ACA Health

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About ACA Health

What is ACA Health?

ACA Health Benefits Fund (ACA Health) is a private health insurer that operates as a restricted health fund.

Background

ACA Health began in 1934 when the Australian Union Conference of the Seventh-day Adventist Church set up the Union Conference Medical Policy Fund. The aim was to give employees access to a fund that would help them pay for medical or hospital care.

In 1971, the original fund was replaced by the ACA Health Benefits Fund, which became a registered fund in 1986.

Who can join ACA Health?

ACA Health provides private health insurance for employees of the Seventh-day Adventist Church and their families. 

You can join ACA Health If you are a past or present employee of:

• Sanitarium Health and Wellbeing Company
• Life Health Foods
• Vitality Works
• Sydney Adventist Hospital
• Signs Publishing Company
• Adventist Development & Relief Agency
• Avondale College University
• Adventist Schools
• Adventist Retirement Villages
• ACA Health Benefits Fund
• Karalundi Aboriginal Education Centre
• Mirriwinni Gardens Aboriginal Academy
• A literature evangelist distributing for Home Health Education Service.

You can also join ACA Health if you are a past and present officer of the Seventh-day Adventist Church, which includes elders, deacons, deaconesses, Sabbath School leaders, bible coordinators and other local church officers.

You can even join ACA Health if you are a family member of a Seventh-day Adventist Church employee or officer. Eligible family members include:

• partners/spouses and former partners
• dependants
• adult children
• parents
• grandchildren.

You do not have to be a Seventh-day Adventist to join ACA Health.

What products does ACA Health offer?

ACA Health offers:

• Hospital Cover
• Extras Cover
• Combined Hospital and Extras Cover.

Do ACA Health policies include Ambulance Cover?

In NSW and ACT, ACA Health includes emergency Ambulance Cover with:

• Hospital Cover 
• Combined Hospital and Extras Cover.

In VIC, SA, WA and NT, ACA Health includes emergency Ambulance Cover with:

• Extras Cover 
• Combined Hospital and Extras Cover. 

In VIC, SA, WA and NT it is not included with Hospital Cover.

In QLD and TAS, residents are already covered by state government ambulance services.

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Is ACA Health a not-for-profit health insurer?

Yes. ACA Health is a not-for-profit health insurer.

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Does ACA Health operate in all Australian states and territories?

Yes. ACA Health operates in all Australian states and territories.

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How does ACA Health Hospital Cover compare with other insurers?

Benchmarks	ACA Health	Industry average
Member retention for Hospital Cover	91.4%	86.9%
% hospital-related charges covered	93.8%	89.9%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

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Does ACA Health have agreements with some private hospitals or day hospitals to provide services at low cost or with no out-of-pocket costs?

Yes. ACA Health has agreements with a number of private hospitals that allow it to provide services to its members at low cost or with no out-of-pocket costs:

Location	Number of private Agreement Hospitals	Industry maximum
ACT	5	6
NSW	97	98
NT	2	2
QLD	49	60
SA	22	23
TAS	9	9
VIC	73	76
WA	21	24

ACA Health also has agreements with a number of day hospitals so it can provide services at low cost or with no out-of-pocket costs:

Location	Number of day Agreement Hospitals	Industry maximum
ACT	8	9
NSW	86	103
NT	1	2
QLD	48	57
SA	24	30
TAS	5	8
VIC	69	79
WA	20	24

Source: ACA Benefits Fund: Performance

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How does ACA Health Extras Cover compare with other insurers?

Benchmark	ACA Health	Industry average
% Extras Cover charges covered	56.5%	51.1%

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

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How does ACA Health compare with other private health insurers?

Benchmarks	ACA Health	Industry average
Market share	0.1%	–
% medical services with no gap	92.8%	88.3%
% services with no gap or where known gap payment made	97.9%	97.2%
Market share of complaints to the PHIO	0.0%	3.1%
% complaints investigated by the PHIO	0.0%	3.1%
Benefits as a % of contributions	75.6%	80.5%
Management expenses as a % of contribution income	11.7%	13.1%
Management expenses per average policy	$686	$592

Source: Private Health Insurance Ombudsman: State of the Health Funds Report: 2023

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Is ACA Health a member of any industry associations?

Yes. ACA Health is a member of the Members Health Fund Alliance, an alliance of not-for-profit, member-owned, regional or community-based health insurers.

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Does ACA Health let me claim online or via an app?

Yes. ACA Health allows you to make a claim online or via the ACA Health Mobile Claiming App.

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How to contact ACA Health

Phone:

1300 368 390

Website:

https://acahealth.com.au/

Email:

info@acahealth.com.au

Address:

148 Fox Valley Road
WAHROONGA NSW 2076

Postal address:

Locked Bag 2014
WAHROONGA NSW 2076

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