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Change Member Details

This form can be used to change your existing level of cover. If you prefer you can download and print a Health Partners membership application form (139 Kb PDF). Just fill it out and fax to (08) 8227 2055 or send it to Health Partners Reply Paid 1493, Adelaide, SA 5001.

If you have any questions please phone us on 1300 113 113, or send us an email: ask@healthpartners.com.au.

Fields marked with an * required and must be filled in to proceed.

Membership Details

Please complete the section below to confirm your membership.

If you wish to change your address details please download an ‘Update of personal member details’ form and send the signed form to Health Partners Reply Paid 1493, Adelaide SA 5001, or fax to (08) 8223 1108.
Title:	Surname:*		Given Names:*
Address:*
Suburb:*
Postcode:*
Phone Home:*			Phone Work:
Date of Birth:*			Mobile No:
Enquiry Code (if applicable):			Email:*
Member Number:*			Date to Commence Change*
Level of Health Cover Required
Hospital:	Extras:	Natural Plus (Available with Extras Cover): YesNo













Transfer of Membership from another fund
Previous fund name:
I wish to resign from my old Fund effective from:
Membership No.:
Please forward to Health Partners a letter of clearance specifying details relating to your membership of your health fund.
Application to receive the Federal Government 30% Rebate on private health insurance as a reduced premium.
No, I do not wish to receive the Federal Government 30% Rebate on private health insurance as a reduced premium. Yes, I wish to receive the Federal Government 30% Rebate on private health insurance as a reduced premium.
Will this policy cover you?		If No, employers and trustees of organisations cannot claim Federal Government Rebate on policies paid on behalf of employees.
Your Medicare Number:*			Valid to:*
Are you a permanent resident of Australia?
Your full name on the Medicare Card:*
Are all the people included in this membership listed on your Medicare Card or entitled to a Medicare Card?
I declare the statements in this application are true and complete. I apply for the health cover indicated above and If not already a member, to become a member of Health Partners Limited (ABN 43 128 282 904) and I will be bound by the rules and constitution of Health Partners Limited. I have read and agree with the important information relating to waiting periods.
I agree to the information relating to waiting periods:
A confirmation letter will be sent to you within 7 working days.

*Required

In this Section

Quick Links

Members Online

Change Member Details

Membership Details

Level of Health Cover Required

Transfer of Membership from another fund

Application to receive the Federal Government 30% Rebate on private health insurance as a reduced premium.