Existing Student Registration ACU | Medibank Overseas Students Health Cover

Existing student - Renew

#1Identification

Please enter your Membership Number or Student ID:

Membership Number:*

Student ID:*

First Name:* As shown on your policy certificate

Last Name:* As shown on your policy certificate

Your Date of Birth:*

Gender:*

Male

Female

*Required information. Please refer to details on your Passport, Certificate of Enrolment and Policy Certificate.

I confirm that I give consent for collecting my personal details, and I confirm that I have the consent of other members who are covered under my Medibank OSHC membership (where applicable) to view and manage their personal details and claims under this policy. I understand that personal information of Medibank OSHC members is managed in line with Medibank OSHC's Privacy Policy and that I have understood and agree to the Terms and Conditions of the Site.

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Quote

Based on your details

Purchasing your Overseas Student Health Cover (OSHC)

You can pay for your cover now via Credit Card or PayPal. You will need to pay the full amount in the next step, so please ensure you have the funds available before proceeding.

You may also want to contact your bank/credit card issuer at least 24 hours in advance of making your OSHC payment. This will ensure they are aware of the transaction and can avoid delays processing your payment to Medibank.

Cover Name	Cover Type	Start Date	End Date	Quote
Medibank OSHC comprehensive				$ AUD (inclusive of GST, where applicable).

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Student Details

Student ID

The ACU Student ID Number is on your ACU Letter of Offer.
Only numbers can be entered in this field.

Email Address

Gender

Passport details

First Name

Last Name

Passport Number

Passport country of issue?*

Date of birth

Is the primary student visa holder currently located in Australia (Y/N)?*

Yes

Declaration

You are applying for OSHC under an overseas health insurance contract issued by Medibank Private Limited ABN 47 080 890 259 and you agree to be bound by the conditions set out in the Medibank's Overseas Student Health Cover Member Guide. You are responsible for this membership, and will communicate to all current and future persons covered by the membership, the terms and conditions set out in the Overseas Student Health Cover Membership Guide and the fact that this guide applies to all persons on an OSHC policy.

You confirm that your visa status allows you to apply for this cover. You declare that all of the statements made in this application are true and complete and understand we may refuse payment of benefits if any statements are false in any respect. We reserve the right to vary our premiums, our OSHC products or benefits payable, subject to the requirements imposed by the Department of Health.

If you have paid premiums in advance, you will not be exempt from such changes. You consent to the collection, use and disclosure of personal information in accordance with the Medibank OSHC Privacy Policy. You warrant that each named beneficiary has also given that consent. You authorise Medibank OSHC to collect or disclose relevant information to or from your educational institution and/or any relevant government agency including the Department of Home Affairs or as otherwise allowed by law.

I am the applicant and I have read, and agreed to, the above declaration.

Payment

Cover Name	Cover Type	Start Date	End Date	Quote
Medibank OSHC comprehensive				$AUD (inclusive of GST, where applicable).

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