
11 September 2010

Arrows - Red - 2 Download Forms

download forms

Simply select the appropriate form that meets your needs from the table below.

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Claims and Direct Debit Forms		Download Form
Claim form^	Need to make a claim? Speed up your claim by taking advantage of our FreeFax service.		[195KB PDF]^
Direct debit/claims credit form	Prefer everything automatically transacted? Use this form to credit or debit your Building Society, Credit Union, Bank or credit card.		[207KB PDF]
Psychology benefits claim	Psychology benefits are claimable for members on Healthcover Plus Extras, Healthmate Ultimate, Healthmate Executive or Healthmate Advanced. Benefits are available to members who have been claiming psychology benefits under Medicare and have exhausted their Medicare entitlements. The psychology treatment must be necessary and ongoing, and with a state registered psychologist who is treating you as a private patient.		[132KB PDF]
Exercise & gym benefits claim	Manchester Unity members with extras cover (excluding Healthmate Essentials) have a Health Management Program benefit (replacing KeepFit). Under this benefit members can claim towards the costs of an exercise program or gym membership, if the exercise program is designed to address or improve a specific health or medical condition. Please submit this completed form along with receipts for your gym fees or exercise program.		[130KB PDF]
Hospital, Baby Program and Student Enrolment Forms		Download Form
Hospital Pre-Admission	Going into hospital? Use this form to confirm your eligibility to hospital treatment.		[112KB PDF]
Manchester Unity Baby Program	New baby on the way? Use this form to allow our midwife to have your relevant details before contacting you.		[405KB PDF]
Student enrolment*	Do you need to add a student or dependent to your membership? Use this form to register any dependants as 'student dependants'.		[111KB PDF]
Member Services Forms		Download Form
Change your level of cover*	Time to change your level of cover? Fill in this form and we'll handle the rest.		[140KB PDF]
Change your membership details*	Need to update your details? Use this form to make changes.		[263KB PDF]
Order a replacement card*	Lost your membership card? Use this form to receive a replacement. TIP: Registered members can order a new card online.		[113KB PDF]
Transferring from another fund*	Switching to Manchester Unity? Use this form to cancel your membership with your existing health fund.		[116KB PDF]
Government Forms		Download Form
Federal Government rebate*	Are you an existing private health insurance member? Use this form to claim the Federal Government rebate.		[120KB PDF]
Provider Registration Application	Are you a non-Government registered practitioner? Use this form to apply to become a recognised provider with Manchester Unity.		[114KB PDF]
Travel and Overseas Visitors Forms		Download Form
Overseas Visitors*	Visiting Australia? Use this form to join Manchester Unity's Overseas' Visitors Health Cover.		[143KB PDF]
Resume membership*	Traveling overseas? Use this form to resume your membership. Need travel insurance? Receive a discounted rate with Manchester Unity Travel Insurance. Select "Fast Quote" now!		[115KB PDF]

Submitting Completed Forms

Submit your signed, completed forms to: FreeFax^: 1800 451 131 FreeFax: 1800 789 130*
Postal address:	Manchester Unity Reply Paid 9964 IN YOUR CAPITAL CITY

Further Assistance

Call Member Services on 13 13 72 (8:30 am to 6:00 pm – Monday to Friday AEST).