ACA Health Fund Hospital Cover

Find tailored hospital cover for Seventh-day Adventist members and families with ACA

The ACA health fund is for the benefit of Seventh-day Adventist Church members and families, with surplus profits finding their way back to you and your community. You can join if you are

  • A Seventh-day Adventist Church employee or former employee
  • The partner, spouse or other family member of a church employee

Church employees are workers of incorporated companies affiliated with the Seventh-day Adventist Church in Australia. If you’re eligible, see how the hospital cover with this member’s health fund compares to other cover available.

What does the policy cover?

Members can benefit from features you might not be able to find elsewhere. Specifically, you can get unlimited benefits with 100% cover for costs.

ServiceDeluxe coverPrivate coverBasic cover
Intensive care100% cover100% coverPublic hospital only
In-home hospital or hospital substitute100% cover100% cover-
In-hospital psychiatric100% cover100% cover-
In-hospital rehabilitation100% cover100% cover-
Surgical prosthetics100% cover for no-gap items100% cover100% cover
Co-payments$0$100 per day, except prosthetics$0

Theatre fees

Procedure room100% cover100% coverNo cover
Labour ward100% cover100% coverNo cover
Co-payments$0$100 per day-

In-hospital medical services

Specialist doctors100% cover100% cover100% cover
Anaesthetists100% cover100% cover100% cover
Pathology100% cover100% cover100% cover
Radiology100% cover100% cover100% cover
Co-payments$0$0$0

Are there any additional benefits?

Cover with ACA Health Fund delivers the following special benefits for members, letting you live longer and healthier:

  • 100% cover policies with no limits.
  • 100% of surplus goes back to members.
  • Combine different levels of hospital and extras to find cover that’s right for you.
  • Choose your own doctor and private hospital with deluxe or private level cover, or public hospitals with the basic plan.
  • Access the Federal Government Rebate to reduce your premium.
  • Ambulance cover in the ACT and NSW. For other states, ambulance cover is available with extras cover.
  • 30-day cooling off period after signing up if you change your mind.

In addition, you can choose a different membership level to enjoy benefits for yourself and the rest of your family.

  • Family membership gets cover for you and your partner.
  • The optional dependent extension can cover your children up to the age of 25.

Limitations, exclusions and waiting periods

Waiting periods apply and are the same for all cover levels. There are no excesses for any claims, with the exception of the $100 co-payment that applies to certain services under the Private level policy.

  • Accidents not relating to pre-existing conditions: None
  • Ambulance: None
  • Obstetrics: 12 months
  • Treatment for pre-existing conditions: 12 months
  • All other services: 2 months

You cannot claim any procedures or services that take place within the waiting periods or while your membership is in arrears.

Exclusions to be aware of

All cover levels have the following exclusions:

  • Surgeon’s or podiatric surgery fees
  • Services for which Medicare pays no benefits, such as cosmetic procedures
  • Services that may otherwise be claimable under forms of compensation insurance
  • Services claimed more than two years after the procedure was performed
  • Outpatient services, such as GP visits that are not explicitly covered by the policy

It’s important to remember that the Basic policy does not cover you for private hospital expenses.

How much does ACA Health Fund hospital cover cost?

The cost of your policy will depend on the level of cover you choose as well as whether you’ve chosen the optional dependants extension.

How to sign up

If you’re eligible for membership, as an employee of the Seventh-day Adventist Church or as a family member, you can apply online or print out an application form and send it to any one of the following.

After receiving your application, a representative of ACA Health Fund will be in touch to let you know about the costs and the next steps.

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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