Join Now

Thanks for applying to join ACA Health. Before you begin this process, please make sure you have these documents handy:

• Proof of eligibility (e.g. Company ID card or payslip)
• Proof of age (e.g. Driver’s Licence or Birth Certificate for all adults on the policy)
• Bank account details (for direct credit)
• Credit card details (for direct debit if applicable)

• Confirming eligibility*
  • Current or past employee of an Adventist Church company
  • Relative of eligible person
  • Past or transferring member or Dependant
  • Local Church Officer
  Past and present employees of incorporated Adventist organizations are eligible to join including their partners/spouses, dependents, siblings, parents and grandparents are also welcome. Most Adventist organizations were incorporated between 2000 and 2004. If you were employed before 2000 you may not be able to join ACA-Health. If in doubt please feel free to contact ACA-Health on 1300 368 390.
• Relative of elegibile person*
  PartnerSpouseSonDaughterGrand SonGrand DaughterParentStep SonStep Daughter

Local Church Officer

• Local Church Officer*
  EldersDeacons and DeaconessesClerkTreasurerDepartment and Organisation LeadersChildren’s Ministries Coordinator and Committee MembersCommunication SecretaryFamily Ministries Coordinator and Committee MembersHealth Ministries Leader and Council MembersMusic CoordinatorsReligious Liberty LeaderSabbath School Superintendent and Other Sabbath School OfficersBible School CoordinatorAdventist Community Services Leader or Dorcas Society LeaderStewardship Ministries LeaderPathfinder Club Directors, Deputy Directors and Counselors / Instructors
• Location held (Church)*
• Year position held*

Current or past employee of an Adventist Church company

• Select Company Name*
  Adventist Retirement villagesAdventist Development and Relief AgencySigns Publishing CompanySanitarium Health and wellbeing companyAvondale College FoundationSydney Adventist Hospital FoundationKaralundi Aboriginal Education CentreMirriwinni Gardens Aboriginal CentreOr any other incorporated entity that is affiliated with the Seventh-Day Adventist Church
• Please attach proof of employment (e.g. ID card, payslip)*
  Drop files here or

Relative of eligible person

• Eligible persons full name*
• Eligible persons phone number*
• Eligible persons membership number
• Employment or Local Church Officer*
  • Employment
  • Local Church Officer
• Select Company Name*
  Adventist Retirement villagesAdventist Development and Relief AgencySigns Publishing CompanySanitarium Health and wellbeing companyAvondale College FoundationSydney Adventist Hospital FoundationKaralundi Aboriginal Education CentreMirriwinni Gardens Aboriginal CentreOr any other incorporated entity that is affiliated with the Seventh-Day Adventist Church
• Please attach proof of employment (e.g. ID card, payslip)
  Drop files here or
• Local Church Officer*
  EldersDeacons and DeaconessesClerkTreasurerDepartment and Organisation LeadersChildren’s Ministries Coordinator and Committee MembersCommunication SecretaryFamily Ministries Coordinator and Committee MembersHealth Ministries Leader and Council MembersMusic CoordinatorsReligious Liberty LeaderSabbath School Superintendent and Other Sabbath School OfficersBible School CoordinatorAdventist Community Services Leader or Dorcas Society LeaderStewardship Ministries LeaderPathfinder Club Directors, Deputy Directors and Counselors / Instructors
• Location held (Church)*
• Year position held*

Past or transferring member or Dependant

• Membership name*
• Membership number*

Local Church Officer

• Declaration*
  • I hereby declare that I have been elected by the SDA Church to serve in the official capacity of . My most recent year of service in this position is/was .

Relative of eligible person

• Declaration*
  • I hereby declare that I am the of . They were elected by the SDA Church to serve in the official capacity of . The most recent year of their service in this position is/was .

• Hospital*
  • Deluxe
  • Private
  • Bare Essentials
  • Basic
  • None
• Extras*
  • Complete
  • Lite
  • None
• Membership type*
  • Single
  • Couple
  • Family
  • Single Parent
• Dependant Extension
  • Yes
  • No

  "Dependant" means and includes:
  (a) A Policy Holder’s spouse or de facto partner;
  (b) A Policy Holder’s children under twenty-one (21) years of age who do not have a spouse or de facto partner;
  (c) "Student Dependants" - A child of the Policy Holder who;
  (i) does not have a spouse or de facto partner;
  (ii) is a full-time student at a school, college or university;
  (iii) is twenty-one (21) years or over and under the age of twenty-five (25) years;
  (iv) is not earning more than $20,000 gross per annum; and
  (v) has been accepted by the Fund as a "student dependant."
  (A statement in respect of Student Dependants must be provided each year by the Policy Holder).
  (d) “Dependent Child Non-Student” - A child of the Policy Holder who;
  (i) does not have a spouse or de facto partner;
  (ii) is twenty-one (21) years or over and under the age of twenty-five (25) years; and
  (iii) is not receiving full‑time education at a school, college or university.
  A Dependent Child Non-Student may only be covered as a dependant on an “extended family policy”.
  (e) Such other persons approved by the Board of Directors as being dependants.

• Please start my membership & pay the appropriate contributions from:*

• Title
  MrMrsMissMs
• Surname*
• Given names*
• Street address*
• Suburb*
• Postcode*
• Home phone number
• Mobile/other phone number*

• Date of birth*
• Gender*
  m/fMaleFemale
• Email Address*

• Please attach proof of age (e.g. Driver’s license, birth certificate or passport)*
  Drop files here or

• *

  Relation to member*	Surname*	Given names*	Date of birth*	Gender*	Email address*	Mailing address*	Phone number*	Authorise*

• Please attach proof of age for people over age 21 (e.g. Driver’s license, birth certificate or passport)
  Drop files here or

• Do you wish to apply for Medicare Rebate?*
  • Yes
  • No

  Families and individuals who pay private health insurance premiums may be eligible for Australian Government rebates.

  Your costs may be reduced if you have a health insurance policy with an Australian registered health insurer that provides the following cover:
  Hospital
  General and extras, or
  Both
  

  The rebate reduces the amount you pay for private health insurance. The rebate amount you get is based on the age of the oldest person covered by the policy and by annual earnings.

  You must be covered by the policy and be eligible for Medicare to receive the rebate. For more information, you can go to https://www.humanservices.gov.au

• Please click here to download and complete the Medicare Rebate form and upload below.

• Upload your completed Medicare Rebate form*
  Drop files here or

• Are you transferring from another health fund?*
  • Yes
  • No

  Lifetime Health Cover and Loadings

  Persons taking hospital policies pay 2% more for each year they are over 30 years old, to a maximum of 70% and for a maximum of 10 years. Ancillary only policies are not affected.

  Persons born on or before 1 July, 1934 will not have to pay more. All existing members as at 1/7/2000 were credited with a certified age of 30 and will attract the base rate premium for as long as they maintain their hospital policy.

  Please refer to the Department of Health website www.health.gov.au for full details of minimum period of membership, periods of absence, periods of suspension, special provisions for refugees and Australians overseas and LHC loading removal.

• You may be subject to LHC Loading which will alter your policy’s cost

• Name of previous Fund*
• Membership number*

• Transfer certificate on my behalf*
  • Please request a transfer certificate on my behalf to be sent to ACA Health.

• Name of Financial Institution*
• Account Name*

• Direct Credit - BSB*
• Direct Credit - Account Number*

• I agree to ACA Health’s terms and conditions*
  • I agree to ACA Health's terms and conditions

• How would you like to pay?*
  • Direct Debit
  • Self Managed
  Direct Debit: Monthly charged by ACA usually on the 20th of the month.
  Self-Managed: Members are required to make regular payments prior to their next payment coming due using the below options
• Self Managed
  • Website Payments
  • Phone Payments
  • BPAY

• • Use previous bank details

• Name of Financial Institution
• Account Name

• Direct Debit - BSB*
• Direct Debit - Account Number*

• Where did you hear about us?
  • HR/Payroll office
  • Family
  • Sales Representative
  • Friend
  • Work colleague
• 
  
• ACA Health’s Terms and Conditions*
  • I have read and understood ACA Health’s Terms and Conditions
• ACA Health’s Privacy Statement*
  • I confirm that I am the registered policyholder for this account, I have read and agree to ACA Health's Privacy Collection Statement and Privacy Policy
• I declare all information provided in this form to be accurate and true*
  • I declare all information provided in this form to be accurate and true