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Doctors Health Fund
Doctors Health Fund is a not-for-profit health funds that provides cover for the medical community, with three levels for hospital and extras policies.
Doctors Health Fund is available for current or former medical practitioners and their families
It offers three levels of hospital cover and three levels of extras cover
Doctors Health Fund may not be right for you if you are after a lower level of cover and premiums
Who is Doctors Health Fund?
Doctors Health Fund was created by doctors to meet the health care needs of the wider medical community. Since 1977 it has offered a broad range of cover options and a selection of unique benefits to its members.
Who can join Doctors Health Fund?
Doctors Health Fund is a restricted fund, with membership only open to current or former medical practitioners and their families. More specifically, you can join if you are a current or former:
Registered medical practitioners in the fields of medicine
Medical radiation
Optometry
Dental
Occupational therapy
Physiotherapy
Psychology
Students studying to become a medical practitioner
Employees of medical practitioners
Overseas qualified doctors
Australian Medical Association (AMA) employees
In addition, the partner, child, parent, sibling, grandchild, former partner or partner of an adult child of any of eligible members can also qualify for cover.
What health insurance options are available?
The fund offers products tailored to suit the unique needs of its members, with three levels of hospital cover and three levels of extras cover available. These can be taken out as standalone cover or paired together to offer a higher level of protection.
Hospital
Top Cover Gold. This unique comprehensive cover option offers the highest level of hospital cover available. With no preferred provider networks and a medical gap scheme that doesn't require your doctor to opt in, you can choose who treats you. No excess is payable and there are no exclusions or restrictions on services for which a Medicare benefit is payable. National ambulance cover is also included.
Prime Choice Gold. Another comprehensive hospital cover option that uses the Access Gap Scheme to help reduce or even eliminate your out-of-pocket medical expenses. There are no exclusions or restrictions on services for which Medicare pays a benefit. Ambulance cover is included nationwide. Available with the choice of a $0, $500, or $750 excess, this policy covers all your accommodation costs in a contracted private hospital or day surgery, or treatment as a private patient in a public hospital.
Smart Starter Bronze Plus. Designed for young singles and couples who are taking out their first private health insurance policy, Smart Starter is designed to cover some essential treatments and also offer affordable premiums.
Extras
Total Extras. This is Doctors Health Fund's premium extra cover option and it offers high limits across a wide range of benefits. It covers health management, hearing aids, physio, remedial massage, psychology, occupational and speech therapy, podiatry, dietetics, pregnancy care, home nursing and health aids and appliances.
Essential Extras. Superior mid-range extras cover, providing a combination of a wide range of benefits with affordable premiums. It covers general dental and orthodontics, optical, non-PBS pharmaceuticals, physio, remedial massage, psychology, occupational therapy, speech therapy, podiatry, dietetics and midwifery services.
Starter Extras. Entry-level extras cover perfectly suited to singles and couples when combined with Smart Starter Bronze Plus hospital cover.
Doctors Health Fund youth discount
Under new government reforms for private health insurance, insurers may now provide a discount for young people. Doctors Health Fund will give members the option for the discount, which is allowable between 2% and 10% per annum; depending on when a person purchases health insurance between the ages of 18 and 29. For couples and family policies, it will apply individually to the two adults on the policy.
Members will retain that discount until they turn 41, after which it reduces at 2% per annum until they are 45 years old.
Member offers
Doctors Health Fund doesn't have any preferred providers, giving you the freedom to choose the provider you want
Australia-wide ambulance cover is included in all hospital policies
Extras packages cover 100% of your dental check-up costs twice a year
97% member satisfaction rate
Doctors Health Fund members receive discounts of up to 25% off at optical partners including Clearly.com.au, Eyebenefit, OPSM, Laubman & Pank and Specsavers.
Top Cover covers your hospital bills up to the AMA List fee
How to make a claim?
Making a private health cover claim is very straightforward. For hospital cover claims, the hospital will usually send your bill straight to your health fund. Any excess or co-payment that applies to your policy will need to be made directly to the hospital.
For extras, the most convenient way to submit a claim is through HICAPS. This allows your claim to be processed on the spot so you can simply pay the difference, provided that your health provider is signed up to HICAPS.
Depending on your age, you may be eligible for an
aged-based discount. This is used to estimate your
rebate.
Under 65
65 - 69
70 or older
What's your household's taxable income?
This is the combined income you and your spouse earn before tax. It's needed to calculate the correct Australian government rebate.
$93,000 and under
$93,001 to $108,000
$108,001 to $144,000
$144,001 and over
What kind of health insurance do you need?
Combined (Extras + Hospitals)
Extras
Hospital
What level of hospital coverage would you like?
You can change this at any time later.
Legend
Covered
Restricted cover, You may be partially covered for
this category.
Not covered. Optional for insurer to include.
*Prices updated March 2024, in line with Finder's
database of health insurance policies. Prices are based
on a single individual with less than $93,000 income and
living in Sydney with a $750 excess.
What extras cover do you need? (Optional)
Select as many as you want or move to the next step
Preventative & general dental
Major dental & implants
Optical
Physiotherapy
Podiatry
Non-PBS pharmaceuticals
Chiropractic
Emergency ambulance
Remedial massage
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Why you can trust Finder's health insurance experts
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You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
Frequently asked questions
Yes, Doctors Health Fund is a not-for-profit organisation created by doctors to meet the needs of the wider medical community.
Yes, doctors health fund does have an app and it is available on Apple and Android.
Doctors Health Fund doesn't have any preferred providers, giving you the freedom to choose the provider you want.
Waiting periods for Doctors Health Fund depend on individual circumstances. The maximum waiting period is 12 months but can be lower in specific circumstances e.g. palliative care and rehabilitation which have a 2 month waiting period.
As Finder's insurance group publisher, Alex Holderness aims to make confusing topics easy to understand. She's been published in Money Mag, Yahoo Finance, Hospital Health, and is a contributing author for Google's Startup Grind. She has a keen passion for running and is currently studying for her General Insurance certification. See full bio
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You pay nothing. Finder is free to use. And you pay the same as going direct. No markups, no hidden fees.
You save time. We spend 100s of hours researching health insurance so you can sort the gold from the junk faster.
You can trust us. We say it like it is. We aren't owned by an insurer and our opinions are our own.
