Notice to patients of AHSA member funds
Information for patients regarding our contract status and how it may impact your out-of-pocket costs.
Notice to patients of AHSA member funds
Information for patients regarding our contract status and how it may impact your out-of-pocket costs.
Notice to patients of AHSA member funds
Following protracted negotiations, Macquarie Health Corporation (Macquarie) has been unable to reach an agreement with Australian Health Service Alliance (AHSA). As a result, Macquarie has given notice to terminate its existing agreement with AHSA.
Macquarie’s contract with AHSA will terminate on 11 March 2026, in respect of AIA, and on 17 March with respect to all other AHSA member funds. Patients of AHSA member funds who are currently being treated at Macquarie hospitals will not immediately be affected.
Throughout negotiations, Macquarie has had a clear objective – to have our hospitals paid on an equal basis for providing the same service, and to be paid an acceptable increase that will ensure the continued provision of quality healthcare for our patients and recognises the impact of rising costs on providing this care.
We are committed to continuing negotiations with AHSA in the hope of reaching agreement. However, if we are unable to do so, following a transitional period, additional out-of-pocket costs will apply for patients of AHSA member funds when attending one of Macquarie’s Hospital:
Macquarie’s Hospitals
Sydney
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Melbourne
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The decision to terminate our contract has been a difficult one. As a hospital group, we are focused on driving efficiencies and reshaping models of care to meet the evolving needs of those we care for. But we require funding agreements which financially support innovative care in our hospitals and return patients to their homes as soon as clinically appropriate.
Below is a list of key FAQs to help answer any questions you may have relating to this matter. If you have any further questions, please contact your local Macquarie Hospital. Alternatively, please call us on ph: 9692 7900 or email us at: [email protected].
You can read our full media release here.
The following funds form AHSA and are affected by this announcement
- ACA Health Benefits Fund
- AIA Health Insurance
- Australian Unity Health
- CBHS Corporate Health
- CBHS Health Fund
- Defence Health Ltd
- Frank Health Insurance
- The Doctors’ Health Fund Limited
- GMHBA Limited
- HBF Health Limited
- Health Care Insurance
- Health Insurance Fund of Australia
- Health Partners
- Latrobe Health Services
- Navy Health Ltd
- Nurses & Midwives Health
- Onemedifund
- Peoplecare Health Insurance
- Phoenix Health Fund
- Police Health Limited
- Queensland Country Health
The following funds and their associated brands have agreements with Macquarie Hospitals
- ahm health insurance
- Bupa
- GU Health
- HCF
- Medibank Private
- nib
- RT Health
Transitional Arrangements
The following transitional arrangements take effect from the termination date (either 11 March in respect of AIA, or 17 March in respect of all other AHSA funds). You will still be covered by an AHSA member fund for treatment at a Macquarie Hospital in the following cases:
a. You are undergoing treatment at the time of termination of this Agreement
b.You are booked for a procedure(s) at a Macquarie Hospital or to be provided by the Hospital at the time of termination of this Agreement, with the procedure to be completed within six months after termination of this Agreement
c.You have ongoing arrangements with a Hospital (including psychiatric and rehabilitation patients) at the time of termination
The Right to Change
We want patients of AHSA member funds to be prepared for any potential impacts to their upcoming admission at a Macquarie hospitals so they can make an informed decision about their private health insurance options. Private Health Insurance laws include ‘portability’ rules to protect consumers who may wish to change from one health insurer to another health insurer.
A summary of these rules can be found in the Commonwealth Ombudsman’s “The right to change” brochure. Generally, these rules exempt you from having to re-serve the normal waiting periods before you can access hospital benefits if you maintain the same level of hospital cover. However, you may need to serve waiting periods on any additional categories added to your new cover.
Full details of the Commonwealth Ombudsman Private Health Insurance ‘The right to change’ can be found here.
FAQs
Why has this happened?
AHSA has refused to pay our hospitals on an equal basis for providing the same service, and to pay an acceptable increase that will ensure the continued provision of quality healthcare for our patients and recognises the impact of rising costs on providing this care.
How does this affect existing patients?
Patients who are currently receiving treatment, booked in for a procedure prior to termination (to be completed within six months after termination) and those patients who have an ongoing treatment arrangement (including psychiatric and rehabilitation patients) will not be affected. To check if you are affected, please call us.
What happens during the notice period?
Services continue as normal during the notice period.
Which Macquarie hospitals does this involve?
The termination involves all 11 Macquarie hospitals
Why is my health fund impacted?
Your fund is affected because they are part of AHSA and have not chosen to seek alternative arrangements with Macquarie
What is the Australian Health Service Alliance (AHSA) and which funds are part of this alliance?
AHSA is a registered buying group and represents 31 member funds.
What are the transitional arrangements?
The transitional arrangements are explained above and take effect from 11 March 2026 for AIA and from 17 March 2026 for all other AHSA member funds.
What are my additional out-of-pocket expenses?
AHSA is yet to advise how much their member funds will contribute towards hospital treatment following the termination and transitional periods. For more information, please contact the relevant Macquarie Hospital.
How can I avoid out-of-pocket expenses after the transitional period?
You can switch to an alternative health fund with whom Macquarie has an agreement including HCF, nib, Medibank, and Bupa. When you switch, you are generally exempt from having to re-serve the normal waiting periods before you can access hospital benefits if you maintain the same level of hospital cover. However, you may need to serve waiting periods on any additional categories added to your new cover.
Can I see my doctor/specialist somewhere else?
We recommend patients speak to their doctor about their personal circumstances.
Where do AHSA fund members go if they need more information?
They can contact their relevant Macquarie hospital or ph: 9692 7921 or email at [email protected]