Overseas visitor forms downloads

Please find below links to forms that you may need – an application form, claim forms, the Government Rebate form, a Clearance Request form, Letter of Authority and more.

If you have trouble downloading any of the forms linked to from this page please refer to our download help page.

Download help

Confidentiality form

Application form

Claim form

Particulars of Ambulance Transportation form

Direct debit form

Government Rebate form

Clearance Request form

Letter of Authority form

Suspension form

Confidentiality form

Whether you like to keep things private or would rather share, it's important that you're comfortable with who sees your health claim information. Whichever group you fall into, we give you a choice to suit your needs.

Please complete and return this form ensuring all people on your membership except those under 17 have indicated their preferred option.

Download a confidentiality form

Application form

If you'd like to join Mutual Community, you can download and complete this form then post it to us, or join online. In order to complete either form you will need to:

Know which cover(s) you would like
Know the details of all persons you would like to cover
Be able to name the fund you are transferring from (if applicable)

Download an application form

Join online

Claim form

You can claim by mail or online.

To claim by mail, download and print out a claim form, complete it, attach the original account(s) you received from your health care provider - and the original receipt(s) if you paid your provider - and post to:

Mutual Community
Customer Claims
GPO Box 990
Adelaide SA 5001

Please note that if you make a claim in the first 12 months you may need to provide a medical certificate.

If you are making an Emergency Ambulance claim, please also complete and attach the Particulars of Ambulance Transportation (PAT) form.

Download a claim form

Claim online

Particulars of Ambulance Transportation form

Emergency Ambulance claims need to be supported with a completed Particulars of Ambulance Transportation (PAT) form.

Download a Particulars of Ambulance Transportation form

Claim queries

Please remember that claims can only be paid within 2 years of the date on which the service was rendered.

If you have a question about:

The status of your claim
How to fill in a claim form
What documents you need to attach to your claim form

Please do not hesitate to contact us.

Direct debit form

Pay by direct debit from a credit card, cheque or savings account and keep your health insurance payments up-to-date automatically. Simply complete and return the direct debit authority form or use our online payment form for your convenience.

Download a direct debit authority form

Pay online

Government Rebate form

As an overseas visitor, if you choose a combined hospital and extras cover, you may be eligible for the Government Rebate on your extras premiums. This only applies if you are from a country that has a RHCA with Australia and you hold a Reciprocal Medicare card.

To apply for the Government Rebate upfront, eligible overseas visitors must be able to provide details of their Reciprocal Medicare card upon joining. All the people listed on the policy must be eligible to claim Medicare for you to receive the rebate as a reduced premium.

Download a Government Rebate application form

Clearance Request form

Complete and return this form if you are transferring from another recognised Australian health fund and Mutual Community will cancel your existing membership for you.

Your previous fund will subsequently forward a Clearance Certificate to us that will confirm your previous cover details so we are able to determine your eligibility for continuity of cover on your new membership.

If your previous fund sends you the Clearance Certificate directly, please forward it to Mutual Community for processing.

You must personally advise your bank to cancel any direct debit arrangement with your existing health fund.

Please note: if you are tranferring from a recognised international or general insurer, you will need to provide evidence of your previous cover along with the start and end dates of your cover. This may be in the form of a Clearance Certificate or Certificate of Currency.

Download a Clearance Request form

Letter of Authority form

This letter authorises another person to be given the same level of access as you have to your membership.

Download a Letter of Authority form

Suspension form

This form enables you to suspend your membership after you have served six months continuous membership with Mutual Community.

Suspension form