Doctors Health Fund
Doctors Health Fund covers the medical community, with three levels for hospital and extras policies.
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Are you a medical professional? Or working in the wider medical community? Doctors Health Fund has private health cover for you. With a range of policies, the fund aims to provide the best health insurance for doctors, and the broader medical industry.
Top 3 features
- Good for anyone working in the medical community.
- Good for a top level of cover.
- Beware if you're after a lower level of cover and lower 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. Membership of the fund is open to current or former:
- Registered medical practitioners in the fields of medicine
- Medical radiation
- Occupational therapy
- 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.
- 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.
- 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.
Information on tiers
Doctors Health Fund has adopted the Private Health Insurance (PHI) Reforms introduced by the government on 1 April 2019. This includes new categorisation of hospital policies as Gold, Silver, Bronze or Basic; including 'plus' categories for any products that include services above the minimum requirement, and allowing people to choose a higher excess on hospital policies to reduce premiums.
Young people 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.
- 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.
PO Box Q1749, Queen Victoria Building, Sydney NSW 1230, or fax it to 02 9260 9958.
In order for your claim to be considered valid and processed as quickly as possible, it needs to:
- Be filled out by you or other authorised person
- Include the valid tax invoice
- Include any relevant receipts
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