Is ACA Health Insurance Right for Australians? Reviews 2025
Our expert's review of ACA
ScoreACA Health stands as a reliable not-for-profit health fund in Australia, notable for its varied hospital and extras (ancillary) options, ranging from Basic up to Gold Deluxe. Its coverage excels in areas such as 100% reimbursement for most hospital admissions and generous benefits on services like dental (up to $1,700 per year in Complete Ancillary), optical ($450 limit), and allied therapies. Waiting periods are standard, with accidents and ambulance generally having no waiting period, but higher-level services like obstetrics or pre-existing conditions subject to a 12-month wait. Compared to larger for-profit competitors, ACA Health offers strong benefits, limited exclusions, and no excess on select premiums, making it a compelling choice for families, couples, and individuals seeking robust cover, particularly those valuing straightforward coverage without hidden fees or multi-tier pricing. ACA Health's contract suits those seeking predictability, such as families, older adults, and persons with high dental/optical needs. While precise financial data and customer review ratings like Trustpilot are not publicly available, ACA Health’s claims are processed in a competitive 3–5 working days, reflecting efficient member service. The fund’s direct model and claim transparency position it as a trustworthy, traditional health fund in Australia.
- ✅100% reimbursement on most hospital admissions
- ✅Generous dental and optical annual limits
- ✅No excess for some hospital products
- ✅Unlimited ambulance cover on extras
- ✅Fast claims processing in 3–5 working days
- ✅Clear restrictions and exclusions listed
- ✅Strong cover for allied health and therapies
- ❌No public Trustpilot or customer review scores
- ❌No cover for some specialist services (cosmetic, podiatric surgery)
- ❌Limited assistance beyond standard cover
- ❌Lower dental and optical limits in Lite extras
- ❌Obstetrics and some therapies only on Gold/Complete
Score- ✅100% reimbursement on most hospital admissions
- ✅Generous dental and optical annual limits
- ✅No excess for some hospital products
- ✅Unlimited ambulance cover on extras
- ✅Fast claims processing in 3–5 working days
- ✅Clear restrictions and exclusions listed
- ✅Strong cover for allied health and therapies
Our expert's review of ACA
- ✅100% reimbursement on most hospital admissions
- ✅Generous dental and optical annual limits
- ✅No excess for some hospital products
- ✅Unlimited ambulance cover on extras
- ✅Fast claims processing in 3–5 working days
- ✅Clear restrictions and exclusions listed
- ✅Strong cover for allied health and therapies
- ❌No public Trustpilot or customer review scores
- ❌No cover for some specialist services (cosmetic, podiatric surgery)
- ❌Limited assistance beyond standard cover
- ❌Lower dental and optical limits in Lite extras
- ❌Obstetrics and some therapies only on Gold/Complete
Score- ✅100% reimbursement on most hospital admissions
- ✅Generous dental and optical annual limits
- ✅No excess for some hospital products
- ✅Unlimited ambulance cover on extras
- ✅Fast claims processing in 3–5 working days
- ✅Clear restrictions and exclusions listed
- ✅Strong cover for allied health and therapies
- What does ACA health insurance cover?
- What is the cost of ACA health insurance in 2025?
- Is ACA health insurance accessible to new arrivals?
- Does ACA health insurance cover seniors?
- How does reimbursement work with ACA?
- How to contact ACA health insurance?
- ACA Promo Codes
- FAQ
- On the same topic
Why trust HelloSafe?
Why trust HelloSafe? HelloSafe is a leading international expert in health insurance, helping over a million users worldwide each month to choose the right cover. Our experts have assessed policies from over 30 insurers in Australia, conducting an in-depth analysis of their benefits, premiums and quality of service.
What does ACA health insurance cover?
ACA offers a structured range of hospital and extras (ancillary) covers, from Basic (covering public hospital only) up to Gold Deluxe (comprehensive private and public cover with no exclusions except some podiatric surgery). Reimbursement rates are generous, typically at 80% for extras, with clear annual and lifetime limits. Waiting periods apply: accidents have none, dental/optical range from 2 to 9 months, and pre-existing conditions are subject to 12 months. ACA stands out for full ambulance cover and strong dental caps with high annual limits, but lacks naturopathy and overseas service coverage.
Important
for you to easily compare and make your choice, we have added a column with what the public health system reimburses.
Routine medical care
| Garantie | Medicare | Basic Hospital / Ancillary Lite | Gold Deluxe Hospital / Complete Ancillary |
|---|---|---|---|
| Médicaments sur ordonnance | par défaut (PBS, co-payment applies) | Up to $50 after PBS Annual cap: $250 | Up to $100 after PBS Annual cap: $800 |
| Hospitalisation | 100% Standard shared room in public hospital | 100% shared room (public) Limited private | 100% private/shared room (contracted) Unlimited days |
| Transport ambulancier | par défaut (state-based, often partial) | 100% Unlimited | 100% Unlimited |
| Soins à domicile | par défaut (limited eligible public schemes) | non couvert | non couvert |
| Analyse de laboratoire | 100% if Medicare-eligible/test in public hospital | non couvert | non couvert |
(PBS, co-payment applies)
Annual cap: $250
Annual cap: $800
Standard shared room in public hospital
Limited private
Unlimited days
(state-based, often partial)
Unlimited
Unlimited
(limited eligible public schemes)
if Medicare-eligible/test in public hospital
Dental care
| Garantie | Medicare | Ancillary Lite | Complete Ancillary |
|---|---|---|---|
| Soins dentaires préventifs et courants | par défaut Montant limité, actes publics/remboursables | 80% jusqu'à 700 $/an Période : par an | 80% jusqu'à 1 700 $/an Période : par an |
| Soins dentaires de base | par défaut Montant limité (caries, obturations, actes remboursés) | 80% inclus dans 700 $/an Par an | 80% inclus dans 1 700 $/an Par an |
| Soins dentaires majeurs | par défaut Principalement hôpital public ou actes Medicare-eligible | 80% jusqu'à 400 $/an Période : par an | 80% jusqu'à 1 700 $/an Période : par an |
| Orthodontie | non couvert Hors hospitalier, public adulte rarement inclus | non couvert | 80% jusqu'à 3 600 $ (plafond vie) Par année |
Montant limité, actes publics/remboursables
Période : par an
Période : par an
Montant limité (caries, obturations, actes remboursés)
Par an
Par an
Principalement hôpital public ou actes Medicare-eligible
Période : par an
Période : par an
Hors hospitalier, public adulte rarement inclus
Par année
Vision care
| Garantie | Medicare | Ancillary Lite | Complete Ancillary |
|---|---|---|---|
| Lunettes, lentilles, chirurgie | par défaut Limité, enfants/urgence uniquement | 200 $/an 4 mois attente Par an | 450 $/an 4 mois attente Par an |
| Consultation d’un optométriste | 100% Consultation optométriste, fréquence limitée | non couvert | non couvert |
Limité, enfants/urgence uniquement
4 mois attente
Par an
4 mois attente
Par an
Consultation optométriste, fréquence limitée
Specialized and paramedical care
| Garantie | Medicare | Ancillary Lite | Complete Ancillary |
|---|---|---|---|
| Médecines douces | non couvert Aucune prestation ni remboursement | 80% jusqu’à 20 $/consult 100 $/an | 50% du coût Jusqu’à 500 $/an |
| Psychologue | non couvert Faible accès, généraliste, restrictions | non couvert | 80% jusqu’à 150 $/consult Plafond 500 $/an |
| Orthophonie | non couvert Faible accès, enfants priorisés | non couvert | Discours, orthophonie, ergothérapie Montant selon planning annexe, sub-limites annuelles |
| Assurance voyage | non couvert Aucun remboursement | non couvert | non couvert |
Aucune prestation ni remboursement
100 $/an
Jusqu’à 500 $/an
Faible accès, généraliste, restrictions
Plafond 500 $/an
Faible accès, enfants priorisés
Montant selon planning annexe, sub-limites annuelles
Aucun remboursement
Good to know
Who can get ACA Health Insurance: - Any resident of Australia - Must be eligible for Medicare - Minimum age to join is 18 - Dependant children can be covered up to the age of 25 if they are studying full-time. You can add or remove family members (like a partner or children) from your policy at any time. Choose from 4 types of cover to suit your situation: - Single – For just yourself. - Couple – For you and your partner. - Single Parent – For one adult and your dependant children. - Family – For two adults and dependant children.
What is the cost of ACA health insurance in 2025?
| Type of protection (household composition) | Basic Hospital / Ancillary Lite | Bronze Essentials Hospital 500 / Complete Ancillary | Silver Plus Hospital 500 / Complete Ancillary | Gold Private Hospital / Complete Ancillary |
|---|---|---|---|---|
| Individuelle (1 insured) | Approx. $45/month | Approx. $70/month | Approx. $105/month | Approx. $145/month |
| Couple (2 insured) | Approx. $88/month | Approx. $137/month | Approx. $198/month | Approx. $275/month |
| Single parent family (1 adult + 2 children) | Approx. $67/month | Approx. $110/month | Approx. $165/month | Approx. $210/month |
| Family (2 adults + 2 children) | Approx. $110/month | Approx. $180/month | Approx. $272/month | Approx. $352/month |
*Ces tarifs sont donnés à titre indicatifs. Les primes réelles peuvent différer en fonction de votre situation personnelle et des options choisies.*
👉 Compare the best health insurance offers in Australia for free.Discover the offersIs ACA health insurance accessible to new arrivals?
ACA health insurance is designed for newly arrived residents, international workers, students, and visitors in Australia who are waiting to access the public health system or need comprehensive private coverage for their stay. This private insurance can help bridge the gap during waiting periods for public cover or when public system access is limited.
- Medical care
- Covers doctor consultations, emergency treatment, and specialist referrals. Example: full reimbursement of GP fee up to set annual limit.
- Prescribed care
- Medications, physiotherapy, and allied health. Prescription medicines covered up to a fixed sum per year (e.g. $250).
- Specialist care
- Hospital treatment in both public and contracted private hospitals with 100% coverage for eligible services, up to annual caps and subject to excess.
- Emergency dental care
- Urgent dental procedures like extraction, pain relief, or infection treatment; benefit capped annually (example: $700 per year, sub-limits for major dental).
- Medical transport
- 100% reimbursement for emergency ambulance transport, with unlimited usage in most cases.
- Additional costs (hospitalisation or death)
- Covers certain expenses related to hospital stays such as prostheses, shared room accommodation, and, in the event of death, may assist with repatriation or funeral costs.
The policy can typically be purchased for up to 12 months but must comply with local visa or residency requirements. Waiting periods apply: accidents usually covered instantly, other benefits after 2 to 12 months depending on service (e.g. 12 months for pre-existing conditions or maternity cover). Admissibility is based on minimum and maximum ages, proof of legal stay, and the requirement to be without access to Medicare. Travel outside Australia is generally not covered, and you must not have other equivalent cover for the same risks.
Keep in mind
direct billing networks may not apply everywhere, and you may need to pay up-front before claiming reimbursement.
Does ACA health insurance cover seniors?
The ACA health insurance offer is designed for retirees and seniors who are ending their group insurance coverage and wish to maintain health protection individually. The Parcours assurance santéMD program is accessible without requiring a medical questionnaire or proof of good health, making the transition seamless no matter your age or pre-existing conditions. To benefit from this continuity, you must apply within 60 days following the end of your collective policy.
You can choose among several options under the Parcours assurance santéMD:
- Basic health cover
- Covers specialist consultations, general practitioner visits, basic laboratory tests, and necessary hospital care.
- Extended health cover
- Includes all the basic guarantees, with higher reimbursement ceilings and access to additional treatments such as physiotherapy and occupational therapy.
- Comprehensive package
- Offers wider benefits, integrating dental (preventive and care), optical (lenses, frames), as well as broader coverage for pharmaceuticals and medical equipment.
- Travel health cover
- Protection for medical emergencies during short or long trips abroad, including hospitalisation and repatriation.
- Home care support
- Assistance for home nursing care, medical aids delivered at home, or adapted accommodation in case of loss of autonomy.
Right of transformation
Please note: only the Parcours assurance santéMD program guarantees the right of transformation from group to individual without proof of insurability. Contact ACA quickly after the end of your group plan to avoid any interruption in coverage.
How does reimbursement work with ACA?
| Functionality | Availability | Expert opinion |
|---|---|---|
| Online claim submission | ✅ | Members can scan and send claims from anywhere, making reimbursement more convenient and quick. |
| Mobile application | ✅ | Accessing account, claims, and member services by app means easier management on your phone. |
| Online portal for claim tracking | ✅ | Tracks all submitted claims so members get clear updates on statuses and payment outcomes. |
| Benefits simulator | ❌ | Members must contact service or check documentation for detailed estimates on reimbursements. |
| Claim processing time | 3–5 days | Reimbursements typically appear in your account within five business days after submission. |
| Free addition/removal of family members | ✅ | You can add or remove covered dependants with no handling fees, making account changes simple. |
| Telephone nurse support | ❌ | No phone-based health advice service, members must use standard channels for queries or care. |
| Second medical opinion | ❌ | Members need to consult external specialists for another opinion as ACA does not manage this. |
| 24/7 travel assistance | ❌ | No global travel emergency hotline; members arrange emergency support independently when abroad. |
How to contact ACA health insurance?
| Reason for contact | Contact ACA |
|---|---|
| I want a health insurance quote 🧾 | Complete the online quote request or call 1300 368 390, Mon–Thu 8:30am–6pm, Fri 8:30am–12pm (choose 'New Member'). |
| I need an insurance certificate 🧾 | Request via your online member account or email [email protected]. |
| I need medical assistance 🩺 | Call 1300 368 390, Mon–Thu 8:30am–6pm, Fri 8:30am–12pm, then select 'Hospital or Emergency support'. |
| I want to report an incident or track a claim 🔍 | Log in to your online account or call 1300 368 390 (select 'Claims'). |
ACA Promo Codes
| ACA promo codes | Details |
|---|---|
| Code promo HelloSafe | -5% clickable towards the comparator |
Note : Les codes promos sont susceptibles de changer. Pour obtenir les derniers codes promos, rendez-vous sur notre comparatif des meilleures assurances santé.
FAQ
Who can purchase ACA health insurance?
If ACA is not a HelloSafe partner, you can purchase ACA cover directly on the official ACA website. However, it is strongly recommended to compare offers online first using our health insurance comparator to ensure you find the best cover for your needs.
Are there any age limits with ACA?
ACA does not publicly state an age minimum or maximum for new memberships. Cover is available for singles, couples, families, and dependents, so most adults and children living in Australia can apply for ACA, subject to standard eligibility in private health insurance.
Can I add or remove insured members with ACA?
Yes, you can add a partner or child to your ACA policy, or remove them in case of major life events (such as marriage, divorce, or a new child) at any time by contacting ACA member services or updating your details online.
What are the main waiting periods with ACA health insurance?
For hospital cover, there is generally a 2-month waiting period for most treatments, 12 months for pregnancy and pre-existing conditions, and none for accidents. Extras benefits have separate waiting periods, typically 4 to 12 months for dental, optical, and appliances.
Is orthodontics covered in ACA extras policies?
Orthodontic treatment is only included in the Complete Ancillary (Extras) policy, reimbursing up to 80% of the cost with a maximum $3,600 lifetime limit per person. The Lite option does not include orthodontics or dentures.
How do I submit a claim to ACA?
You can easily submit claims online via your member account, or send original signed forms and invoices by post. Many dentists, physiotherapists, and providers can process a claim instantly at the appointment through HICAPS.
Does ACA have gap cover for medical bills?
ACA participates in the Access Gap Cover Scheme, which reduces or sometimes eliminates the medical gap you pay between the Medicare Benefits Schedule and what your doctor charges. You should always confirm your doctor’s participation before treatment.
Who can purchase ACA health insurance?
If ACA is not a HelloSafe partner, you can purchase ACA cover directly on the official ACA website. However, it is strongly recommended to compare offers online first using our health insurance comparator to ensure you find the best cover for your needs.
Are there any age limits with ACA?
ACA does not publicly state an age minimum or maximum for new memberships. Cover is available for singles, couples, families, and dependents, so most adults and children living in Australia can apply for ACA, subject to standard eligibility in private health insurance.
Can I add or remove insured members with ACA?
Yes, you can add a partner or child to your ACA policy, or remove them in case of major life events (such as marriage, divorce, or a new child) at any time by contacting ACA member services or updating your details online.
What are the main waiting periods with ACA health insurance?
For hospital cover, there is generally a 2-month waiting period for most treatments, 12 months for pregnancy and pre-existing conditions, and none for accidents. Extras benefits have separate waiting periods, typically 4 to 12 months for dental, optical, and appliances.
Is orthodontics covered in ACA extras policies?
Orthodontic treatment is only included in the Complete Ancillary (Extras) policy, reimbursing up to 80% of the cost with a maximum $3,600 lifetime limit per person. The Lite option does not include orthodontics or dentures.
How do I submit a claim to ACA?
You can easily submit claims online via your member account, or send original signed forms and invoices by post. Many dentists, physiotherapists, and providers can process a claim instantly at the appointment through HICAPS.
Does ACA have gap cover for medical bills?
ACA participates in the Access Gap Cover Scheme, which reduces or sometimes eliminates the medical gap you pay between the Medicare Benefits Schedule and what your doctor charges. You should always confirm your doctor’s participation before treatment.
On the same topic
