ACA Health Extras Cover

Compare the extras health insurance options for employees and family members of the Seventh-day Adventist Church

ACA Health is a member-owned community health fund designed for past and present employees of the Seventh-day Adventist Church and their immediate family. It caters to its members and gives 100% of its surplus profits back to its members.

See how ACA Health extras cover compares to other insurance policies and find out whether it’s the right cover option for you.

What’s covered by ACA Health extras cover?

ACA Health extras covers a wide range of out-of-hospital medical services, including 100% back on ambulance transport with no annual limits and 80% back on dental procedures.

Lite Extras

ServiceCoversBenefit per person, per procedureAnnual limit
AmbulanceTransport costs100% of total costUnlimited
DentalPeriodic examinationPlaque removalFluoride treatmentTooth extraction Crowns and bridges

Fillings

Periodontics

Root canal treatment

Implants

Dentures

Orthodontics

80% up to $10080% up to $10080% up to $10080% up to $120

Up to 80% of total cost

Up to 80% of total cost

Up to 80% of total cost

Up to 80% of total cost

Nil

Nil

Nil

$700 total, $400 individual treatment sublimit
OpticalSingle lensLensesFramesRepairs

Contact lenses

Contact lenses solution

80% of total cost$200
PharmaceuticalPrescription medication over the PBS limit$50 per script, minus the PBS amount$250
Physiotherapy, hydrotherapy, chiropractic, osteopathyVisits with registered practitionersUp to $25$300 combined
Remedial massage, naturopathy, acupunctureVisits with registered practitionersUp to $25$100 combined

Complete Extras

ServiceCoversBenefit per person, per procedureAnnual limit
AmbulanceTransport costs100% of total costUnlimited
DentalPeriodic examinationPlaque removalFluoride treatmentTooth extraction Crowns and bridges

Fillings

Periodontics

Root canal treatment

Implants

Dentures

Orthodontics

80% up to $10080% up to $10080% up to $10080% up to $120

80% up to $1,000

Up to 80% of total cost

Up to 80% of total cost

Up to 80% of total cost

Up to 80% of total cost

Up to 80% of total cost

Up to 80% of total cost

$1,700 total$1,000 orthodontics sublimit$1,200 limit for other procedures$3,600 lifetime limit
OpticalSingle lensLenses (pair) including single vision, bifocal and multifocal lensesFrames (for prescription lenses)Contact lenses

Contact lenses solution

Repairs

$140$280$120
80% up to $28080% of total cost

80% of total cost

$400
PharmaceuticalPrescription medication over the PBS limit$50 per script, minus the PBS amount$800
Physiotherapy, hydrotherapy, chiropractic, osteopathy, orthotics, speech therapy, occupational therapyVisits with registered practitioners, including x-rays, extended treatments, subsequent assessments and more80% up to $85$850
Remedial massage, naturopathy, homeopathy, acupunctureVisits with registered practitioners50% up to $30$400 combined

In addition to this, the Complete Extras policy includes a range of benefits that the Lite Extras policy doesn’t, such as:

  • Allergy management
  • General appliances, such as CPAP machines and accessories, wheelchairs, glucose monitors and a range of other approved medical devices
  • Audiology, with 50% cover and no limits
  • Cardiac rehabilitation
  • Diabetics education
  • Dietetics
  • Hearing aids, with 80% cover and a $1,500 three-year limit
  • Home nursing, with a $1,200 annual limit
  • Mammography and bone density testing
  • Maternity services and appliances, including midwife services
  • Orthopaedic shoes and orthotics
  • Podiatry and chiropody
  • Psychology
  • Surgical corsets, stocking and braces
  • Vitamins, minerals and herbs
  • Wound care clinics

Annual and per-item limits generally apply to most items and the amount reimbursed may vary.

Are there any additional benefits to choosing ACA Health?

As a member-owned community health fund, ACA Health gives back 100% of its surplus profits and delivers some market-leading policies that allow you to claim back up to four times your annual membership fee. In addition to this:

  • Waiting periods are waived if you sign up when switching from a different private health fund, allowing you to claim sooner, up to the level of your previously available extras.
  • ACA Health extras policies will cover 100% of emergency ambulance transport costs nationwide, with no annual limits, while ACA Health’s hospital policies will only cover it similarly in the ACT and NSW.

Exclusions and waiting periods

With the Lite Extras policy, waiting periods are:

  • 4 months for optical
  • 9 months for dental
  • 2 months for all other services

With the Complete Extras policy, waiting periods are:

  • 4 months for optical
  • 9 months for dental
  • 12 months for hearing aids
  • 12 months for prescribed health appliances
  • 12 months for foot orthotics and surgical shoes
  • 2 months for all other services

You are not covered:

  • While your ACA Health membership is in arrears
  • For any services not listed in your chosen plan
  • Before the applicable waiting periods have elapsed

In addition, you may not claim when:

  • You are entitled to payments under another insurance policy (such as workers compensation)
  • The claimable service occurred more than two years ago
  • Products or services were acquired or undergone in countries other than Australia

With specific policies, it’s also important to know that:

  • You are not covered for orthodontics under the Lite Extras policy
  • You are not covered for podiatric surgery procedures or in-hospital extraction of wisdom teeth with the Complete Extras policy

How to make a claim

You can submit your extras claims to ACA Health through the email claims process that can be found on the ACA Health website.

You can pay your premiums via:

  • Direct debit
  • Credit card (Mastercard, Visa and BankCard only)
  • Payroll deduction
  • Mail or in person, with cash or cheque

How to join ACA Health

If you’re eligible for membership as an employee of the Seventh-day Adventist Church or as a family member, you can apply online.

Alternatively, you can send in your completed application via post, email or fax:

After hearing from you, ACA Health will be in touch and let you know what the next steps are.

Andrew Munro

Andrew writes for finder.com.au, comparing products, writing guides, sniffing out deals and looking for new ways to help people get the most out of their money.

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