
- suffering acute significant haemorrhaging and requiring urgent assessment and treatment.
- requiring immediate admission to avoid imminent illness or death and transfer to another facility is impractical.
Patients who do not meet the above criteria may have additional out-of-pocket expenses when admitted via one of our Emergency Centres.
**Courses of treatment
The following scenarios are considered courses of treatment and fall under transitional arrangements
Scenario 1
A baby is born (mother is pre-booked for maternity) and requires admission to a special care nursery or neonatal intensive care unit.
Scenario 2
A patient is pre-booked for maternity, but due to complications such as dehydration or high blood pressure the patient is admitted for observation prior to the delivery.
Scenario 3
A patient is admitted for a pre-booked procedure, has the procedure, and then is discharged but is readmitted within 7 days due to a related condition.
Scenario 4
A patient is pre-booked and the operation is cancelled, but then the operation is performed at a later date (within a 6 month period).
Scenario 5
A patient has been referred from their GP to a surgeon who has booked the patient in for a colonoscopy before the termination date. After the patient has had the colonoscopy the patient requires bowel surgery which is performed one month after the termination date. In this instance the bowel surgery is considered a course of treatment.
Scenario 6
A patient has seen their ophthalmologist and requires cataract surgery on both eyes. The first procedure was booked in prior to the termination date. The second procedure was booked in after the termination date. In this instance, both cataract procedures will be covered under transitional arrangements.
If you are unsure whether your treatment falls into this category, call 1800 882 217 to discuss.
The right to change
We want patients of AHSA member funds to be prepared for any potential impacts to their upcoming admission at a UnitingCare hospital so they can make an informed decision about their private health insurance options. Private Health Insurance laws include 'portability' rules to protect consumers who may wish to change from one health insurer to another health insurer.
A summary of these rules can be found in the Commonwealth Ombudsman’s “The right to change” brochure. Generally, these rules exempt you from having to re-serve the normal waiting periods before you can access hospital benefits if you maintain the same level of hospital cover. However, you may need to serve waiting periods on any additional categories added to your new cover.
Full details of the Commonwealth Ombudsman Private Health Insurance 'The right to change' can be found here.
Contact us
Our patient hotline is operational Monday to Friday from 8am to 4pm.
Hotline: 1800 882 217
Frequently Asked Questions
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Why has this happened?
As a not-for-profit healthcare provider, UnitingCare cannot remain sustainable without adequate funding agreements which allow for the continued provision of quality healthcare for our patients and recognise the impact of rising costs on providing this care.
It is openly recognised that the pressures on our industry are significant, and like all private hospitals, we are facing increased costs in areas including wages, technology, food, energy and maintenance. Now more than ever, we need to ensure our sustainability so we can continue to provide high quality care for our patients.
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How does this affect existing patients?
There will be no immediate impact to existing UnitingCare patients.
The timing of potential changes are as follows:
- Patients booked and admitted before 21 November will not be affected – current funding arrangements will apply.
- Patients booked and admissions after 21 November may incur additional out-of-pocket costs as the contribution from the patient's health fund may reduce. Some patient cohorts may not be affected – as soon as this is agreed with AHSA, we will udpate you.
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What happens during the notice period?
A notice period of 60 business days commenced on 26 August 2024 when UnitingCare provided notice to AHSA to terminate the current contract. During the notice period, there will be no impact to members of AHSA member funds – all procedures will continue without any changes.
If a new agreement is not reached by the conclusion of the notice period, transitional measures will be introduced to minimise disruption for patients.
Following contract termination and the agreed transition period, patients of AHSA member funds will have additional out-of-pocket expenses when attending a UnitingCare hospital.
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Which UnitingCare hospitals does this involve?
Patients admitted to any of our four not-for-profit private hospitals — The Wesley Hospital, St Andrew’s War Memorial Hospital, Buderim Private Hospital and St Stephen’s Hospital in Hervey Bay.
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Why is my health fund impacted?
It is vital we receive adequate funding to provide quality health care for our patients. We will continue to negotiate a new agreement with AHSA by 21 November 2024. After which, if an agreement cannot be reached, UnitingCare will end its agreement with AHSA and its member health funds.
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What is the Australian Health Service Alliance (AHSA) and which funds are part of this alliance?
AHSA negotiates hospital funding agreements on behalf of its member funds. AHSA member funds include:
- ACA Health Benefits Fund
- AIA Health Insurance
- Australian Unity Health Limited
- CBHS Corporate Health Pty Ltd
- CBHS Health Fund Limited
- Defence Health
- Emergency Services Health Pty Ltd
- Frank Health Insurance
- GMHBA
- HBF Health Ltd (previously CUA)
- Health Care Insurance Limited
- Health Insurance Fund of Australia Limited (HIF)
- Health Partners
- Latrobe Health Services
- Navy Health
- Nurses & Midwives Health Pty Ltd
- Onemedifund
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health Fund Ltd
- RACQ Health Insurance
- Reserve Bank Health Society Ltd
- See-u
- Teachers Health Fund
- The Doctors’ Health Fund Pty Ltd
- Teachers Union Health (TUH)
- Territory Health Fund
- UniHealth Insurance
- Union Health
- Westfund
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What are the transitional arrangements?
Transitional arrangements for AHSA member funds take effect after midnight 20 November 2024, as outlined in the table above.
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What are my additional out-of-pocket expenses?
AHSA is yet to advise how much their member funds will contribute towards hospital treatment following the termination and transitional periods. For more information, please contact your health fund directly.
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How can I avoid out-of-pocket expenses after the transitional period?
UnitingCare has agreements with all other major private health insurers in Australia. If you’re currently insured with an AHSA member fund and looking to change funds, there are portability rules which apply.
A summary of these rules can be found in the Commonwealth Ombudsman’s "The right to change" brochure. Generally, these rules exempt you from having to re-serve the normal waiting periods before you can access hospital benefits if you maintain the same level of hospital cover. However, you may need to serve waiting periods on any additional categories added to your new cover.
Full details of the Commonwealth Ombudsman Private Health Insurance 'The right to change' can be found here.
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Can I see my doctor/specialist somewhere else?
We recommend patients speak to their doctor about their personal circumstances.
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Does this affect other funds, and which other health funds does UnitingCare have contracts with?
UnitingCare has agreements with all other major private health insurers in Australia. This means these additional out-of-pocket costs will only apply to patients of funds that are AHSA aligned.
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What do agreements between health funds and private hospitals mean for patients?
Under these agreements, the health fund pays an agreed fee in relation to health services provided for patients. This means that patients who are members of these funds will continue to have no out-of-pocket expenses aside from any applicable excesses.
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What impact will this have on hospital operations?
UnitingCare’s current contract with AHSA will terminate from 21 November 2024. There is no immediate impact to current AHSA patients.
We have agreed some transitional arrangements with AHSA member funds to further limit the financial impact of this decision on members of AHSA funds. These transitional arrangements range from three to nine months from 21 November 2024, depending on the treatment type and patient status.
Once the transitional period expires, patients of AHSA member funds will be required to contribute to their treatment costs to cover the difference between costs of services provided and the amount UnitingCare receives from their health fund.
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Where do AHSA fund members go if they need more information?
To find out more about your options, please contact us:
Website: unitingcareqld.com.au/AHSAupdate
Hotline: 1800 882 217