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Single Parent
As Emergency Services Health Pty Ltd ABN 98 131 093 877 is a not-for-profit, restricted access private health insurer for people who are or were employed (including volunteering) in the provision of emergency services, eligibility is largely restricted to the emergency services community and their family members (as defined on this application). You may either be eligible through your emergency services employment, volunteer involvement or through your relationship to such a person.

You must be able to select at least one of the following criteria to be eligible to be a policy holder with Emergency Services Health:

I am:
Emergency Services Health is committed to protecting all personal information entrusted to us. We ensure all personal information we collect is treated and stored confidentially in accordance with our Privacy Policy.

Your details
Date of Birth
Residential Address
Postal Address
Contact Details
Our primary communication is through email. You can change your communication preferences at any time when you log into the Online Member Portal or by contacting us. We are required to send some items to you via post.
Are you switching from another Private Health Insurer?
Lifetime Health Cover Loading (LHC)
Lifetime Health Cover (LHC) is a Government initiative designed to encourage people to take out hospital insurance earlier in life and to maintain their cover.
The price shown here estimates your LHC loading and will be adjusted when your previous insurer provides us your clearance certificate.
If you have special circumstances or are exempt from LHC please let us know after you have submitted your membership application.

Your information may be provided to the Australian Government Services Australia. Services Australia uses this information for administering the Australian Government Rebate on private health insurance as a reduced premium. The collection of this information is permitted by the Privacy Act 1988. Services Australia may disclose this information to other Commonwealth departments or agencies, anyone who you have agreed to have your information or other parties where the release is required or authorised by law (including for the purpose of research or conducting investigations). You can get more information about the way in which Services Australia will manage your personal information, including its privacy policy, at

Are all people on the policy eligible for Medicare?

Privacy and your personal information

The privacy and security of your personal information is important to us, and is protected by law. We need to collect this information so we can process and manage your applications and payments, and provide services to you. We only share your information with other parties where you have agreed, or where law allows or requires it.
For more information, go to

Your name as it appears on your Medicare Card

For more information about the Australian Government Rebate on Private Health Insurance, go to

Questions about Medicare eligibility can be made at any Services Australia Service Centre or by calling 132 011.
Note: Call charges apply - calls from mobile phones may be charged at a higher rate.

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.

Do you wish to claim the Australian Government Rebate on Private Health Insurance?
Payment Type:

Review & Submit

Quote Date: 8/12/2023

The price shown is subject to change based on your selections and personal circumstances. Emergency Services Health will contact you to confirm any change to your premium.

I declare that:

  • The statements in this application are true and complete and agree to be bound by the Rules of the Fund. I acknowledge that this application form and the Health Fund brochure do not contain all the Rules of Emergency Services Health and I understand the pre-existing condition rule and other waiting periods
  • Emergency Services Health has made me aware of the Privacy Policy and its availability to me, and I have made,or will make, other people on the application aware of the statement's availability.
  • I acknowledge, where practicable, information is provided with the consent of the individual to whom it relates and I confirm I have the authority to act on behalf of other persons named in this Application Form.
  • I (and on behalf of the other persons stated on the form) consent to the use and disclosure of my (or our) personal information, including health information, in accordance with the Privacy Policy, and note that personal information about a person insured on the health insurance policy may be disclosed to other people insured under the same health insurance policy.
  • I(and on behalf of the other persons stated on the form) authorise Emergency Services Health to collect and authorise any third party to supply from time to time full and complete details of all of any information necessary to the assessment of any claim or any operration of the health insurance policy.
  • I(and on behalf of the other persons) acknowledge that, from time to time, Police Health may request information or envidence of a person's eligibility to be insured under the policy or confirm their classification of registration, and I (and on behalf of the other persons) agree to providing the requested information or evidence.
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