Compare ACA health insurance

How ACA Health rates for member complaints, gap cover and ambulance.

Fact-checked

Last updated: 13 May 2024

Who is ACA Health?

ACA Health is a nonprofit health fund open to present and past employees of incorporated companies affiliated with the Seventh-day Adventist Church in Australia including Sanitarium Health and Wellbeing Company, Sydney Adventist Hospital, Signs Publishing Company, Adventist Development & Relief Agency, Adventist Schools, Adventist Retirement Villages and eligible family members. ACA Health is part of Members Health, an alliance of nonprofit and mutual health funds.

Phone: 1300 368 390

Website: acahealth.com.au

Does ACA Health get many complaints from members?

ACA Health has a Medium complaints rating.

When we score policies we give each fund a complaints rating, based on the number of complaints and serious disputes the Ombudsman deals with. We take into account the size of the fund, so big funds don’t get automatically penalised for having more complaints. The ratings are Low, Medium and High. A Low rating is better than a High rating – it means the fund has fewer complaints and fewer serious disputes for its size.

How good is ACA Health’s gap cover?

A medical gap is the difference between Medicare’s recommended fee and what your doctor actually charges for a treatment or service.

Health funds have agreements with particular doctors and hospitals to cover all of the gap, which are called ‘no gap agreements’, or part of that gap, which are called ‘known gap agreements’ (these will have lower out-of-pocket costs, usually less than $500).

Our graphic below displays the CHOICE gap rating, which takes into account the percentage of services where members either paid no gap or a known gap, compared to the state average.

Rating scale

Well above average
Above average
Average
Below average
Well below average

Text-only accessible version

Australian Capital Territory

Above average.

New South Wales

Above average.

Northern Territory

Well above average.

Queensland

Above average.

South Australia

Average.

Tasmania

Average.

Victoria

Above average.

Western Australia

Above average.

How many hospital agreements does ACA Health have in my state?

The benefit amount your fund pays you for hospital services depends not only on the type of cover you buy, but also whether your fund has an agreement with the hospital where you’re treated.

The table below shows how many hospital agreements ACA Health has in your state compared to the fund with the highest number (the industry maximum). Note that public hospitals don’t have agreements with specific funds and are generally treated as though they’re agreement hospitals.

Text-only accessible version

ACA Health hospital agreements

In the Australian Capital Territory ACA Health has…

5 private hospital agreements out of an industry maximum of 6.

8 day hospital agreements out of an industry maximum of 9.

In New South Wales ACA Health has…

91 private hospital agreements out of an industry maximum of 92.

91 day hospital agreements out of an industry maximum of 105.

In the Northern Territory ACA Health has…

1 private hospital agreement out of an industry maximum of 1.

2 day hospital agreements out of an industry maximum of 2.

In Queensland ACA Health has…

50 private hospital agreements out of an industry maximum of 58.

46 day hospital agreements out of an industry maximum of 54.

In South Australia ACA Health has…

20 private hospital agreements out of an industry maximum of 20.

26 day hospital agreements out of an industry maximum of 31.

In Tasmania ACA Health has…

8 private hospital agreements out of an industry maximum of 8.

6 day hospital agreements out of an industry maximum of 9.

In Victoria ACA Health has…

69 private hospital agreements out of an industry maximum of 71.

71 day hospital agreements out of an industry maximum of 80.

In Western Australia ACA Health has…

21 private hospital agreements out of an industry maximum of 23.

20 day hospital agreements out of an industry maximum of 29.

Does ACA Health offer any discounts?

Discount for direct debit: None

Discount for annual prepay: None

Youth discounts: None.

Does ACA Health offer ambulance cover?

All ACA Health hospital and combined policies cover emergency ambulance in NSW and the ACT.

In Victoria, South Australia, Western Australia and the Northern Territory, cover is included in extras policies, so you’re covered if you select an extras or combined policy.

Do you need ambulance cover?

Depending on where you live, you may not need a policy with ambulance cover.

Queensland and Tasmania: Emergency ambulance services are covered by the state government.
New South Wales and the Australian Capital Territory: All hospital policies come with emergency ambulance cover – so you’ll be covered with any hospital or combined policy you select.
South Australia, Victoria and the Northern Territory: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance in your state or territory or refund at least part of the cost of the ambulance service cover.
Rural Western Australia: You can buy emergency ambulance cover directly from the ambulance service. Alternatively, some health fund policies will cover ambulance or refund at least part of the cost of the ambulance service cover.
Metropolitan Western Australia: If you want to be covered for ambulance you need to buy a health insurance policy with ambulance cover.

Does ACA Health offer family policies that cover adult children?

Adult children are covered on family policies for free until they turn 21.
Full-time students are covered on family policies for free until they turn 25.
Adult children younger than 31 can be covered on extended family policies for an extra cost.