Membership Arrears: Keeping your premiums up to date

Membership arrears occur when you are not up to date with your payment for your Private Health Insurance Policy.

How this can affect you

This situation can be detrimental to you and anyone else on your membership.

  • If you get too far behind in your payments (two months or more) the fund can cancel your policy. If this happens, waiting periods can apply to you when you rejoin.
  • Health funds will not pay benefits toward hospital treatments or ancillary services unless your premiums are up to date.

 What you can do to avoid being in arrears

  • It is your responsibility to make sure that your premium payments are up to date and that you remain financial with your health fund.
  • Find out from your health fund what their requirements are to be financial.
  • Most health funds will advise you if you are in arrears. If you receive a notification you should act on it immediately.
  • Most funds require you to pay your premiums in advance. They will normally allow some leeway if you fall behind in your payments by up to a few weeks.
  • If you pay your premiums by a regular direct debit from a credit card or bank account, check each bank statement to make sure that the payments have been correctly debited.
  • If you pay your premiums by a regular direct debit from a credit card, remember to update your credit card details with your fund each time your bank issues you with a new card, otherwise your payments may be dishonoured.

What to do if you are in arrears

  • If you are having difficulty keeping up with your payments because of a temporary problem, talk to your fund to see if they will agree to a payment plan.
  • If you discover you are in arrears, contact your health fund and discuss the reasons for this situation. Pay the arrears owed if you wish to maintain the policy. If you are in arrears by more than two months, you may have to re-commence your membership. This may mean that you will have to re-serve waiting periods.
  • If you are unable to negotiate a suitable outcome with your health fund, you may wish to contact the Private Health Insurance Ombudsman on 1800 640 695 or www.phio.org.au for advice and assistance.

This brochure is issued by the Private Health Insurance Ombudsman

Download the Membership Arrears factsheet PDF.