Transfer Certificate request

Your Cover

Payment

From

* Based on an Australian Government Rebate of %, % LHC loading, $ excess for a in .

Switching to us from another health fund? We'll arrange the transfer for you. By submitting the form on this page, it gives us permission to contact your previous fund to obtain your cover details.

The record of your health cover that we request from your current fund is known as a Transfer Certificate or Clearance Certificate.

If you're transferring to an equivalent level of cover with equivalent benefits, you won't have to re-serve your waiting periods.

When you cancel your health insurance membership with another health fund, you'll need to join UniHealth within 60 days to make sure you receive continuity of cover.

We can pay benefits when we’ve received a Transfer Certificate from your previous fund and your membership has been paid up to the date on which you received the service.

If you and your partner are transferring from separate memberships, you'll each need to complete a Transfer Certificate Request.

Please provide your existing fund details below

UniHealth member no.:

Previous fund name *

Previous membership number

Full name *

Date of birth *

Please provide information to UniHealth about *

Myself

My partner

My dependants

Date of existing fund termination *

By submitting this form, I hereby authorise UniHealth to terminate my membership from the above mentioned date with my existing fund and / or obtain details about my membership.* * indicates mandatory fields