Review your details

You’re nearly done, we just need you to check all the details that will be included in your Australian Government Rebate application that we’ll send to the Government.

Application to receive the Australian Government Rebate on Private Health Insurance as a reduced premium


All the people listed on the policy must be eligible to claim Medicare for you to receive the rebate as a reduced premium.

Name of private health fund
ahm health insurance
Are you covered by the policy?

(If No) Applicants not covered by the policy cannot claim the Australian Government Rebate on Private Health Insurance (excluding child only policies) and employers and trustees of organisations cannot claim the Australian Government Rebate on Private Health Insurance on policies paid on behalf of employees.

Date premium reduction to commence

Your Medicare Card details


Number
Medicare card valid to
Full name as it appears on your Medicare card
Postal address
Permanent address
Daytime phone number
Date of birth
Sex
Are all the people on the policy listed on a Medicare card or entitled to a Medicare card?

You may be entitled to a Medicare card if you are:

  • a person who lives in Australia; and
  • an Australian citizen; or
  • a holder of a permanent resident Visa; or
  • a New Zealand citizen, or
  • an applicant for a permanent resident visa.

Any enquiries about Medicare eligibility can be made at any Department of Human Services service centre or by phoning 132 011 (call charges apply).

Level of rebate
- 25.934%

If at any stage you wish to nominate a new income tier or stop receiving the Australian Government Rebate as a reduced premium, you must notify your health fund as soon as possible.



Declaration


Date of declaration
21/10/2017

Privacy notice: Your personal information is protected by law, including the Privacy Act 1988, and is collected by the Australian Government Department of Human Services for the assessment and administration of payments and services. Your information may be used by the department or given to other parties for the purposes of research, investigation or where you have agreed or it is required or authorised by law. You can get more information about the way in which the Department of Human Services will manage your personal information, including our privacy policy at humanservices.gov.au/privacy or by requesting a copy from the department.


Calendar

30 day cooling off period

It’s OK if you change your mind. Just let us know within 30 days of joining and as long as you’ve made no claims we’ll refund your premiums.

Padlock

Safe and secure payment

MasterCard or Visa cards incur a 0.25% surcharge