HCi Membership Application

Cover Member Contact details People covered Rebate Payments Confirm
 
 

Thank you for choosing to join HCi!

Please complete the following form to start your membership.

Before starting the application, please ensure your browser’s pop-up blocker is turned off.


You will need the following information to complete the application:

  • the details of all persons to be covered
  • your bank account/credit card details
  • Medicare Card details for each person to be covered
  • the details of any previous health fund (including join/cease dates)

 

Please ensure the details you enter are accurate.

Your contact details

First Name*
  
Family name*
  

* Either a phone number or email address must be specified

Phone
 
Email Address
  
* required fields

You can read the HCi Privacy Policy to understand how we protect your information.